In 2020, the COVID-19 pandemic was the primary policy focus at both the federal and state levels. As we look forward, this public health emergency will continue to impact state policy as legislators and governors work toward rebuilding their economies and healthy communities.

COVID-19 Trends

It is not surprising that most “state of the state” addresses this year largely focused on the COVID-19 crisis. In 2020, state leaders were inundated with bills and modified regulations to recruit more health care workforce, coordinate contact tracing, and increase funding and planning for vaccine dissemination. Moving into 2021, states are eager to increase vaccination rates and are looking to the federal government for help.

Budget Outlooks

In addition to a focus on COVID-19, states in the coming months will release their fiscal year 2021 budgets. Even more so than prior years, states face significant challenges in producing balanced budgets for 2021. Most states faced budget shortfalls and revenue losses last year and will face challenging discussions related to budget changes. To help get their economies back on track, state policy this year likely will focus on reinvesting in business and commerce; however, states differ in their approaches and their desire for federal government involvement.

Health Equity and Infrastructure

COVID-19 also laid bare disparities in health care and magnified the need to invest in health care infrastructure. In response, several states are:

  • dedicating resources to identifying and addressing health inequity;
  • implementing policies to improve maternal health, especially in communities of color;
  • permanently changing telehealth policies to offer broader flexibility; and
  • investing in public health strategies and emergency preparedness. 

The association will continue to track and report on these state-level trends as the year progresses.