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Medicate, Mitigate and Rejuvenate: An Agenda for States in 2024

Mental health, climate and workforce are at the core of a complex cluster of issues confronting lawmakers this year.

The podcast cover image for The Future in Context (TFIC) episode continues the discussion begun in the last episode with the writers and editors of Governing in setting out the issues to watch in the year ahead.
Listen to this episode on the player below or subscribe for free on YouTube or the podcast app of your choice — Apple Podcasts, Spotify, Audacy and Audible.

Legislators are under growing public pressure to address mental health challenges, implement climate policies and stabilize public pensions, while also dealing with workforce shortages. And those are just the top of the list of issues vying for attention. Even with a relatively healthy budget situation this year, it will still be a delicate balance.

On this episode of the podcast, Alan Greenblatt, Jared Brey, Zina Hutton and Carl Smith return to complete the discussion of Governing’s Issues to Watch.

Show Notes

Here are the top takeaways from this episode:

Mental Health Legislation and Funding
  • Increased cases of mental illness, especially among youth, have prompted legislation in several states to regulate social media use and increase mental health education in schools.
  • Efforts aim to move away from solely relying on policing for mental health crises, emphasizing instead earlier identification and support for mental health challenges before they escalate.
  • The surge in mental health issues increases demand for more funding, but states are struggling to find novel and sustainable sources to meet the need.

Public Health
  • To counterbalance high post-pandemic attrition rates, public health agencies are employing community health workers, providing family members with incentives to provide in-home care and seeking expanded Medicare coverage. Unwinding pandemic-expanded coverage remains a priority.
  • States are focusing on controlling health-care costs and curbing excesses in prescription drug pricing.
  • Despite funding reductions, states continue to enhance state-level data systems and push for a potential national data system for better coordination during crises.

Climate and Energy Policies
  • States are now potential drivers for climate progress (despite federal challenges) after disappointing COP28 results that refused to phase out fossil fuels.
  • The implementation of climate-related provisions of the Inflation Reduction Act has been slow even though they come with significant funding, especially that focused on hydrogen hubs, contingent on emissions and clean energy usage.
  • On renewable energy, there is a growing recognition of the need for increased transmission capacity to utilize existing renewable energy resources effectively.

International Affairs and State-Level China Policies
  • There is growing hostility toward China reflected in state-level bans on Chinese-owned apps like TikTok and restrictions on Chinese land ownership.
  • Local governments feel pressure to engage in international issues despite their limited jurisdiction, reflecting a broader trend to nationalize politics.

Public-Sector Workforce and Pension Reforms
  • Efforts to diversify the public-sector workforce continue by targeting Gen Z, adjusting job requirements for skill-based hiring and providing internships to bridge skill gaps.
  • Some states grapple with underfunded pensions, leading to potential cuts impacting education and health care, while others explore riskier investment ventures to improve funding.
  • States are focused on maintaining stability by stress-testing public pensions for potential financial risks and preparing for future uncertainties in pension funding.

Related link to the stories referenced in the episode:

Previous Episodes
*Note: Governing and Government Technology are both part of e.Republic. Our editors used ChatGPT 4.0 to summarize the episode in bullet form to help create the show notes. The main image for this story was created using DALL-E 3.
Paul W. Taylor is the Senior Editor for e.Republic Editorial and of its flagship titles - Governing and Government Technology. He can be reached at or on Twitter at @pwtaylor.
Ashley Silver is the co-host of The Future in Context podcast and a staff writer with Governing’s sister publication, Government Technology.
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