1077: Hypertension, Hill Day, and the Future of Public Health Policy

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This is Public Health Review
Morning Edition for Thursday,

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February 26th, 2026.
I'm John Sheehan for the

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Association of State and
Territorial Health Officials.

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Today, two conversations
highlighting public health

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policy both in communities and
on Capitol Hill.

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First for American Heart Month,
Beth Jambrone, senior analyst

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for state health policy at ASTO,
explains how states are.

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Rethinking their.
Approach to hypertension.

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It's the topic of her recent
health policy update.

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From telehealth and remote blood
pressure monitoring to expanded

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insurance coverage, policy
makers are leveraging new

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technology to improve heart
health across the lifespan.

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Later, Jeffrey Ekoma, Asto's
senior director of government

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affairs, shares what's top of
mind in Washington.

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In preparing for Asto's upcoming
Hill Day, Jeffrey will outline

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key priorities, including
sustained federal investment,

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workforce sustainability, and
emerging issues such as vaccines

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preparedness and federal
leadership transitions.

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First, here's Beth Jambrone on
the importance of public policy

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and treating hypertension.
I've always believed that policy

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is an important tool and it
always has been an important

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tool in hypertension.
But I think what we're starting

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to see now is really more of a
change on how we're using

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policy.
There's a lot of, obviously

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you've seen the changes in
technology over the past year,

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1020 years where we have
telehealth, we have home blood

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pressure monitors.
We have a lot of things that we

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can do in situations that don't
just have to be in a doctor's

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office.
So I think with that, what

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you're actually starting to see
a little more of is a shift in

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the thought process within
legislators and within state

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health agencies themselves about
what they can do to prevent or

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treat hypertension.
And so the marriage of those

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technologies and that thought
process coming together, I think

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leads to more of a change as
opposed to the legislators

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paying attention to it, because
I feel like they've always paid

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attention to it.
It's just what they can do now

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is just different than it was 10
to 20 years ago.

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Sure, and several states are are
doing more in particularly

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around pregnant mothers and
menopause.

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How are other states?
Looking at addressing these

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issues during during that phase
of life.

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So I'll start with menopause and
perimenopause, and I think the

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biggest trend are the things
that we've seen from the States

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is even just beginning to
address the issues that women go

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through while they're going
through perimenopause and

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through menopause.
You know, we've seen over the

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past, you know, 10 or so years,
there's been increased research

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into how perimenopause and
menopause affect Women's Health

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with things like osteoporosis
and obviously with increased

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risk of heart disease.
And you also have the increase

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of people who are willing to
talk openly more about

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perimenopause and menopause and
how it affects woman's health.

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And I think when you have those
two things come together, that's

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when you start to see
legislature, state health

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agencies, the other
organizations start to you think

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about what it is that they can
do to help prevent these types

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of issues in older women as
they're going through that phase

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of life, Especially when it
comes to, you know, heart

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disease and hypertension.
It's the largest cause of death

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for women in the United States.
So, you know, anything that we

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can do for that is going to be
incredibly helpful.

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Now with pregnancy, you know,
10% of pregnancies have some

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form of hypertensive disorders.
So things like, you know,

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preeclampsia and eclampsia.
And so making sure that pregnant

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women have better access to care
during their pregnancies,

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whether that's, you know, having
a comprehensive place where they

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can go and get, you know, all of
the care that they need or being

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able to manage their blood
pressure at home and see where

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the connection is between, you
know, what might be going on in

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their lives, where they might be
in their pregnancy and how

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that's affecting their blood
pressure.

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I think that's going to help
lead to better experiences for

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pregnant women and, you know,
ultimately lower maternal

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mortality.
Because if you are, you know,

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cutting off preeclampsia before
it even begins, then you've got

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a better chance of a safe
delivery.

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You've got a better chance of a
safe delivery for the mother and

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for the baby.
So it's kind of a confluence of

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sort of the cultural readiness
to have these conversations

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along with these new
technologies that are enabling

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better care.
And can you talk a little bit

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more about some of those, some
of those treatments and some of

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those options like the remote
blood?

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Pressure monitoring.
Yeah, sure.

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So I, I think you're right when
you say that it's all of these

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factors coming together that are
bringing so much more, you know,

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such new changes and such new
policies and things that

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legislators and, you know, other
policymakers can do to help

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prevent and treat hypertension.
In terms of, you know, what's

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going like, you know, other
things that are happening.

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Obviously, the biggest is having
access to promote blood pressure

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monitors.
I think that's can be a really

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great tool for people at home to
help, you know, with their blood

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pressure, because one of the
things you have to consider is

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that, you know, blood pressure
monitors can be very cost

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prohibitive for some people.
And so when you have states that

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are looking at legislation or
passing legislation that expands

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coverage and insurance, whether
it's through Medicaid or whether

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it's through private insurance
for your blood pressure monitors

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for, you know, people at home,
that's giving them an access

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point.
And that's giving them a place

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that they can start gathering
information for themselves on

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simply what their blood pressure
is.

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And being able to empower them
and give them the tools to be

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able to, you know, prevent,
treat, and just empower

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themselves to know what's going
on with their own bodies.

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So I think just starting with
that is a great start.

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So.
Definitely expanding insurance

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coverage is is a necessity as
well as sort of controlling

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costs.
And I think telehealth as you

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mentioned opens up those
opportunities.

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Another another factor in it is
just sort of educating the

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public and letting them know
that these things are happening

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and that there are resources and
that there are things that they

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need to be aware of.
No, you're totally right.

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It's the old adage that, you
know, an ounce of prevention is

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worth a pound of cure.
So being able to get that

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information out to people at any
age to know what hypertension

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looks like, you know, what are
the symptoms of it, what could

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happen if you have hypertension,
That alone is for some places an

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entry point.
And I think what we're starting

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to see is we're seeing, you
know, more educational awareness

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and more information in doctor's
offices, information in schools,

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you know, teaching children what
hypertension looks like.

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For a lot of us, that wasn't
information that we got as kids.

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And so, you know, we're almost
learning at the same time that

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our children, our nieces, our
nephews, our grandchildren are.

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So for us to be able to have
that information now is

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incredibly helpful.
And I don't think legislators

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are taking that for granted.
I don't think health agencies

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are taking that for granted.
Yeah.

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And I think you hit the nail on
the head because it's not a

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condition or a topic that's
going to be going away, which

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makes it not just relevant now,
but it's.

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Going to stay relevant.
Yeah, it will always, it will

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always be relevant.
If your heart is beating, it is

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a good time to think about the
health of your heart and how to

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treat or prevent any type of
heart disease or, you know,

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hypertension or, you know,
anything of that nature.

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So just knowing that these are
some of the options, you know,

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for example, oh, I wonder if my
state allows, you know, blood

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pressure monitors to be covered
under insurance.

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I wonder what, you know, my
state is doing on this.

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And this is where you also get,
you know, for people, an entry

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point into thinking about what
is out there for people.

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Beth Jambrone is a senior
analyst for state health policy

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at ASTO.
Find the link to her recent

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article in the show notes.
In the first session of A5 part

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series, Leadership Power Hour,
Your Launchpad for Impact,

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attendees will explore
frameworks for decision making

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and strategies for engaging with
teams, communicating with

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clarity, and prioritizing
competing demands.

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Learn key techniques for
articulating decisions that

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build trust and drive action.
Register for the series now at

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the link in the show notes.
Now let's hear from Jeffrey

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Acoma, Asto's Senior Director of
Government Affairs.

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Jeffrey and the ASTO team are
preparing for Hill Day in DC

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next week, and he's here now to
give us the view from

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Washington.
There are lots of things that

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we've been tracking to start off
with, start with appropriations.

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We're really pleased that the Fr
26 Labor HHS bill was passed out

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of the top appropriation bills,
there's still one that's

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outstanding, which is within the
Department of Homeland Security.

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There's lots of movement
happening with that.

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So we're tracking out really
closely because that might have

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an impact not on so just DHS for
FY20 6, but also for FY20 7.

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We continue to track the
potential for any additional

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grant terminations.
As I'm sure everyone's aware,

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there were grant terminations
that were issued to SAMSA that

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were restored, grant
terminations that were related

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to public health infrastructure
that was restored as well, and

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their current terminations for
grants that impact California,

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Colorado, Illinois and
Minnesota.

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There's a temporary restraining
order related to that, but we're

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still tracking everything
related to that.

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We also have an upcoming Hill
Day next week that we are

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incredibly excited about.
We're also tracking the

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potential release of the
President's budget that will

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likely happen at sometime in
March, hopefully, or it might

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extend all the way up until
April.

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So we're tracking that.
So there's lots of things that

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are top of mind for us there.
One last thing to share is the

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surgeon General had her
nomination confirmation hearing

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earlier this week.
So we're tracking all things

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related to that as well and also
tracking potential votes related

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to her nomination that will
likely happen very shortly out

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thereafter.
OK.

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That's quite a lot of things on
your plate, from appointments

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and confirmations to budget
hearings and and upcoming Hill

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Day.
What are you?

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Focused on in the near term and
say the next couple weeks.

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Hill Day for sure.
I'm surely after Hill Day, our

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team will be shifting our time,
I would say into FY20, 7

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appropriations.
Right now, we're completing

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appropriation forms from many
offices.

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We have a lot of appropriation
requests that we are working on,

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one being public health
infrastructure, the next being

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the public health emergency
program or FEP, the hospital

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preparedness program or HPP.
We are also doing a lot of

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advocacy related to the prevent
Block program, DMI and a host of

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other programs.
So we'll be filling out those

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forms, we'll be meeting with
staff to talk about our request

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for 5/27 and our justification
as to why we'll be asking for

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increases for these programs.
So that's really big top of mind

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and also to on our team we're
also meeting or re meeting I

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would say with new members of
Congress.

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We started those meetings last
year and we're meeting meeting

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with their staff again this year
just to make sure to see if they

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have any questions related to
governmental public health in

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ways in which that we can be
helpful, especially if their

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bosses are working on any public
health related legislation.

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Continuing on the Hill Day event
coming up next week, do you have

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any priorities or any face to
face meetings, anything that you

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need to get?
Accomplished next week.

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Yeah, absolutely.
Yeah, We have a really good

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number of members of that are
going to be on the Hill next

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week.
We're asking our members to

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emphasize the importance of
federal funding.

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What does federal funding mean
to their jurisdictions?

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We're asking them to talk about
how much money they sent to

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local health departments.
We're asking them to highlight

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the importance of the public
Health infrastructure grant

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program.
As I noted, it's part of our

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FY20 7 request.
We're requesting that Congress

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provide a billion dollars for
that program.

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So we're asking our members to
talk about the impacts of that

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program within their respective
jurisdictions.

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What has been the ROI of FIG
money so far?

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We're also asking them to
discuss the impacts of potential

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grant terminations or pauses
that may happen.

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What happens?
What does that do for the

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workforce, for the health
department and other sort of

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partners that the health
department works with closely?

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It's so important to note too,
that our church health officials

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will also be on the Hill as
well, and they'll be sort of

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spending their time talking
about two specific things.

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One, they'll be talking about
the impact of the recently

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negotiated compacts or free
association, as well as the

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importance of territorial
Medicaid funding, among other

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things.
So there are lots of things that

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we discussed on the Hill.
And then also too, we know that

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our members are also going to
want to talk about things that

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are top of mind for their
departments and they'll be

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opportunity to do that as well.
Yeah.

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Do you have a sense of any hot
button issues for for members?

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Yeah, I presume vaccines will be
top of mind for members.

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There's been a lot of news
reporting recently related to

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that.
They may, they may also get

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questions about recent
leadership changes within HHS or

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within CDC.
And what has the working

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relationship been between their
States and CDC?

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You know that many states are
also a part of many

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collaboratives I'm across the
country, so that may come up as

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well.
So lots of things, lots of

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things that may come up in there
also be a lot of regional

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topics, right, things that are
more regionally focused.

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And I'm sure that they'll talk
about.

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They may also even talk about
preparedness efforts, ways in

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which that they collaborate with
neighboring states, etcetera,

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etcetera.
Jeffrey Akoma, thanks so much.

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Thank you so much and I'm really
excited to be back on the

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newscast.
We are really grateful for

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everyone that continue to share
information with us about the

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impacts of things that may be
happening at the federal

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government level and how that
impacts the work that they're

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doing in their state.
Jeffrey Acoma is Asto's senior

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director of government affairs.
Earlier we heard from Beth Jam

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Brown, a senior analyst for
state health policy at ASTO.

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ASTO welcomes new member Cameron
Webb, state health commissioner

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for the Virginia Department of
Health.

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Doctor Webb is a board certified
internal medicine physician,

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attorney and public health
expert.

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His past experiences include
serving as a White House fellow

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during both the Obama and Trump
administrations and as a senior

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advisor in the White House
Office of COVID-19 Response

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during the Biden administration.
He's also served as an assistant

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professor at the University of
Virginia School of Medicine and

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Frank Batten School of
Leadership and Public Policy.

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This has been public health
review MORNING Edition.

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I'm John Sheehan for the
Association of State and

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Territorial Health Officials.