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

JOHN SHEEHAN:

This is Public Health Review Morning Edition for Thursday, February 26, 2026. I’m Jonn Sheehan for the Association of State and Territorial Health Officials. Today, two conversations highlighting public health policy, both in communities and on Capitol Hill. First, for American Heart Month, Beth Giambrone, senior analyst for state health policy at ASTHO, explains how states are rethinking their approach to hypertension. It’s the topic of her recent Health Policy Update. From telehealth and remote blood pressure monitoring to expanded insurance coverage, policymakers are leveraging new technology to improve heart health across the lifespan.

Later, Jeffrey Ekoma, ASTHO’s Senior Director of Government Affairs, shares what’s top of mind in Washington in preparing for ASTHO’s upcoming Hill Day. Jeffrey will outline key priorities, including sustained federal investment, workforce sustainability, and emerging issues such as vaccines, preparedness, and federal leadership transitions. First, here’s Beth Giambrone on the importance of public policy in treating hypertension.

BETH GIAMBRONE:

I’ve always believed that policy is an important tool, and it always has been an important tool in hypertension. But I think what we’re starting to see now is really more of a change on how we’re using policy. There’s a lot of, obviously, you’ve seen the changes in technology over the past 10, 20 years, where we have telehealth, we have home blood pressure monitors, we have a lot of things that we can do in situations that don’t just have to be in a doctor’s office. So, I think with that, what you’re actually starting to see a little more of is a shift in the thought process within legislators and within state health agencies themselves about what they can do to prevent or treat hypertension. And so the marriage of those technologies and that thought process coming together, I think, leads to more of a change as opposed to the legislatures paying attention to it, because I feel like they’ve always paid attention to it. It’s just what they can do now is just different than it was 10 to 20 years ago.

SHEEHAN:

Sure. And several states are doing more in particularly around pregnant mothers and menopause. How are other states looking at addressing these issues during that phase of life?

GIAMBRONE:

So, I’ll start with menopause and perimenopause. And I think the biggest trend are the things that we’ve seen from the states is even just beginning to address the issues that women go through while they're going through perimenopause and through menopause. You know, we've seen over the past 10 or so years, there's been increased research into how perimenopause and menopause affect women's health with things like osteoporosis and obviously with increased risk of heart disease. And you also have the increase of people who are willing to talk openly more about perimenopause and menopause and how it affects women's health. And I think when you have those two things come together, that's when you start to see legislature, state health agencies, other organizations start to think about what it is that they can do to help prevent these types of issues in older women as they're going through that phase of life, especially when it comes to, you know, heart disease and hypertension. It's the largest cause of death for women in the United States. So, you know, anything that we can do for that is going to be incredibly helpful. Now with pregnancy, you know, 10% of pregnancies have some form of hypertensive disorder, things like, you know, preeclampsia and eclampsia. And so making sure that pregnant women have better access to care during their pregnancies, whether that's, you know, having a comprehensive place where they can go and get, you know, all of the care that they need or being able to manage their blood pressure at home and see where the connection is between, you know, what might be going on in their lives, where they might be in their pregnancy and how that's affecting their blood pressure. I think that's going to help lead to better experiences for pregnant women and, you know, ultimately lower maternal

mortality, because if you are, you know, cutting off preeclampsia before it even begins, then

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

SHEEHAN:

So it’s kind of a confluence of sort of the cultural readiness to have these conversations

along with these new technologies that are enabling better care. And can you talk a little bit

more about some of those some of those treatments and some of those options, like the

remote blood pressure monitoring?

GIAMBRONE:

Yeah, sure. So I think you're right when you say that it's all of these factors coming together

that are bringing so much more, you know, such new changes and such new policies and

things that legislators and, you know, other policymakers can do to help prevent and treat

hypertension. In terms of, you know, what's going like, you know, other things that are

happening, obviously, the biggest is having access to remote blood pressure monitors.

I think that can be a really great tool for people at home to help, you know, with their blood

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

monitors can be very cost prohibitive for some people. And so when you have states that

are looking at legislation or passing legislation that expands coverage and insurance,

whether it's through Medicaid or whether it's through private insurance for your blood

pressure monitors for, you know, people at home, that's giving them an access point. And

that's giving them a place that they can start gathering information for themselves on

simply what their blood pressure is and being able to empower them and give them the

tools to be able to, you know, prevent, treat, and just empower themselves to know what's

going on with their own bodies. So I think just starting with that is a great start.

SHEEHAN:

So definitely expanding insurance coverage is a necessity as well as sort of controlling costs.

And I think telehealth, as you mentioned, opens up those opportunities. Another factor in it

is just sort of educating the public and letting them know that these things are happening

and that there are resources and that there are things that they need to be aware of.

GIAMBRONE:

Yeah, you're totally right. You know, it's the old adage that, you know, an ounce of

prevention is worth a pound of cure. So being able to get that information out to people at

any age to know what hypertension looks like, you know, what are the symptoms of it, what

could happen if you have hypertension, that alone is, for some places, an entry point.

And I think what we're starting to see is we're seeing, you know, more educational

awareness and more information in doctors' offices, information in schools, you know,

teaching children what hypertension looks like. For a lot of us, that wasn't information that

we got as kids. And so, you know, we're almost learning at the same time that our children,

our nieces, our nephews, our grandchildren are. So for us to be able to have that information now is incredibly helpful. And I don't think legislatures are taking that for granted. I don't think health agencies are taking that for granted.

SHEEHAN:

Yeah, and I think you hit the nail on the head because it's not a condition or a topic that's

going to be going away, which makes it not just relevant now, but it's going to stay relevant.

GIAMBRONE:

Yeah, it will always, it will always be relevant. If your heart is beating, it is a good time to

think about the health of your heart and how to treat or prevent any type of heart disease

or, you know, hypertension or, you know, anything of that nature. So just knowing that

these are some of the options, you know, for example, oh, I wonder if my state allows, you

know, blood pressure monitors to be covered under insurance. I wonder what, you know, my state is doing on this. And this is where you also get, you know, for people an entry point into thinking about what is out there for people.

SHEEHAN:

Beth Giambrone is a senior analyst for state health policy at ASTHO. Find the link to her

recent article in the show notes.

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Now, let’s hear from Jeffrey Ekoma, ASTHO’s Senior Director of Government Affairs.

Jeffrey and the ASTHO team are preparing for Hill Day in D.C. next week, and he’s here now

to give us a view from Washington.

JEFFREY EKOMA:

There are lots of things that we’ve been tracking to start off with appropriations. We’re

really pleased that the FY26 labor HHS bill was passed. Out of the 12 appropriation bills,

there’s still one that’s outstanding, which is within the Department of Homeland Security.

There’s lots of movement happening with that, so we’re tracking that really closely because

that might have an impact not on sort of just DHS for FY26, but also for FY27. We continue

to track the potential for any additional grant terminations. As I’m sure everyone’s aware,

there were grant terminations that were issued to SAMHSA that were restored, grant

terminations that were related to public health infrastructure that was restored as well, and

there are current terminations for grants that impact California, Colorado, Illinois, and

Minnesota. There’s a temporary restraining order related to that, but we’re tracking everything related We’re also tracking the potential release of the President’s budget that will likely happen at some time in March, hopefully, or it might extend all the way up until April, so we’re tracking that. There’s lots of things that are top of mind for us. One last thing to share is the Surgeon General had her nomination confirmation hearing earlier this week, so we’re tracking all things related to that as well, and also tracking potential votes related to a nomination that will likely happen very shortly thereafter.

SHEEHAN:

Okay, that’s quite a lot of things on your plate, from appointments and confirmations to

budget hearings and upcoming Hill Day. What are you focused on in the near term, in say

the next couple weeks?

EKOMA:

Hill Day for sure. Shortly after Hill Day, our team will be shifting our time, I would say, into

FY27 appropriations. Right now, we’re completing appropriation forms from many offices. We have a lot of appropriation requests that we are working on, one being public health infrastructure, the next being the Public Health Emergency Program, or PHEP, the Hospital Preparedness Program, or HPP. We are also doing a lot of advocacy related to the Prevent Block Program, DMI, and a host of other programs, so we’ll be filling out those forms. We’ll be meeting with staff to talk about our requests for FY27 and our justification as to why we’ll be asking for increases for these programs, so that’s a really big top of mind. Also, too, on our team, we’re also meeting or re-meeting, I would say, with new members of Congress. We started those meetings last year, and we’re meeting with their staff again this year, just to make sure to see if they have any questions related to governmental public health and ways in which we can be helpful, especially if they are working on any public health related legislation.

SHEEHAN:

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

face-to-face meetings, anything that you need to get accomplished next week?

EKOMA:

Yeah, absolutely. We have a really good number of members that are going to be on the Hill

next week, and we’re asking our members to emphasize the importance of federal funding.

What does federal funding mean to their jurisdictions? We’re asking them to talk about how much money they send to local health departments. We’re asking them to highlight the importance of the public health infrastructure grant program. As I noticed, part of our FY27 requests, we’re requesting that Congress provide a billion dollars for that program, so we’re asking our members to talk about the impacts of that program within their respective jurisdictions, what has been the ROI of PHIG money so far. We’re also asking them to discuss the impacts of potential grant terminations or pauses that may happen, what happens, what does that do for the workforce, for the health department, and other partners that the health department works with closely. It’s also important to note, too, that our territorial health officials will also be on the Hill as well, and they’ll be spending their time talking about two specific things. One, they’ll be talking about the impact of the recently negotiated compacts of free association, as well as the importance of territorial Medicaid funding, among other things. So, there are lots of things that will be discussed on the Hill. And also, too, we know that our members are also going to want to talk about things that are top of mind for their departments, and there’ll be opportunity to do that as well.

SHEEHAN:

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

EKOMA:

Yeah. I presume vaccines will be top of mind for members. There’s been a lot of news

reporting recently related to that. They may also get questions about recent leadership changes within HHS or within CDC, and what has the working relationship been between their states and CDC. We know that many states are also a part of many collaboratives across the country, so that may come up as

well. So, lots of things, lots of things that may come up. And there’lll also be a lot of regional topics, right, things that are more regionally focused that I’m sure that they’ll talk about. They may also even talk about preparedness efforts, ways in which that they collaborate with neighboring states, et cetera, et cetera.

SHEEHAN:

Jeffrey Ekoma, thanks so much.

EKOMA:

Thank you so much, and I’m really excited to be back on the newscast. We are really grateful for everyone that continues to share information with us about the impacts of things that may be happening at the federal government level and how that impacts the work that they’re doing in their state.

SHEEHAN:

Jeffrey Ekoma is ASTHO’s senior director of government affairs. Earlier, we heard from Beth

Giambrone, a senior analyst for state health policy at ASTHO.

ASTHO welcomes new member Cameron Webb, state health commissioner for the Virginia Department of Health. Dr. Webb is a board-certified internal medicine physician, attorney, and public health expert. His past experiences include serving as a White House fellow during both the Obama and Trump administrations and as a senior advisor in the White House Office of COVID-19 Response during the Biden administration. He’s also served as an assistant professor at the University of Virginia School of Medicine and Frank Batten School of Leadership and Public Policy.

This has been Public Health Review Morning Edition. I’m John Sheehan for the Association of State and Territorial Health Officials.