#MACoCon Recap: Strategies for Prescription Drug Spending

Prescription drug costs are no longer a back-office benefits issue for counties; they’re a frontline challenge shaping budgets, workforce retention, and long-term sustainability. Counties across Maryland are facing a familiar but intensifying challenge: how to sustain high-quality employee health benefits as prescription drug costs continue to climb. At MACo’s Winter Conference, the panel “Rx for Retention: County Strategies for Prescription Drug Spending” brought together county leaders, policy experts, and benefit consultants to unpack what’s driving…

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#MACoCon Recap: The State of Maryland’s Economy

Maryland’s economy is growing slightly, but mounting uncertainty around affordability, labor, and federal policy is reshaping what that growth really means for counties and communities. At MACo’s Winter Conference, economist Dr. Daraius Irani delivered a sobering but practical economic outlook during “Troubling Trends: The State of Maryland’s Economy,” offering county leaders a clear-eyed assessment of the forces shaping budgets and long-term planning decisions across the state. Amid growing uncertainty, Dr. Irani opened with a national…

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Troubling Trends: The State of Maryland’s Economy at #MACoCon

Maryland’s economy is shifting in ways that are already reshaping local budgets, services, and long-range priorities. Across Maryland, state and county leaders are confronting an economic landscape defined by uneven growth, demographic transitions, and persistent workforce pressures. At the same time, national trends, like rising interest rates, a cooling labor market, and slowdowns in key industries, are filtering down to the local level, affecting everything from hiring and retention to revenue reliability. Maryland’s unique mix…

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Maryland Among States Working to Curb Soaring Rx Drug Prices

As federal action on prescription drug costs remains limited, states across the country are stepping in with new laws to make medications more affordable for residents. According to an article from Stateline, in 2025 alone, at least 31 states have enacted nearly 70 laws targeting various parts of the complex drug pricing system, from Pharmacy Benefit Managers to drug manufacturers. Prescription drug prices continue to rise, and local governments are increasingly footing the bill. Counties…

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Governor Moore Expands State Support for Federal Workers

As the federal government shutdown continues, Maryland is taking steps to shield residents from its growing economic and household impacts. Governor Wes Moore has announced expanded state programs that provide relief and assistance to affected workers. Governor Wes Moore has announced new measures to assist Maryland federal workers affected by the ongoing federal government shutdown, which is now the longest in US history. The expanded support includes an additional round of no-interest loans for federal…

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Report Shows Maryland Trailing Region in Economic Outlook

Maryland’s declining economic rankings indicate deeper challenges that could impact jobs, local revenues, and long-term growth throughout the state. According to the Maryland Chamber of Commerce, Maryland's latest national economic rankings indicate that the state is continuing to fall behind its neighbors, raising concerns about long-term growth and fiscal stability. These rankings, released by the American Legislative Exchange Council, highlight long-standing challenges tied to high business costs, regulatory hurdles, and a lack of pro-growth policies. From…

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Rx for Retention: County Strategies for Prescription Drug Spending

As prescription drug costs continue to climb, counties face a difficult balancing act between protecting employee health and keeping budgets in check. Prescription drug spending has become one of the fastest-growing pressures on county health plans, directly affecting both workforce retention and fiscal stability. Counties serve as major employers and rely on competitive health benefits to attract and retain qualified workers, particularly in essential roles like public safety. Yet escalating drug prices and opaque pricing…

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Changes AHEAD in MD’s Health Care Model?

Maryland’s hospital payment system has long kept costs low, hospitals stable, and care accessible, but the model now faces a major turning point. As the state’s Total Cost of Care waiver nears expiration and Maryland prepares to transition to the federal AHEAD model, potential sweeping changes to hospital payments and healthcare costs could have significant effects on counties as employers and public sector health plan sponsors. Introduction For decades, Maryland has stood apart in how…

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Health Care Costs Keep Climbing for Public Employers

Public employers face rapidly rising health care costs, straining already-tight local budgets. While there are a few immediate fixes, long-term solutions are possible through coordinated action. In a Governing article, health care premiums for 2026 are set to rise far faster than inflation or tax revenues, leaving public employers and employees alike bracing for another expensive year. With costs driven by new treatments, high-priced drugs, and aging workforces, local governments are likely to face increased…

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A Seat at the Table: MACo’s 24-County Tour Hits St. Mary’s

This week on the Conduit Street Podcast, Michael Sanderson...goes solo? Just kidding! He does set the stage, however, for a special recording from St. Mary’s County, where MACo President and Queen Anne’s County Commissioner Jack Wilson joins Michael for a briefing with St. Mary’s County leaders to talk all things local governance.  Tune in to the Conduit Street Podcast weekly, wherever you get your podcasts! Subscribe to the Conduit Street Blog and stay in the…

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