Policy Impacts of COVID-19: The widespread effect of COVID-19 on all areas of our lives has been remarkable. State budgets are being hit hard, driving lawmakers to pass legislation to protect and support vital programs and policies as best they can. Here's an overview of just how deep and wide the virus' influence has been.

• Author: Blackman, Kate

As the novel coronavirus began to spread across the country, the public health and health care systems were the first sectors affected and the first to respond.

To date, governors in every state and territory have declared emergencies, allowing greater authority and flexibility to respond to COVID-19. Even with many state legislatures suspending or postponing sessions, more than 20 states, the District of Columbia and Puerto Rico have passed more than 35 health-related bills that appropriated money and supported other efforts in the health care and public health systems. Here's a look at state responses to the pandemic.

* Bolstering the health care system

To address concerns about health care system capacity, states loosened requirements around the health care workforce and telehealth. Most of the changes are for the duration of the pandemic only and, to date, have been led by the executive branch.

More than 40 states have modified licensing requirements and expedited approvals for physicians and other health care providers to recruit out-of-state, inactive and retired providers to expand the state's workforce. At least 29 states also expanded the scope of practice for nurse practitioners and physician assistants, allowing them greater independence in providing care to patients.

Telehealth was used early in the crisis, particularly to help determine whether people's symptoms required a test or hospital visit. Other uses included managing chronic conditions and providing mental health care or substance use disorder treatment at home to reduce the need to visit a health care facility.

Federal and state action expanded tele-health by ensuring coverage and relaxing a number of restrictions, such as requirements related to providers and telehealth methods. Although governors' orders led many state changes, legislatures in Alaska, Maine, New Jersey and Puerto Rico also took similar action.

* Ensuring affordability and accessibility of care

As the virus spreads, coverage and access to needed health care services, including COVID-19 testing and treatment, remains critical. Federal and state leaders first focused on reducing patients' costs, such as copays and deductibles, for testing.

The Families First Coronavirus Response Act requires insurers to cover testing for the virus without any cost to patients or prior authorization requirements. The federal law also gives states the option to cover COVID-19 testing and test-related visits for uninsured...