Healthcare policy groups including FARB, NAIC, NAMD, NASHP, and NCOIL serve as platforms for state policymakers to collaborate and shape emerging trends. In 2025, multiple organizations adopted model legislation on facility fees and site-neutral payments, with NCOIL passing its Prior Authorization Reform Model Act in November. Groups are now focusing on the Rural Health Transformation Program and 340B oversight for 2026.

Florida's Senate Committee on Health Policy voted 6-4 on January 29th to advance SB 1756, the Medical Freedom Act, which prohibits the State Health Officer from ordering vaccinations and establishes conscience protections as exemptions from school-entry vaccine requirements. The bill requires providers to obtain signed informed consent before administering vaccines to minors and awaits consideration in the Appropriations Committee.

As legislative sessions wind down across the country, attention turns to the executive branch as governors make decisions on bills passed by the legislature. In the past month, various governors have taken action on significant healthcare legislation by signing, vetoing, or allowing bills to become law.

Over the past month, arguably no Governor and Legislature have been as proactive in healthcare reform as newly elected Indiana Gov. Mike Braun (R) and Indiana’s General Assembly. In late January, the Governor issued six executive orders pertaining to healthcare access, affordability and transparency.

During the 2024 state legislative sessions, 33 bills were enacted in 20 states related to the regulation of pharmacy benefit managers (PBMs). States used a variety of tactics, including spread pricing prohibitions, 340B pharmacies, patient steering and affiliated pharmacies, and mandates for increased reporting of PBM activities.

In 2025, state lawmakers are expected to prioritize healthcare affordability and access, building on key legislative trends from this year. Here are our thoughts on key trends and issues from 2024 and how they might show up in state capitols next year.