Five states enacted significant healthcare legislation during spring 2026 sessions. Arizona launched AI-powered Medicaid fraud detection, while Iowa banned insurers from using AI to deny prior authorizations under HF 2635. Missouri's comprehensive HB 2372 awaits gubernatorial approval, expanding Medicaid coverage and hospital transparency requirements. Maryland's Prescription Drug Affordability Board capped Ozempic payments at Medicare rates for state plans. Connecticut's budget bill (SB 1) overhauled Certificate of Need requirements for hospitals.

Nebraska became the first state to implement Medicaid work requirements on May 1, 2026. North Dakota's 340B pharmacy law was ruled unconstitutional, the second such ruling favoring drug manufacturers. Tennessee enacted legislation allowing Ballad Health's Certificate of Public Advantage to expire in June 2028 despite FTC warnings. Virginia legislators unanimously rejected Governor Spanberger's amendments delaying Medicare Maximum Fair Price controls.

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 federal vaccine recommendations become less consistent, states are increasingly asserting independent authority over immunization policies. Several states formed regional collaboratives for vaccine guidance and procurement in late 2025, while others enacted legislation replacing federal recommendations with state-based advisories. Conversely, some states like Florida are moving to eliminate school vaccine mandates and emphasize parental choice through regulatory changes.

Delaware legislators introduced SB 213 eliminating hospital budget oversight authority, while Florida faces court-ordered Medicaid termination pauses after constitutional violations. North Carolina's certificate of need laws face ongoing legal challenges, and New York Governor Hochul proposed $71 million in healthcare investments including mental health licensing reforms. Utah became the first state implementing AI prescription renewals for chronic conditions.

Legislation we’re watching this month, including Certificate of Need in Mississippi, facility fees in Oregon, Medicaid reform in Indiana, and more.

Legislation we’re watching this month, including Medicaid policy activity in several states, a bill to eliminate the New Hampshire Vaccine Association, and more.