California Legislature Passes Several Healthcare Bills as Session Concludes
California's legislature concluded its August 31 session by enrolling multiple healthcare bills addressing AI in clinical care, prior authorization practices, and coverage expansion. Key legislation includes AB 1979 requiring professional judgment for AI clinical decisions, AB 1887 mandating 30-day prior authorization for rare disease drugs effective January 1, 2027, and SB 1089 expanding GLP-1 medication access through the state's CALRx purchasing program.
New CMS Framework Helps States Determine Medicaid Frailty Exemptions from Work Requirements
CMS released a slide deck introducing an optional three-tiered framework to help states determine medical frailty exclusions from Medicaid community engagement requirements. The framework ranges from automatic qualification based on single ICD-10 codes for severe conditions to manual individualized reviews when data is insufficient. States including Georgia and Wisconsin can adopt, modify, or create alternative methodologies, provided they link conditions to functional impairment and remain auditable.
Louisiana's 2026 Healthcare Legislation Advances Major Changes
Louisiana's 2026 legislative session, which adjourned June 1, enacted major healthcare reforms targeting Medicaid, drug pricing, and pharmacy benefit managers. Act 572 requires Medicaid authorization decisions within seven calendar days. SB 433 mandates coverage of FDA-approved weight loss medications. HB 870 requires insurers to favor lower-cost generics and biosimilars. SB 401 establishes a Prescription Drug Affordability Board to identify high-cost drugs and recommend cost-reduction strategies.
Does Medicaid Cover GLP-1 Drugs? A State-by-State Guide (2026 Update)
Only 13 state Medicaid programs cover GLP-1 medications for weight loss as of early 2026, down from 17 states before January 1. California, New Hampshire, Pennsylvania, and South Carolina dropped coverage citing budgetary constraints. The 13 remaining states impose strict restrictions including BMI thresholds over 30, prior authorization, and step therapy requirements. CMS introduced the BALANCE demonstration program allowing states to expand coverage through negotiated pricing beginning May 2026.
State Healthcare Legislative Trends Emerge
States are advancing healthcare legislation across three key areas as legislative sessions conclude. Multiple states enacted insurance reforms targeting utilization management and prior authorization, with Iowa, Utah, South Dakota, Washington, and New Mexico leading efforts. Indiana, Wyoming, and Utah passed Medicaid eligibility verification measures responding to federal reforms. Several states expanded scope of practice for pharmacists and mid-level providers to qualify for Rural Health Transformation Program funding.
States Tackle AI Healthcare Utilization Management Laws Despite White House Executive Order
Despite a December 2025 White House Executive Order threatening to cut BEAD Program funding for states with comprehensive AI oversight, nine states including Alabama, Hawaii, Indiana, Mississippi, Oklahoma, Rhode Island, Tennessee, Virginia, and Vermont have introduced 2026 legislation restricting insurers' use of AI in coverage decisions, with federal review expected by mid-March.
Governors’ Final Actions on Major Healthcare Bills
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.