Weekly StateVitals Update: Volume 39 (September 29, 2025)

California

• Governor Newsom Signs Bill Prohibiting ICE in Hospitals. This past week, Governor Gavin Newsom (D) signed SB 81 into law. As enacted, the bill updates the definition of medical information to include immigration status, which prohibits healthcare providers and insurers from intentionally sharing, selling, or otherwise using that information for any reason that is not related to rendering healthcare services to the patient. In doing so, it prohibits a provider or insurer from providing said information to federal authorities, such as the Immigrant and Customs Enforcement (ICE) agency. The bill further requires healthcare providers to establish or amend procedures for monitoring, documenting and receiving visitors related to immigration enforcement. Notably, the bill prohibits a provider facility and its personnel from allowing any person access to nonpublic areas of the provider’s facilities for immigration enforcement purposes. The bill takes effect immediately and providers have 45 days to ensure procedures are in place relative to visitation procedures. 

Florida

• AHCA Requests Funds for Current FY for Drug Importation, Medicaid Services Review, and Network Audits in Recent Budget Request. As part of its most recent legislative budget request, the Agency for Health Care Administration has requested an additional $4 million to sustain operations at a warehouse necessary to facilitate the state’s Canadian Prescription Drug Importation Program. Notably, AHCA has noted that without such funding they will be unable to continue operations of the program. Albeit, the program has yet to be implemented and the funding would be utilized for the purpose of paying a contract to the builder and operator of the warehouse facility. Additionally, AHCA wants to solicit bids for a $3.5 million contract to conduct a baseline analysis of its Medicaid population’s health and social services available to those members with the intent to inform future policy-making. Finally, in its budget request, AHCA is requesting an additional $6.8 million to hire an external auditor to audit the Medicaid managed care provider networks and quality and accuracy of provider directories. In the request, the AHCA notes that the funds for this project will come from managed care plans to be equitably split by the population that each managed care plan serves. 

• Medicaid Expansion Proponents to Delay Ballot Measure Until 2028. This past week, Florida Decides Healthcare, the group behind the effort to get Medicaid expansion on the ballot in Florida, has announced that they will delay their effort until 2028. This comes largely in response to passage this past year of HB 1205, which would prohibit voters from collecting in excess of 25 signed ballot petitions (in excess of their immediate family) if they are not registered with the state as a petition circulator. The bill requires petition circulators to also be Florida residents and revises the deadline as to when forms dictating signed petitions must be delivered to a supervisor of elections, among other requirements. The group notes that the bill makes it virtually impossible to collect the number of signatures requisite to obtain placement on a ballot in 2026.

• Dental Therapists Intend to Make Play in 2026. This past week, Floridians for Dental Access announced plans to pursue legislation in 2026 that would establish a licensure and scope of practice for dental therapists. As filed in 2025, it’s likely the bill would follow a similar mold in 2026; requiring therapists to have graduated from an accredited dental therapy school, complete a clinical exam or practical, and complete at least 24 hours of continuing education to maintain licensure. Notably, this year, Speaker of the House Daniel Perez (R) is supportive of the idea since having sponsored the original licensure bill as a freshman legislator years back. Under the proposal, it’s likely that dental therapists would work under the supervision of a dentist but that could be via a collaborative agreement that does not necessitate the dentist being on-site. The Florida Dental Association remains opposed to the effort. No legislation has yet to be pre-filed for 2026. 

Georgia

• CMS Authorizes Temporary Extension of Pathways to Coverage Program. The Centers for Medicare & Medicaid Services (CMS) announced this past week that it has approved a temporary extension of the state’s 1115 waiver that authorizes the state’s Pathways to Coverage program. The program is the state’s Medicaid expansion program for qualifying individuals up to 100 percent of the federal poverty level, provided such individuals meet work requirements. The approved amended waiver also expands the qualifying activities for eligibility purposes to include Supplemental Nutrition Assistance Program (SNAP) able-bodied adults without dependents and individuals who are caregiving for a child under six. Additionally, the amended waiver moves the requirement of beneficiary reporting for work requirements compliance from monthly to just once per year. The amended waiver also eliminates premiums and member rewards accounts that had previously been implemented. The waiver program is now extended through December 31, 2026.

Kansas

• Special Committee Considers Impacts of 340B Program in Kansas Healthcare. This past week, the Legislature’s Special Committee on Pharmaceutical Studies held a meeting with an agenda item discussing the implications for the 340B drug program and received extensive testimony from stakeholders. Notably, as has been the case this past year, the Paragon Health Institute has begun to emerge in state-level proceedings and in this case provided testimony that the 340B program has been exploited by large health systems to maximize profits. Arising from the committee meeting was a recommendation for the need for specific legislation to address transparency concerns with the 340B program and a call for an audit of 340B programs by the Legislative Division of Post Audit. 

Maine

• Federal Court Denies Preliminary Injunctions to 340B Law. This past week, the U.S. District Court for the District of Maine issued an order denying requests from drug manufacturers to implement preliminary injunctions on the implementation of LD 1018. LD 1018 prohibits manufacturers from restricting or otherwise interfering with the acquisition of a 340B drug or a delivery of such a drug to a 340B contract pharmacy on behalf of a 340B covered entity. In the order, the District Court highlighted two federal appellate court rulings in Arkansas and Mississippi involving similar requests and laws, in addition to the Court’s interpretation that nothing in the 340B federal statute suggests that Congress had any intent to limit the number of patients for whom covered entities could prescribe drugs to at the 340B discounted rate. 

Missouri

• Ballot Summary for Anti-Abortion Constitutional Amendment Struck Down. Recently, a county circuit court judge found that a ballot summary that had been written for 2026 consideration of a constitutional amendment presented an unfair and insufficient description to voters. In doing so, the circuit court judge ruled that the ballot summary must be rewritten but he stopped short of providing relief requested by abortion proponents who had asked for an entire block of the proposed constitutional amendment from going before voters on a ballot in 2026. The constitutional amendment adopted by the Legislature and requiring voter approval would repeal the recently passed amendment in 2024 granting Missouri residents access to abortion services. Under the proposed language, state law would allow abortions only for a medical emergency or fetal anomaly, or in cases of rape or incest up to 12 weeks of pregnancy. The proposed amendment also includes other prohibitions, inclusive of gender transition surgeries, hormone treatments and puberty blockers for minors. 

North Carolina

• Legislature Adjourns Until October Without Medicaid Budget Agreement. This past week, the North Carolina Legislature adjourned until October 20th without an agreement to increase Medicaid funding for the remainder of the fiscal year and delay planned Medicaid reimbursement rate cuts initiated and planned by the Department of Health and Human Services (DHHS). DHHS had announced Medicaid reimbursement cuts back in August after the Legislature passed a mini-budget at a rate of Medicaid funding below the Governor’s requested amount. Expecting to run low on funding in the Spring (assumption of a $319 million shortfall), DHHS is planning to make reimbursement cuts to accommodate for the assumed funding shortfall. To do so, the Department plans to reduce Medicaid reimbursement rates in the following ways: 

  • A 10 percent cut for applied behavioral analysis, psychiatric residential treatment facilities, and  inpatient and outpatient physical health services, among other services. 

  • An 8 percent cut for personal care services, inpatient and outpatient behavioral health services, hospice and other similar services. 

  • A 3 percent cut for all providers not impacted by the 10 or 8 percent cuts. 

  • A 1.5 percent reduction for Medicaid managed care organizations (in addition to the actuarial adjustments based on the aforementioned provider cuts).

  Those cuts are planned to go into effect October 1, 2025. Notably, both chambers had individually passed separate mini-budget bills with the appropriated funds requested to an extent by the Governor. However, the House failed to agree with the Senate’s desire to also include funding for a new children’s hospital in the state as part of the increased funding for DHHS. 

North Dakota

• Legislature Forms Interim Committee for State’s Rural Transformation Program Application. This past week, the Legislature announced they will form an interim committee tasked with forming recommendations and assisting the Department of Health and Human Services with submitting the state’s application for the Rural Health Transformation Program. The program was created as part of the One Big Beautiful Bill Act and is a $50 billion grant program that will be dispersed across states for appropriation to rural health facilities as outlined in the aforementioned application. North Dakota is working on the assumption that they will receive at least $500 million in funding over the next five years. The interim committee is made up of 33 legislators with representation from the standing Human Services Committee, Chairs of Senate and House Appropriations Committees, and lawmakers that serve on the Human Services Division of the Budget Committee. Notably, legislative leaders said it’s likely a special session will be called in 2026 to accommodate the newly acquired funds given the Legislature doesn’t reconvene until 2027.

For additional information and updates on state activity this past week relative to state COVID-19 vaccine guidance, StateVitals Subscribers can check out our guidance tracker.