Weekly StateVitals Update: Volume 50 (December 22, 2025)
*Programming Note: Due to the Holidays, StateVitals Weekly Update will not be published the next two Mondays. The StateVitals Weekly Update will return Monday, January 12, 2026.
National
Bipartisan Coalition Targets Misleading AI-Generated Weight-loss Ads. Last Wednesday, Attorneys General Jeff Jackson (NC), Dave Sunday (PA), William Tong (CT), and Dave Yost (OH) co-led a coalition of 35 attorneys general calling for increased enforcement against misleading AI-generated weight-loss advertisements on social media platforms. In a signed letter, the coalition alleged that these platforms permit companies to use false advertising despite their own policies that prohibit deceptive AI-generated before-and-after comparison photos and false guarantees in pharmaceutical and health and wellness ads. Moreover, the listed platforms already have policies that prohibit these practices; policies that the coalition claims are not enforced. The ads cover several GLP-1 drugs, several of which are not FDA-approved or compounded. The coalition also seeks to limit prescription drug ads to FDA-approved drugs, require clear disclosure of risks and potential side effects, and prohibit AI-generated content in weight-loss drug ads. This letter comes around the same time as a recently released executive order seeking to limit state-level regulation of AI and instead shift authority to a minimally burdensome federal standard. The executive order’s legal authority over states’ ability to regulate AI is currently unclear, and litigation will likely follow in the coming year.
Judge Orders $1 billion in School Mental Health Grants to be Reinstated. Last Friday, U.S. District Judge Kymberly Evanson ruled that the U.S. Department of Education’s cancellation of its Mental Health Service Professional Demonstration Grant Program (MHSP) and its School-Based Mental Health Services Grant Program (SBMH) was illegal. The Court agreed with states that argued that the Department had acted illegally when it told grantees it would discontinue the grants due to the Administration’s new priorities. The District Court granted a summary judgment motion and ordered the Department to meet with states and agree on a timeline to make continuation decisions. The grants were originally awarded for a five-year project period with annual reviews by the Department. Although Washington led the suit, states including California, Colorado, Connecticut, Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, New Mexico, New York, Nevada, Oregon, Rhode Island, and Wisconsin joined it.
Connecticut
Reserve Funds to Offset Potential Loss of ACA Tax Credits. Last Thursday, Governor Ned Lamont submitted a plan to the Connecticut General Assembly outlining the use of funds from the newly created Emergency State Response Reserve. The plan transferred $167.9 million to Connecticut’s general fund, leaving $332.1 million in the reserve. Of the transferred funds, $64.1 million was designated to offset the projected $295 million loss in federal tax credits used to subsidize health insurance premiums of residents enrolled in Covered CT. Additionally, the plan specified $50.8 million to cover the loss of enhanced health care subsidies for individuals not under Covered CT and $5 million in supplemental payments to federally qualified health centers to promote access to primary and preventative care. Connecticut is among several states responding to the potential end of Affordable Care Act (ACA)-subsidized tax credits, and Governor Lamont has until February 4th, 2026, to allocate any of the remaining $332 million reserve.
Illinois
Illinois Legalizes Medical Aid in Dying. This past week, Governor JB Pritzker signed SB 1950, titled Deb’s Law, which authorizes terminally ill patients who have a prognosis of less than six months left to live to request a prescription from their physician to end their life. The law requires two physicians to determine that a patient has a terminal disease and to inform the patient of all end-of-life care options. Additionally, the medication must be able to be taken orally, and patients must submit written documentation of their request and self-administer it. With Governor Pritzker’s signature, Illinois became the 13th state to legalize medical aid in dying, with eight other states considering similar legislation. This also makes Illinois the first state in the Midwest to legalize Medical Aid in Dying. Looking ahead, the states currently considering medical aid in dying legislation include Connecticut, Indiana, Massachusetts, Minnesota, New Hampshire, New York, and Pennsylvania.
Louisiana
Governor Landry Reverses Medicaid Contract Terminations. Last Thursday, Governor Jeff Landry’s administration confirmed that it would not be ending any Medicaid Managed Care contracts set to expire on December 31, 2025. Earlier this month, the state sent letters to two Managed Care Organizations (MCOs) notifying them that their 2026 contract extensions would not be renewed. Notably, this end came in contrast to state lawmakers who voted two weeks prior to extend the contracts. Now, Health Secretary Bruce Greenstein proposed a short-term arrangement to extend an $561 million MCO contract through March 31, 2026. Critically, the MCO has indicated it will not remain with the state’s Medicaid program beyond the 90-day extension. This extension is intended to serve as a transition period, allowing the MCO to transfer its 330,000 members to other MCOs. Governor Landry’s reversal demonstrates the effectiveness of legislative pressure after state senators questioned the health department's ability to shift hundreds of thousands of people’s Medicaid coverage by the end of the year without major disruptions.
Nebraska
Nebraska to Become One of First States to Implement New Medicaid Work Requirements. Last Wednesday, Governor Jim Pillen announced Nebraska’s intent to implement HR1’s Medicaid work requirements starting May 1, 2026. The announcement comes a week after CMS released additional guidance on how states should implement mandatory community engagement requirements for able-bodied adults age 19-64. In particular, these requirements only apply to a portion of beneficiaries with slightly higher incomes who receive Medicaid coverage under a prior program expansion. Current Nebraska Medicaid members will be assessed for the new requirements during their renewals; eligible beneficiaries will be required to submit paperwork demonstrating compliance at least every six months. Notably, this reporting schedule is now required under federal law and is twice as frequent as it is for traditional Medicaid members, which could create additional work for state agencies amid significant updates. It’s expected that these changes could impact around 30,000 beneficiaries within the state. As state legislatures reconvene in January, it’s likely that governors and legislators will deliberate on how to implement these requirements ahead of the July 2027 deadline.
New York
Governor Hochul Announces Support for Medical Aid in Dying Legislation. Last Wednesday, Governor Kathy Hochul announced she will sign New York’s medical aid in dying bill once the session resumes in January. Governor Hochul reached an agreement with the Legislature on S138 / A136 to add language covering additional guardrails around a patient’s decision. The Legislature has agreed to include the following provisions from Governor Hochul:
Establishing a 5-day waiting period between when a prescription is written and filled.
Requiring a video or audio recording of the patient’s oral request for medical aid in dying.
Requiring a mandatory mental health evaluation and an in-person initial evaluation.
Prohibiting anyone who may financially benefit from a patient’s death from serving as their witness or interpreter
Authorizing religiously-oriented home hospice providers to opt out of offering medical aid in dying.
Extending the law’s effective date by 6 months.
Governor Hochul’s announcement comes shortly after Illinois Governor JB Pritzker signed their own medical aid in dying law on December 12th. New York is currently one of eight states deliberating medical aid in dying legislation and would be the 14th state to legalize the practice.
Texas
Texas and Florida File Lawsuit Challenging Abortion Drug Access. Recently, the attorney general offices of James Uthmeier (FL) and Ken Paxton (TX) filed a lawsuit against the FDA to restrict access to mifepristone, one of two abortion drugs that can be used to end a pregnancy before 10 weeks. Dispensing regulations initially applied during the COVID-19 Pandemic allow someone to receive the drug via mail. The plaintiffs claim that such dispensing regulations are unsafe and undermine state rights to enforce abortion laws. In particular, they allege the Comstock Act of 1873 prohibits abortion pills from being sent through the mail. Moreover, this suit follows a similar case in Missouri, where the attorneys general of Missouri, Kansas, and Idaho filed a lawsuit to end mail distribution, alleging risks of taking the drug without in-person care. As it stands, Mifepristone’s brand-name version has held FDA approval since 2000, with generic formulations receiving approval in 2019 and 2025. These lawsuits are indicative of ongoing challenges to mifepristone’s safety and access, with ongoing reports indicating that an FDA safety review will not be completed until after the 2026 midterm elections.
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.
