State Updates:

What is Happening with Fertility Preservation?

• California has a new law that will require individual or small group health plans to include infertility treatment services including fertility preservation as an essential health benefit.
• Florida has improved protections for state employees with a new law that will require its state employee group health insurance plan to provide egg, sperm, or ovarian tissue preservation as well as 3 years of storage for those facing cancer treatments that may cause infertility. Health insurers may not require prior authorization for these services.
• Nevada’s new law will require fertility preservation coverage for breast and ovarian cancer patients on state regulated private health plans, Medicaid, and public employee health plans.

What is Happening with Health Care Access and Affordability?

• California reduced barriers to health care access and affordability with two new laws:
  • SB 306: Phases out prior authorization requirements for commonly covered health care services by 2028.
  • AB-1312: Hospitals will have to screen patients for charity care financial assistance programs if they are uninsured, have a Covered California Marketplace plan, or are enrolled in/eligible for Medi-Cal cost sharing. Hospitals must also presume charity care eligibility for certain patients, including those enrolled in CalFresh or CalWORKS.
• Maryland has a new law that will ban the use of co-pay accumulators. This means any discounts, manufacturer coupons, or financial help for prescription drugs must count towards a plan’s deductible and out-of-pocket maximum.

What is Happening with State Paid Leave Programs?

• Maine expanded its Earned Paid Leave so workers can carry over 40 unused hours of paid leave without reducing what they can earn next year. This allows for a total of up to 80 hours of earned paid leave.
• Washington has a new law that eases access to its Paid Family & Medical Leave program by eliminating the hours-worked requirement and reducing the service time from one year to 180 days. Access to this program for smaller employers will be phased in over the next 3 years, providing coverage for those with 25+ employees in 2026; 15+ in 2027; and 8+ in 2028.

What is Happening with Medical Debt Relief?

• A new Delaware law blocks medical debt from being reported to credit agencies or used in decisions about credit, employment, or housing.
• North Carolina’s Medical Debt Relief Program has canceled or reduced the medical debt of more than 2.5 million people. Eligible individuals will receive a letter from a hospital or Undue Medical Debt. This initiative was part of a broader effort tied to increasing hospital funding under North Carolina’s Healthcare Access and Stabilization Program. Participating hospitals agreed to relieve medical debt and expand charity care policies.
• A new rule from the federal Consumer Financial Protection Bureau, asserts that only the federal government has the authority to restrict medical debts from credit reports. This means that a state’s ability to protect consumers regarding medical debt and credit reports will be limited. At this point, it does not overturn existing state law.

What Else is Happening in Health Care News?

• Illinois has moved its State Health Insurance Marketplace from HealthCare.gov to GetCovered.Illinois.gov. Starting November 1st, if you are in Illinois, visit the Get Covered Illinois website to enroll in health plans and apply for financial help for the 2026 plan year.
• Under the Aviation Cancers Examination Study (ACES) Act, the National Academies of Sciences, Engineering, and Medicine will investigate cancer rates among fixed-wing military pilots and aircrew. The research will look at potential causes like radiation and UV light exposure. The goal is to improve care and disability support for service members facing elevated cancer risks.