Here are new state healthcare laws taking effect in 2025

By Hayley Desilva / January 2, 2025

Providers and insurers in several states will have to grapple with health-related laws taking effect in 2025. Most of the legislation concerns reproductive care and insurance coverage.

Here are some of the laws affecting healthcare this year.

Arkansas

In 2025, any organization that participates in the state’s Medicare-managed care programs will need to submit an action plan to the state on how to either reduce or completely eliminate prior authorizations. 

California

In July, insurers will be required to provide coverage for fertility services, including in vitro fertilization. The law also broadens the definition of infertility to include people who cannot reproduce either individually or with a partner without treatment, expanding family planning options for members of the LGBTQ+ community.

Another new law will require medical facilities in the state to provide bias training and report adherence to the training to the state attorney general's office in an effort to reduce Black maternal mortality.

Colorado

As of Jan. 1, all pregnant individuals and children are eligible to receive Medicaid coverage, regardless of immigration status. The state program will cover prenatal and postpartum care for pregnant individuals and medical, dental, vision and mental health care for children.

Connecticut

Every hospital in the state will need to undergo a cybersecurity audit each year, which includes having a well-crafted plan of action in the event of a cybersecurity attack or outage. The law took effect Jan. 1.

Delaware

By the end of June, all public high schools must employ one full-time behavioral health professional for every 325 students. In 2026, the law will require one professional per 250 students.  
 
Under another law, the state's Medicaid program will be required to cover up to $750 for abortion services. Other private health and state health plans will be expected to follow the same coverage stipulations in 2026.

Idaho

Pharmacy benefit managers will be required to report any changes in amounts paid to pharmacies on behalf of insurers. The law also requires pharmacy benefit managers who own, control or are affiliated with a pharmacy to be transparent with any changes in reimbursement or fees that they make with other pharmacies. They also will have to offer an explanation each time they move or reassign drugs to higher cost formulary tiers.

Illinois

Most of the new insurance laws expand coverage, by both commercial and Medicaid insurers, on certain prescription drugs, testing and reproductive health services. Some of the laws also include measures prohibiting insurers from pushing patients toward lower-cost treatment options or having to use step therapy, where a patient has to try cheaper forms of treatment before moving to more expensive types.

Some new procedure regulation laws include one permitting social workers to administer opioid agonists and another allowing pharmacists to administer certain injections for mental health or substance abuse disorders with a prescription.

Minnesota

Like several other states, Minnesota will require all health plans to provide coverage for abortion services and if copays are required, they cannot exceed the cost of copays for similar services. However, some private organizations may be able to deny coverage in cases of religious objections.

The state also will require insurers to provide and expand coverage for wigs for patients who have lost their hair due to a health issue, gender-affirming care and biomarker testing.

Also, copays on prescription drugs for chronic conditions like diabetes cannot exceed $25 per one-month supply. Copays for medical supplies like syringes will be capped at $50 per month.

New Jersey

Starting in July, all patient notices on medical debt or billing must include notifications of the patient's rights and new consumer protection guidelines. Additionally, interest on medical debt will be capped at 3% and debt collectors will be banned from using wage garnishment for people earning up to 600% of the federal poverty level.

Pennsylvania

The state has several legislative changes going into effect in the new year, including expanded coverage for postpartum care.

Beginning Jan. 1, healthcare providers are required to take in newborns who are 28 days old or younger and unharmed, an update to the state's existing 'safe haven' law requiring emergency personnel to take in babies from individuals who are unable to care for them.

Additionally, doula care during pregnancy and postpartum will be covered under Medicaid. Healthcare providers also will be required to provide resources to pregnant patients on what kinds of perinatal and postpartum mental health care are available and where they can receive it.

Washington

The state's definition of healthcare employees will change July 1 to expand who is included in the state's mandatory overtime prohibition law, which prevents employers from making staff members work more than a set amount of overtime hours. The new definition will be healthcare facility employees involved with direct patient care or clinical services, receive an hourly wage or are covered by a collective bargaining agreement. Previously, the law only mentioned licensed practical nurses, technologists and specialists.

Another new law requires physician assistants to work under a written collaboration agreement with one or more physicians. The legislation specifies that insurers can reimburse employers for services provided by physicians assistants as they would for physicians.