The Source Blog

It is mid-February 2026, and most state legislative sessions are officially in full swing.  This year's docket is a mix of carryover issues and intriguing new bills that could reshape the healthcare landscape.  But in policy work, "enacted" isn't the only measure of success—influential ideas often spark trends across states or take several sessions of persistent reintroduction before they finally cross the finish line.

Snapshot of 2026 Sessions

For 2026, only 46 states will have regular legislative sessions, with Montana, Nevada, North Dakota, and Texas not holding regular sessions in even-numbered years (although North Dakota will hold a short special session on rural healthcare this year).  Even-numbered years tend to be a bit quieter for state legislative activity, as most states are in the second year of a two-year cycle and heading into fall elections (New Jersey and Virginia are the outliers, as they hold statewide elections in odd-numbered years, so they are starting their two-year cycles).  Many states also hold limited sessions in even years, focusing on budgets and emergency matters only, rather than doing broad policy-making.  Even so, there will still be a lot of new legislation this year.  As of February 15, 42 states have begun their 2026 sessions; four states (Arkansas, Louisiana, Minnesota, and North Carolina) have yet to convene.

Although most states still have active legislation carrying over from 2025, this post focuses on what is new for 2026.  Below are some of the interesting items we’ve seen introduced for the new legislative session.

States Looking at Addressing Anticompetitive Provider Contract Terms

Market concerns arise when healthcare systems and insurers leverage significant market share to stifle competition and inflate prices, including through the use of anticompetitive provider contract terms.

This year, the Oklahoma legislature introduced two bills that would make specific contract terms unlawful.  SB1626 would ban "all-or nothing" clauses, "anti-steering/anti-tiering" clauses, "gag" clauses, and "most-favored-nation" clauses from contracts between health insurance companies, health plan administrators, and providers.  These terms would be considered unfair or deceptive acts enforceable by the Attorney General.  However, parties may obtain a waiver if they demonstrate that the term is necessary to achieve consumer welfare improvements that could not be achieved by less restrictive means.  HB3259 would prohibit these clauses and would declare any such clauses in existing or future provider contracts to be void and unenforceable.  This House version does not include any waiver provision.  Similarly, Missouri HB3088 would ban "anti-steering” clauses, "anti-tiering” clauses, "gag” clauses, and "most-favored-nation” clauses in the state.

New Jersey Considering Physician Joint Negotiations

When individual healthcare providers negotiate rates with insurance companies, the providers are often at a disadvantage.  Antitrust restrictions limit independent contractors' ability to jointly engage in fee negotiations.

New Jersey introduced S952 and S1386, which would allow independent physicians to jointly negotiate with health insurance carriers and engage in joint activities in non-fee-related matters impacting patient care, including utilization management criteria and clinical practice guidelines.  Any joint negotiation addressing fees could occur only if the Attorney General determines that the carrier has substantial market power or that contract terms threaten patient care quality and availability.

Vermont and Florida Looking at Ways to Assist Financially Struggling Hospitals

States are interested in ways to assist struggling hospitals and facilities.  Facilitating collaboration between systems is one potential solution.

Vermont’s H0719/S0249 would allow health systems to collaborate on cost containment, improving access to care, enhancing quality, or preserving rural hospitals, with immunity from antitrust lawsuits if the collaborations follow specific state oversight procedures.  Sharing cost, utilization, workforce, and quality data among collaborating parties would not be considered a violation of antitrust law.

In Florida, H1047/S1122 would allow two or more special hospital districts (which are local government units created to operate healthcare facilities within a specific area) to jointly develop, participate in, and manage various ventures, partnerships, or collaborations, including business entities or service networks, protected from both state and federal antitrust laws.

States Increasingly Concerned With the Role of Artificial Intelligence in Healthcare

As artificial intelligence (AI) increasingly takes hold in a variety of aspects of our lives, states are starting to show concerns about how the use of AI could affect the delivery of healthcare.

The Rhode Island legislature introduced S2010 that would require insurers to report to the state how they use AI, including the types of AI models, their role in decision-making, training data, performance metrics, and risk management policies.  Tennessee’s HB1866/SB2010 would prevent health issuers from denying or modifying healthcare services based on AI or algorithms unless a licensed, competent healthcare professional has reviewed the decision.  In Virginia, SB586 would require health insurers to publicly disclose how they use AI to manage insurance claims and coverage, and prohibit them from relying solely on AI for adverse determinations.

Merger Review Remains a Concern

Hospital systems with significant market share create problems for healthcare costs and quality.  Giving state regulators greater control over reviewing, approving, and imposing conditions on mergers remains of interest to state legislatures.

Pennsylvania HB2115, for example, requires healthcare entities involved in material changes (including mergers, acquisitions, or affiliations) to notify the Attorney General at least 120 days in advance.  The Attorney General would be empowered to investigate transactions for potential anticompetitive conduct and consumer harm, and could seek injunctions, divestiture of assets, and civil penalties.  This bill is similar to legislation introduced in Pennsylvania in 2025 that failed to pass.

Can Benchmarking Address Excessive Prices?

States are increasingly interested in what can be done to limit dominant health systems' ability to charge excessive prices.

New Jersey’s S3012 would create a new state entity to collect and analyze data on healthcare expenditures and prices and make the information publicly available.  The bill would also create a Health Care Cost Containment and Price Transparency Commission to set benchmarks for overall healthcare cost growth and hospital price growth.  The Commission would identify entities that exceed these benchmarks and could issue civil penalties.

States Showing More Interest in Universal Healthcare

State governments often act in the opposite direction of the federal government – when the federal government addresses an issue, the states often pull back, but when Congress is perceived as failing to address a problem, states are more likely to act in that arena.  As Congress pulls back from some provisions and subsidies in the Affordable Care Act, states are showing more interest in attempts to provide coverage.

Variations on the universal coverage theme have been seen in several states.  Florida’s H1489/S0740 would create the "Healthy Florida Act," a state-managed health care system providing universal health coverage for all Florida residents, regardless of immigration status.  In New Jersey, S426 would expand Medicare to cover all residents, regardless of age, health, or disability status.  The bill would eventually prohibit private health insurance companies from offering plans comparable to Medicare, ensuring that everyone participates in Medicare.  Washington state has had two bills introduced (SB5947 and SB5948) to create an entity that would design and implement a healthcare plan to provide universal coverage to all state residents.

Other Issues

Issues that have gained traction in state legislatures in previous years continue to draw interest, including price transparency, prior authorization, noncompete agreements, pharmacy benefit managers, and drug prices.

As is the case every year, most of these bills will not get enacted.  But they help show policymakers' priorities, and they may inspire future legislators to consider similar actions.  Overall, healthcare costs, quality, and access remain a major priority for states but the potential options for addressing these concerns are wide ranging.  The Source will continue to monitor state actions, and will report on approaches that are new, unique, or of high importance.

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