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Roundup of selected state health developments, first-quarter 2026 

May 1, 2026

The first quarter of 2026 was active on the state legislative and regulatory fronts.

Maryland finalized paid family and medical leave (PFML) regulations in advance of contributions starting next year. New York and Washington, DC, tweaked their PFML laws. Oregon issued guidance on PFML and paid sick and safe leave.

Puerto Rico authorized emergency paid leave due to an influenza epidemic. Four states and Washington, DC, addressed vaccines. Florida, Ohio, and Virginia passed significant pharmacy benefit manager laws while Maine clarified a prior law through regulations.

New Mexico and South Dakota focused on prior authorization. Indiana, New Jersey, and Utah passed insurance mandates. Alabama and New York clarified how insurance mandates affect HSA-qualifying high-deductible health plans. West Virginia concluded three enforcement actions against healthcare entities. Mississippi eased access to association health plans, and a Wyoming law enabled independent contractors to open portable benefit accounts.

California issued provider directory rules and fined a carrier for grievance process failures. San Francisco’s new methodology for compliance with the Healthy Airport Ordinance started.

This 13-page PDF summarizes these and other state health-related developments in the first quarter of 2026.

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