Roundup of selected state health developments, second-quarter 2025 

Second-quarter 2025 showed robust legislative activity, punctuated by pharmacy benefit manager (PBM) laws, many of which impacted self-funded ERISA plans.

The US Supreme Court let stand a lower court decision concluding that ERISA preempts an Oklahoma PBM law. Separately, a district court invalidated parts of a Tennessee PBM law on ERISA preemption grounds. Maryland again delayed the start dates for paid family and medical leave (PFML) contributions and benefits.

Missouri’s paid sick and safe leave (PSSL) started on May and will end on Aug. 28, and New York City has a new paid prenatal leave mandate. Insurance coverage requirements for fertility services passed in Georgia, Nevada and California, which delayed the effective date of its mandate by six months.

Six states passed telehealth laws, including Montana, which joined a psychological services compact. Alabama and Tennessee created benefit accounts for independent contractors.

And an Oklahoma law authorizes a state-facilitated public exchange for individual insurance.

This GRIST summarizes these and other state health-related developments in the first quarter of 2025.