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Improving Community Access to Care Through Health Disparities Grant Learn how states have addressed COVID-related health disparities and improved health equity in their jurisdictions in these case studies. In 2021, as part of the COVID-19 pandemic response, CDC distributed critical funding to state, territorial, and freely associated state health departments through the OT21-2103 COVID Health Disparities grant to promote health equity initiatives. ASTHO, in partnership with the National Association of Community Health Workers and the National Organization of State Offices of Rural Health, created state stories highlighting how some health departments have deployed this funding to advance health equity in their jurisdictions. The following state stories demonstrate how Utah, Virginia, and Texas worked to strengthen public health initiatives in rural communities, empower community health workers, and build stronger bridges between communities and health care. website yes

State Strategies for Advancing Viral Hepatitis Elimination astho, association of state and territorial health officials, public health officials, state health officials, territorial health officials, state health department, population health, health care systems, distribution of such outcomes, triple aim, defined group, individuals including the distribution, health system, outcomes within the group, save lives, group of individuals including, health outcomes, health improvement, community health, health and health, institute of medicine Cases of viral hepatitis are on the rise across the United States. There are many barriers on the road to progress. See what's being done about it. Cases of viral hepatitis are on the rise across the United States. Current barriers to progress include recent increases in rates of injection drug use, lack of awareness, limitations on testing and diagnostic capacity, access to treatment, and availability of data. ASTHO strives to support states and territories as they work to solidify comprehensive approaches to viral hepatitis elimination. This report synthesizes key actions and proven strategies for public health leaders to consider as they approach elimination planning within their own jurisdictions. Get the Report (PDF) website

This report highlights how a six-state "payers cohort," through the ASTHO/CDC Heart Disease and Stroke Prevention Learning Collaborative, convened cross-sector teams which included payer partners, local health agency staff, academic institutions, community health workers, and other state‐ or local‐level stakeholders to support efforts to improve cardiovascular health outcomes, focusing on blood pressure control and reducing healthcare costs.

Centering the Community’s Voice in State-Led Health Equity Initiatives health equity, public health departments, health outcomes, michigan public health institute, health disparities, underserved populations, marginalized communities, people of color, indigenous people, premature deaths, minority health, cultural competency, public health, life expectancy, improving health, american indians, health service, african american, native american, social determinants of health, sexual orientation, mortality rate, socioeconomic status, covid-19 pandemic, higher rates, alaska natives, group of people, racial groups, social economic, population health, department of health, astho, association of state and territorial health officials Lana McKinney, Jessica Fepelstein Establishing the community voice in health policy discussions. Over the past two years, ASTHO has worked directly with state public health departments and their communities to build capacity for improving health outcomes. These public health departments are building a culture of health equity through policies, practices, and quality improvement measures. This includes the Strategies to Repair Equity and Transform Community Health (STRETCH) Initiative—a 10-state learning community hosted by ASTHO, the CDC Foundation, and the Michigan Public Health Institute. STRETCH supports states in operationalizing health equity and preventing the constant pressures caused by negative health outcomes on their communities. For example, poverty can create constant pressures just as water pushes against a dam, which can build to the point of breaking and push people into poverty. Additionally, ASTHO supports state and territorial recipients of CDC’s COVID-19 Health Disparities grant to improve the health of high-risk and underserved populations disproportionately impacted by the COVID-19 pandemic. Health disparities impact the quality-of-life and financial well-being of communities, with the economic burden of health disparities increasing from $320 billion in 2014 to $451 billion in 2018. This includes associated costs of excess premature deaths, lost labor market productivity, and excess medical care for Americans of color as compared to their white counterparts. Events in recent years, such as the COVID-19 pandemic, revealed the pressures that Black, Indigenous, People of Color (BIPOC) and other marginalized communities experience because of health disparities. Aligned with the technical assistance received by public health departments, several states have taken concrete steps to achieve optimal health for all by supporting training of public health staff and increasing engagement of under-represented and underserved communities in the policy process. Promoting Staff Health Equity Training Ensuring that public health staff and other leaders are equipped with the knowledge, skills, and attitudes necessary to provide culturally competent and equitable care to all patients, regardless of their social background or identity can improve health outcomes. In recent years, states have worked to expand access to cultural competency and humility training for health system workers. Nevada enacted legislation (AB 267) requiring the state Board of Health to establish the frequency for medical facilities and dependent care facilities to conduct cultural competency training for employees who have direct patient contact. It also (1) requires the Office of Minority Health and Equity and Department of Health and Human Services to establish and maintain a public-facing list of approved courses for cultural competency training, and (2) require nurses, psychologists, marriage and family therapists, counselors, social workers, and behavioral analysts to complete a minimum of three hours of cultural competency training to successfully renew their license. At least four other states—Illinois (SB 2427), Massachusetts (S 1413), Virginia (SB 1440), and Vermont (H 512)—considered bills expanding access to cultural competency training for health care professionals. Vermont’s bill would implement the recommendations of the Health Equity Advisory Commission to provide training and continuing education for health care providers to improve cultural competency, cultural humility, and antiracism in Vermont’s health care system. Public health agencies can also promote health equity training by allocating funding and providing training. For example, the Arizona Department of Health Services leveraged funding from CDC’s COVID-19 Health Disparities grant to establish the Advancing Health Equity, Addressing Disparities (AHEAD AZ) program with the University of Arizona Center for Rural Health, which supports the health care and public health workforce, including support for Arizona’s 17 Critical Access Hospitals health equity strategic plans, and implementing a COVID-19 testing program that provided testing to communities most in need regardless of socioeconomic or immigration status, including those living in correctional facilities and unhoused people. Health Equity Commissions Health equity commissions play a critical role in advancing optimal health for all by bringing together experts, stakeholders, and policymakers to draw on evidence-based approaches that address the root causes of health disparities and to develop strategies to prevent them. At least two states proposed legislation related to health equity commissions in 2023. Colorado passed a law (SB 23-151) extending its Health Equity Commission through 2029. New Jersey is considering S 3136, which would establish and require a Commission on Health Equity to, among other things, recommend implicit bias training requirements for health care providers. Empowering Community Members to Engage in the Policy Process Hearing directly from community members, particularly those with lived experience, provides health agencies with unique insights into the community’s needs and daily life, and helps gain support from those most affected by the policy. There can be several barriers to holistic community engagement, particularly for community members who have fewer resources. Policymakers can take steps to lower these barriers by providing access to childcare, supporting transportation costs to a meeting, and/or compensating community members for their time and effort supporting the policy development process. In 2022, Washington enacted SB 5793 to compensate community members with lived experience for their time and expertise when serving on boards, commissions, councils, committees and other similar policymaking groups. The law directed the state’s Office of Equity to develop equity-driven compensation guidelines for all state agencies, which Washington’s Department of Health used to create and implement its Community Compensation Guidelines. These compensation guidelines outline how and when community members can be paid for their time and expenses when engaging in the policy process. Such methods are particularly valuable because the communities facing the most inequity are also the ones most systemically marginalized. Similarly, in 2023 Oregon’s legislature considered SB 694 to create a Task Force and Work Group Stipend Fund. The fund would provide for providing members who do not otherwise receive compensation for their participation to be compensated for their time and travel for task force or workgroup related work. ASTHO will continue to monitor policy developments supporting health equity programs and initiatives, providing relevant updates. Special thanks to Maggie Davis, JD, ASTHO’s director of state health policy, for her contributions to this blog. Additional Resources to Help Public Health Leaders Increase Community Engagement ASTHO’s Programmatic Health Initiatives and Strategies Georgia Health Policy Center’s Guide to Funding Navigation to help communities design and sustain equity-advancing investment. <!-- Strategies to Repair Equity and Transform Community Health (STRETCH) Initiative framework. --> website yes

Public health leaders are positioned to prevent illness from the "tripledemic” of COVID-19, Influenza, and RSV with approved vaccines and preventative antibody treatments.

While communities transition from emergency response to long-term monitoring and recovery, the federal government and states are taking legislative action to improve emergency preparedness capabilities.

State and Federal Actions to Reduce Per- and Polyfluoroalkyl Substances’ Impact on Public Health safe drinking water act, per and polyfluoroalkyl substances, water supplies, contaminated groundwater, chemical companies, pfas contamination, forever chemicals, synthetic chemicals, maximum contaminant levels, industrial pretreatment program, polyfluoroalkyl substances pfas, chemical sales, chemical industry, bottled water, safe drinking water act sdwa, unregulated contaminants, companies in the world, united states, consumer products, 1996 amendments, national primary drinking water, surface water, water system, largest chemical companies, pfas strategic roadmap, primary drinking water regulations, pfas chemicals, pfoa and pfos, drinking water, testing for pfas, astho, association of state and territorial health officials Maggie Davis, Beth Giambrone State and Federal Actions to Reduce PFAS Impact on Public Health Since 2018, when the city of Stuart, Florida filed its lawsuit, communities across the United States have filed lawsuits against manufacturers that produce Per- and polyfluoroalkyl substances (PFAS), alleging that they contaminated groundwater and exposed residents to these harmful chemicals. In June 2023, manufacturer 3M agreed to pay at least $10.3 billion to settle the Stuart lawsuit and others across the country with public drinking water systems. Similarly, chemical companies DuPont, Chemours, and Corteva reached $1.18 billion settlement with local communities that have detected PFAS in their water supplies. PFAS are synthetic chemicals used in products like nonstick cookware and firefighting foam, which can migrate to soil, water, and air during production and use. Most of these chemicals remain in the environment without breaking down—hence the nickname “forever chemicals”—and can cause harmful health effects (e.g., higher risks of kidney or testicular cancer, and pre-eclampsia or high blood pressure among pregnant people) and are prevalent across the nation. Evidence shows the widespread nature of exposure to the chemicals and the economic costs of exposure. For example, a 2023 USGS study estimated that at least 45% of tap water nationwide could have one or more PFAS, while recent research estimates the annual cost of the disease burden attributable to long-chain (i.e., six or more carbon) PFAS exposure to be at least $5 billion. As communities seek restitution for PFAS contamination, federal and state policymakers are working to eliminate PFAS from ground water and drinking water and to mitigate exposure to these forever chemicals. Eliminating PFAS in Drinking Water Under the Safe Drinking Water Act, EPA has the authority to regulate the public drinking water supply in the United States. These regulations establish legally enforceable Maximum Contaminant Levels (MCLs) or Treatment Techniques and non-enforceable Maximum Contaminant Level Goals (MCLGs) for public water systems. EPA’s recently proposed PFAS National Primary Drinking Water Regulation could potentially add six different PFAS compounds to the list of regulated contaminants. Within the PFAS chemical family, PFOA and PFOS are proposed to each have MCLs of 4.0 parts per trillion (ppt), while PFNA, PFHxS, PFBS, and GenX would be regulated collectively as a mixture using EPA's Hazard Index approach. The proposed rule also could require public water systems to monitor and notify the public of PFAS levels and reduce the levels in drinking water if they exceed proposed standards. According to a survey conducted by the Environmental Council of the States, state guidelines vary; at least eleven states have established statewide MCLs for PFAS in drinking water. Some states prohibit their agencies from setting standards more stringent than federal ones and, in the absence of a federal standard, state agencies may hesitate to establish one that could easily be invalidated. In other cases, a lack of resources inhibits the agency’s capacity to set and enforce a PFAS standard. When a federal standard is established by EPA’s final rule, expected by the end of 2023, state primacy agencies will need to enforce the federal standard and adopt standards aligned with the federal standard or stronger within two years. Additional State Efforts to Reduce PFAS Exposure Even without MCLs, states are finding ways to mitigate the public’s exposure to PFAS. In 2023, states enacted legislation on banning PFAS in consumer products, increased requirements for testing and reporting of PFAS, and PFAS mitigation. Banning PFAS in Products Indiana enacted HB 1341 prohibiting fire departments from purchasing gear unless it contains a permanent label indicating whether it does or does not contain PFAS as of June 30, 2024. Minnesota’s HF 2310 prohibits selling or distributing products containing intentionally added PFAS beginning January 1, 2026. An exception may be made if the manufacturer submits information to the commissioner of the Pollution Control Agency such as the product, the amount of PFAS used, and the amount of PFAS in the product. The Oregon legislature enacted SB 543, which prohibits the selling or using polystyrene foam containers for prepared food, food containers containing intentionally added PFAS, and polystyrene packaging peanuts. Washington enacted HB 1047, which prohibits manufacturing, distributing, and selling cosmetic products with PFAS and other chemicals or chemical classes as of January 1, 2025. Testing/Reporting Indiana enacted HB 1219, establishing a pilot program that collects blood samples of previous or current firefighters, analyzes the samples for serum PFAS levels, and determines whether there are corresponding health implications associated with elevated serum PFAS levels. Maine’s LD 1248 requires bottlers who extract water from the state to sell as bottled water to test, regularly monitor, and report the presence of PFAS to the Department of Health and Human Services and post the results on a public-facing website. Sales of bottled water are prohibited if PFAS levels in the water source exceed the state or federal community water system standards, whichever is lower. Currently, Maine has an interim MCL standard of 20 ppt. Virginia’s HB 2189 directs the State Water Control Board to adopt regulations requiring industrial users of publicly owned treatment works to test waste streams for PFAS before and after cleaning, repairing, refurbishing, or processing items the user knows or reasonably should know uses PFAS chemicals. West Virginia’s HB 3189 requires its Department of Environmental Protection to identify and address sources of PFAS in raw sources of public drinking water systems. It also requires facilities to report the use of PFAS if they discharge to surface waters under a National Pollutant Discharge Elimination System (NPDES) permit or to a Publicly Owned Treatment Works under an industrial pretreatment program. Mitigation Connecticut enacted SB 100 establishing a PFAS testing account, which provides municipalities with grants or reimbursements for testing and remediating PFAS in drinking water. Maine enacted LD 289, which requires the state to purchase the real estate of a commercial farm found to be contaminated by PFAS before January 1, 2023 at the assessed fair market value but at no less than $20,000 per acre, and provides that the fair market value assessment cannot take PFAS contamination into consideration. Two enacted bills in Rhode Island (SB 724 and HB 5861) amend current law to add that if PFAS in drinking water exceed the state’s interim standard of 20 ppt, the state and the public water supply will enter into an agreement that requires dates for submittal of water treatment plans that will reduce the PFAS levels to or below the interim level. As more information emerges about the health effects of PFAS, states will be sure to continue their work to combat, mitigate, and report on their presence in the environment. ASTHO will continue to monitor and report on all legislative and regulatory activity around this issue. Special Thanks-Blog - State and Federal Actions to Reduce PFAS Impact on Public Health website yes

In the current legislative cycle, there are several policy strategies that support the development and integration of community health workers into the public health workforce, including dedicated federal funding and state laws supporting workforce development programs, certification standards, and Medicaid coverage.

States have largely dismissed weakening policies, but legislatures are likely to continue considering vaccine-related bills, which may allow public health leaders to work collaboratively toward improving vaccination rates and bolster the positive impact vaccines have on population health.

A mid-session legislative update on five of ASTHO's top 10 public health state policy issues to watch in 2023: tobacco, HIV, mental health, PFAS, and opioids.

Accompanying an infusion of federal funding, states are considering several policy changes to strengthen the public health workforce and address challenges within the health care workforce.

As many state legislatures seek to expand vaccine exemptions, it’s important to understand the fundamental differences in exemption type and their impact on a community.

In an effort to help meet demand, some states and territories have joined interjurisdictional licensing compacts that allow a mental health care provider licensed in one state to provide care in another state—without needing to gain licensure in multiple states. These agreements also offer guidance on patient privacy for services rendered remotely or from out-of-state.

SepticSmart Week is an annual opportunity for health agencies at all jurisdictional levels to share educational resources about onsite wastewater treatment system upkeep. This post highlights efforts in North Carolina and Virginia to promote safe septic system practices.

This brief examines the ways states can support certification for community health workers.

PrEP is a powerful tool to reduce new HIV infections; expanding access to PrEP is a priority within the federal Ending the HIV Epidemic in the U.S. initiative. One way to increase access to PrEP is by allowing pharmacists to prescribe and dispense it.

In-depth analysis on state health policy surrounding the public health workforce. This is part of ASTHO's annual legislative prospectus series.

Policy Trends Shaping Behavioral Health in 2026 Policy Trends Shaping Behavioral Health in 2026 Learn about the policy trends shaping behavioral health in 2026, including improving access to naloxone, mobile crisis units, and more. Public health efforts remain focused on reducing mental health-related harms and preventing substance use disorder and overdose. In 2024, an estimated 23.4% of U.S. adults — about 61.5 million people or more than one in five — experienced a mental illness, underscoring the widespread and urgent nature of mental health challenges nationwide. After years of rising fatalities, the United States saw its first notable decline in overdose deaths in 2023, followed by a nearly 24% decrease in 2024, with approximately 87,000 deaths reported over a 12-month period. While this progress is promising, overdose is still a leading cause of death in the United States, underscoring the need for sustained prevention, treatment, and recovery efforts. To continue strengthening behavioral health systems and advancing overdose prevention, state and territorial legislatures are considering measures that promote mobile crisis units, support access to overdose prevention tools and treatment, and address the increased use of unregulated substances. Mobile Crisis Response Over the past decade, federal and state policy has emphasized community-based behavioral health crisis response. Building on early local models, the 2021 American Rescue Plan Act created a new Medicaid option for states to fund mobile crisis intervention services with a time-limited enhanced federal matching rate. States also integrated mobile crisis teams into broader crisis response systems aligned with the 988 Suicide and Crisis Lifeline. As implementation expands, state legislatures are considering measures to strengthen service coordination, sustain funding beyond the enhanced federal match period, and address workforce and capacity needs. During the 2025 legislative session, at least 13 states considered and six enacted measures related to behavioral health mobile crisis services. Rhode Island (HB 6118) will require insurance coverage for mobile response and stabilization services for children and adolescents under 18. In Washington, HB 1813 directs additional planning and coordination among service providers to promote access to crisis stabilization services for Medicaid enrollees. Leg Prospectus-2026 - SBH - SAMHSA CMS Naloxone Availability Naloxone is a life-saving medication that quickly reverses opioid overdoses. Approved for over-the-counter sale by FDA in 2023, its expanded availability has increased opportunities for timely intervention. To support access for people at risk for overdose, many states are advancing policies to make naloxone available in public settings — such as schools, libraries, and community centers — to empower bystanders to respond to and prevent overdose deaths. At least eight states have considered legislation to increase naloxone availability with a focus on youth. Colorado enacted SB 25-164 to advance youth overdose prevention, clarifying access to naloxone in school communal areas, like buses, and giving the state board of health authority to establish what entities can receive naloxone for distribution. Michigan is considering SB 404, which would require schools receiving naloxone from the health department to adopt policies regarding administration and explicitly limit liability of school employees administering naloxone. Montana enacted SB 503, which extends liability protections for those who administer expired opioid antagonists — like naloxone — including in schools. Leg Prospectus-2026 - SBH - MOUD Therapeutic Substances for Mental Health Diagnoses Psilocybin and ibogaine are naturally occurring psychoactive substances being studied for their potential to treat mental health and/or substance use disorders. As interest in their therapeutic applications grows, several states are considering legislation to expand access for clinical research and regulated therapeutic use. In 2025, more than two dozen states considered and seven states passed measures related to psilocybin. Arizona (SB 1555), Colorado (HB 25-1063), and Nebraska (LB 72) enacted laws that would allow psilocybin prescribing pending FDA approval, though this approval has not occurred. Iowa (HF 383) and Virginia (SB 1135) passed similar provisions but both governors vetoed the bills, citing the need to wait for FDA approval and DEA rescheduling before taking state-level action. At least 10 states considered legislation to study ibogaine or fund clinical trials exploring its potential to treat PTSD, depression, opioid use disorder, and related conditions. Washington considered SB 5204, which would support the study of ibogaine-assisted therapy for adults with opioid use disorder. And several states — including Nevada (AB 378), New York (S 4664), and Oregon (HB 3817) — considered legislation focused on supporting research and trials that improve the health of veterans and first responders. Finally, Texas enacted SB 2308 to establish a consortium focused on ibogaine research and trials to support FDA approval of the drug for treatment of various mental health and substance use disorders. Kratom Regulation Public health leaders are examining ways to reduce the potential misuse of unregulated substances, including kratom, a product derived from the leaves of a tropical tree that can act as both a stimulant and sedative, and that carries the risk of addiction and abuse. Kratom is not a scheduled drug under federal law, but the FDA has reiterated that there are no legally marketed drugs containing kratom and that it is not an appropriate dietary supplement or approved food additive. While FDA explores a scheduling action for 7-OH, a concentrated byproduct of kratom, a number of state legislatures are considering measures to regulate kratom products. At least 34 states considered and 11 states passed legislation regarding kratom in 2025, including Louisiana (SB 154) which criminalizes the possession and distribution of kratom. Another six states — Colorado (SB 25-072), Mississippi (HB 1077), Nebraska (LB 230), Rhode Island (SB 792), South Carolina (S 221), and South Dakota (HB 1056) — passed legislation restricting the sale of kratom to people under the age of 21 and establishing product labeling standards. Looking Ahead ASTHO anticipates states and territories to continue considering and adopting laws to prevent substance misuse and overdose and reduce mental health-related harms, including those that: Enhance support and capacity for behavioral health mobile crisis units and improve care coordination and entry across the behavioral health care continuum. Expand coverage for peer support specialists and establish baseline standards for peer support specialists in treatment and social support recovery services. Develop measures to study and decriminalize some psychoactive substances for potential mental health and substance use treatment. Develop innovative policies to link recently incarcerated persons to substance use disorder treatment. Improve access to medications for opioid use disorder by expanding telehealth availability, prohibiting prior authorization requirements, and ensuring comprehensive insurance coverage. Explore state regulatory frameworks for commercially available substances with the potential for misuse, including kratom and hemp-derived cannabinoids like Delta-8. OE22-2203 PHIG article yes

Policy Trends Shaping Healthy Food and Chronic Disease in 2026 Policy Trends Shaping Healthy Food & Chronic Disease in 2026 Learn about policy trends shaping healthy food and chronic disease in 2026, such as regulating ingredients and modifying SNAP. A growing focus on links between nutrition and public health outcomes is driving legislative efforts across the country, with states actively responding to rising rates and the cost of chronic disease. As state legislatures consider ways to combat chronic diseases, they are also implementing policies aimed at addressing the food environment by introducing and enacting bills that regulate ultra-processed foods (UPFs), adjust SNAP benefits, and improve access to healthy food. Regulating Food Ingredients and Ultra-Processed Foods While efforts to define and regulate UPFs are still in development at the federal level, several states have decided to move forward with legislation targeting the use of specific artificial dyes and chemical preservatives in food products. West Virginia enacted HB 2354, prohibiting the sale or manufacturing of any food containing a list of specified dyes and certain preservatives. Similarly, Vermont is considering H 260, and New York is considering companion bills S 1239/A 1556. These bills aim to ban the manufacture, sale, or distribution of food containing a core group of chemicals (e.g., potassium bromate, propylparaben, and Red 3). Meanwhile, North Carolina introduced HB 440, which would prohibit additional color additives and ban the sale of food products containing nine specific dyes and chemicals. Pennsylvania introduced HB 1134, which focused on warning labels and would require foods with dyes Blue 1, Blue 2, Green 3, Red 40, Yellow 5, or Yellow 6 to include a label that states, “This product contains synthetic colors, which may have an adverse effect on activity and attention in children.” Leg Prospectus-2026 - CD - CA Restricting Ingredients in School Meals While previous years have focused on access to school meals, a growing wave of recent state legislation aims to eliminate UPFs, synthetic dyes, and chemical preservatives from children's diets. Several states have enacted or advanced bans on specific chemical additives in school meals: Utah’s HB 402 and Virginia’s HB 1910 prohibit schools from offering food containing common food dyes (Blue 1, Blue 2, Green 3, Red 3, Red 40, Yellow 5, and Yellow 6) or certain preservatives like potassium bromate and propylparaben. Similarly, Texas enacted SB 314 prohibiting specific additives in free or reduced-price school meals and SB 25, which mandates warning labels and expands state nutrition curriculum. In addition, other jurisdictions have introduced but not passed numerous bills proposing similar restrictions including South Carolina's HB 4339, which would prohibit certain additives in school meals. Modifying SNAP SNAP is the nation's largest federal food assistance program, providing benefits to low-income households. While the program is federally funded and administered by USDA through its Food and Nutrition Service, individual state agencies operate and manage eligibility and distribution. Since SNAP is governed by federal law, states must obtain a USDA waiver to implement changes that deviate from the federal rules. Several states are exploring waivers to limit the use of SNAP funds for purchasing candy and sweetened beverages or soft drinks, with Arkansas (SB 217), Idaho (HB 109), and Texas (SB 379) having passed legislation. Arkansas's new law requires the Department of Human Services to request a waiver to exclude candy and soft drinks, and reapply annually if denied. This dual ban was also the subject of bills introduced in Wyoming (HB 323) and South Carolina (HB 4061). Indiana (HB 1486) considered broader restrictions on “accessory foods,” aiming to prohibit the use of SNAP benefits for items like chips, energy drinks, sweetened beverages, soft drinks, and prepared desserts while New Jersey (A 5697/S 4348) introduced a narrower set of proposed restrictions, focused on soft drinks (including soda and sugary/sweetened beverages). Expanding Detection and Coverage for Chronic Diseases In response to high chronic disease rates — including diabetes, cardiovascular disease, cancer, and respiratory illnesses — states are enacting and proposing legislation focused on treatment coverage, awareness, and prevention. Several states are directly addressing obesity and pre-diabetes by mandating insurance coverage. Colorado (SB 25-048) enacted legislation requiring large group health plans to cover treatment for obesity and pre-diabetes, including medical nutrition therapy and metabolic/bariatric surgery. In Nevada, AB 555 caps patient cost-sharing for a 30-day supply of insulin for people with state-regulated commercial health plans. To aid early detection of diabetes, New Hampshire (SB 102), Louisiana (SB 26), and Florida (SB 958) enacted new laws requiring the creation of informational materials on Type 1 diabetes risk factors, warning signs, and screening available to students and parents. To reduce financial barriers to necessary cancer screenings, several states have enacted bills to mandate insurance coverage and/or lower the cost of diagnostic breast exams and supplemental testing. Virginia (HB 1828), Florida (SB 158), and Oklahoma (HB 1389) have enacted bills to limit or lower the cost of such breast imaging. Meanwhile, Colorado enacted HB 25-296, clarifying that health insurers cover medically necessary diagnostic and supplemental breast imaging that goes beyond routine screening. Looking Ahead ASTHO expects state and territories to continue advancing legislative proposals that focus on the prevention of chronic diseases and access to healthy foods in 2026. Future legislative action may include: Establishing policies to address food insecurity and promote access to nutritional foods by targeting food deserts. Exploring policy and leadership options to discourage the consumption of high-sugar drinks. Developing and adopting standards for healthy food procurement policies for state agencies and public institutions to increase the demand for nutritious products. Continuing to enact insurance coverage mandates for comprehensive chronic disease screenings and treatment. OE22-2203 PHIG article yes

Learn about the importance of exploring intermediaries that work alongside existing data platforms in addressing ongoing public health challenges.