Health Costs, Coverage and Delivery State Legislation


States continue to evaluate strategies that address health care costs, enhance access and improve health system efficiencies. Through this interactive database, NCSL provides up-to-date information on enacted state legislation related to health costs, coverage and delivery. Topics in the database include but are not limited to:

  • Alternative payment models
  • Health insurance marketplaces
  • Health system consolidation and competition
  • Medicaid reforms
  • Price transparency
  • Surprise billing
  • Telehealth

Database Notes

Click on the graphic below to access the interactive PowerBI database. Users can filter legislation by year, state, topic or keyword. New legislation is added biweekly by NCSL staff. This database only includes enacted legislation.

For legislation before 2022, please see Health Innovations State Law Archive Database | 2015-2021.

Click to View Power BI Application




Topic Explanation

Market—Consolidation and Competition

State legislation related to health system consolidation and oversight, provider-insurer contract provisions, Certificate of Need, Certificate of Public Advantage and other competition-focused topic areas.

Market—Federal Health Reforms

State legislation related to the Affordable Care Act consumer protections, essential health benefits and other federal health reform efforts.

Market—Free Market and Alternatives

State legislation related to association health plans, short-term limited duration health insurance, health care sharing ministries, direct primary care and other alternative coverage options.

Market—Health Insurance Marketplaces

State legislation related to state public options, Section 1332 waivers, reinsurance, premium and cost-sharing subsidies, state-based marketplaces, marketplace outreach and enrollment, and other health insurance marketplace topics.

Market—Health Insurance Coverage and Networks

State legislation related to network adequacy, health insurance mandates and mental health parity requirements.

Market—Payment and Delivery Reform

State legislation related to value-based payment arrangements, global budgeting, reference pricing, accountable care organizations, purchasing alliances, rural emergency hospital licensure and other payment and delivery reforms.

Market—Price Transparency and Cost Containment

State legislation related to all-payer claims databases (APCDs), price comparison tools, right-to-shop programs, provider/insurer transparency requirements (e.g., cost estimates to patients), cost growth benchmarks, cost containment task forces or offices, and other cost containment initiatives.

Market—Surprise Billing and Medical Debt

State legislation related to state surprise billing protections, the No Surprises Act, medical debt collection practices, hospital financial assistance policies and other related topics.


State legislation broadly related to health care costs, coverage and delivery not captured in other tags.

Medicaid—Eligibility and Benefits

State legislation related to Medicaid eligibility expansion or modifications, benefit expansion or modifications, newly eligible groups and newly covered Medicaid benefits.

Medicaid—Payment and Delivery Reforms

State legislation related to Medicaid value-based payment arrangements, alternative payment models, managed care models, provider taxes and fees, and other Medicaid payment and delivery reforms.


State legislation related to newly authorized provider types, scope of practice changes and other Medicaid provider topics.


State legislation broadly related to other Medicaid topics not captured in other tags.

State-Run Programs

State legislation related to state employee health plans and medical assistance for undocumented individuals.


State legislation related to Medicaid coverage for telehealth, including eligible services, eligible providers, Medicaid payment parity and other Medicaid actions.

Telehealth—Private Insurance

State legislation related to private insurance coverage for telehealth, including payment parity, coverage parity and other telehealth private insurance actions.


State legislation related to interstate licensure compacts, telehealth-specific licenses, patient-provider relationship requirements, teleprescribing, authorized providers, originating and distant site requirements and other related telehealth actions.


State legislation related to telehealth not captured in other tags (e.g., broadband).

Additional Resources

Policy Reports, Publications and Toolkits

Other NCSL Databases and Resources

This database is supported by The Commonwealth Fund, a national, private foundation based in New York City that supports independent research on health care issues and makes grants to improve health care practice and policy.