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250 AI Health Care Bills in 47 States

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A Surge of State AI Bills With Health Care Impact

State legislatures across the U.S. are moving aggressively to regulate artificial intelligence in health care — including how AI is used in clinical settings, payer reviews, patient communication tools, and mental-health technologies. With more than 250 AI-related health care bills introduced in at least 47 states through late 2025, this patchwork of state action is creating a regulatory landscape that behavioral health providers can’t ignore.

Because federal AI regulation has not yet materialized, states are stepping in to set their own rules. The breadth of these bills is wide, but several common themes are emerging:

  • Chatbot transparency and patient safety: States are proposing rules to ensure that AI-powered chatbots used in patient outreach or triage clearly disclose that they are automated tools and can reliably detect crises.
  • Insurer use of AI in coverage decisions: Legislators are reviewing bills that would require health insurers and managed care plans to be transparent about how they use AI in claims adjudication and utilization reviews, and to safeguard against unfair denials based solely on automated systems.
  • Bias prevention and high-risk AI oversight: Some proposals target “high-risk” AI systems; those that can make decisions about care eligibility and services, with anti-discrimination standards and accountability measures.
  • Notable Examples by State

    While the legislative landscape varies widely, several states illustrate how this trend is unfolding:

    Maryland, Arizona, Nebraska, and Texas have each enacted AI-related health care legislation that addresses how health plans and insurers use algorithmic tools, requiring protections such as:

  • Decisions based on a patient’s individual medical history and clinical context;
  • Assurance that AI does not replace clinician judgment;
  • Regular accuracy and reliability reviews; and
  • Prohibitions on using patient data beyond intended purposes.
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    In Colorado, the Colorado AI Act, evolving through bills like Senate Bill 205 and later Senate Bill 4, sets a framework for accountability and bias mitigation in AI systems that could affect health care decision-making and consumer protections.
    Wikipedia

    Other states are exploring similar content, often combining transparency requirements with consumer safeguards. Legislative trackers show this activity stretching across states such as Pennsylvania, Michigan, Wisconsin, and more.

    What This Means for Behavioral Health Providers

    Behavioral health organizations need to understand that these state AI bills are not abstract tech policy discussions — they have practical implications for how providers adopt and govern AI tools, including technologies used in:

  • Clinical documentation and assessment automation
  • Predictive risk modeling or crisis detection systems
  • Virtual behavioral health assistants and chatbots
  • Insurer AI systems used for authorization and claims adjudication
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    Inconsistent state standards could mean that an AI governance policy that complies in one jurisdiction may fall short in another. Providers operating multi-state systems will need cross-jurisdictional AI governance frameworks that ensure compliance with the most restrictive applicable rules.

    Why State Action Is Intensifying

    The surge in state AI legislation stems from a policy vacuum at the federal level. With no unified federal standard in place, lawmakers are acting to protect patients and prevent harms such as algorithmic bias, lack of transparency, and unmonitored clinical automation. Experts predict this momentum will continue even as federal proposals are debated.

    Behavioral health leaders should also be aware that states are monitoring risks beyond health care, such as generative AI transparency, deepfake content, and automated decision-making in insurance and employment; signaling broader regulatory expectations that could influence future health AI rules.

    What Behavioral Health Leaders Should Do Now

  • Inventory AI Tools and Uses: Know where and how AI is used in your clinical, administrative, and payer-related workflows.
  • Establish AI Governance Policies: Create or update governance frameworks that include transparency, auditability, bias mitigation, and human oversight.
  • Monitor State Legislative Activity: Track bills in states where you operate and plan for compliance requirements early.
  • Engage Legal and Compliance Teams: Ensure that compliance and legal leadership are integrated into AI procurement and deployment decisions.
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    State-level AI regulation in health care is no longer emerging, it’s here. For behavioral health systems, clinicians, and compliance leaders alike, staying ahead of these rules is essential to responsibly adopt AI technologies that support care delivery while protecting patients and organizational risk.

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