MEMO: As the Trump administration pulls back on affordable healthcare protections and research funding, and fires the federal employees responsible for responding to outbreaks of bird flu and measles, state lawmakers are advancing policies to protect their constituents and make lifesaving healthcare more affordable.
From medical debt forgiveness to maternal health expansion and food safety, here’s how legislative leaders in key states are filling the gap and showing what public health leadership looks like in practice.
PENNSYLVANIA: Codifying ACA Protections and Combatting Bird Flu
Led by Speaker Joanna McClinton, Pennsylvania House Democrats are prioritizing policies to codify key Affordable Care Act provisions into state law, including:
- Allowing young adults to stay on their parents’ insurance until 26
- Protecting coverage for people with pre-existing conditions
- Preserving access to preventive care
These bills have passed out of the House and are currently in Senate committees in a closely divided legislature.
Separately, the state enacted a bird flu workforce expansion policy led by Rep. Johanny Cepeda-Freytiz, enabling more professionals to test and quarantine birds, helping stabilize egg supply and prevent further outbreaks — a crucial move as the FDA cuts staff in this area in response to Trump’s directives.
MINNESOTA: Retiring Medical Debt
Under Senate Majority Leader Erin Murphy’s leadership, Minnesota is working to retire medical debt. This policy is moving forward and is currently in committee. TSP’s work helped Democrats win a majority in the Senate, however, lawmakers are in a power-sharing agreement with the rightwing in the 67-67 MN House following the 2024 elections. During that cycle, Vice President Harris won MN by fewer than 150,000 votes, and if just 80 votes had changed in one seat in Minnesota’s House, Democrats would have retained their majority.
ARIZONA: Reducing Prescription Drug Prices
Arizona Democrats, led by House Minority Leader Oscar De Los Santos and Senate Minority Leader Priya Sundareshan, recently launched the Affordability Agenda, a policy package that:
- Caps prescription drug price increases
- Bars Medicare-eligible patients from being charged the max fair price
- Creates a program to help residents appeal denied insurance claims
These bills face steep hurdles in GOP-controlled committees. In 2024, TSP helped keep the balance of power close in Arizona, even as the state saw the biggest swing toward Trump of any swing state. It remains to be seen if this policy will receive bipartisan support.
MICHIGAN: Expanding Maternal Healthcare + Bird Flu Testing
Senate Democrats under Leader Winnie Brinks are advocating for Michigan families by advancing maternal health policies sponsored by lawmakers including Senator Sarah Anthony that includes:
- Ensuring nondiscrimination policies cover pregnancy and lactation status
- Expanding Medicaid coverage pre- and post-pregnancy
- Reducing bias in maternal healthcare
Lawmakers also introduced a bird flu testing package, sponsored by Rep. Carrie Rheingans, which would expand surveillance and preparedness across hospitals, farms, and backyard flocks.
Several of these policies have already passed out of the Senate with bipartisan support. TSP knew defending Michigan’s State House majority in 2024 would be difficult, as every seat needed to be defended to hold the one-seat majority in the House. With incumbent losses, the balance of power is now 52-58 — the same chamber composition following Biden’s win in 2020, even as Trump won the state in 2024.
NEW HAMPSHIRE: Expanding Maternal Healthcare
As the Trump administration frets over a declining birthrate, Senate Minority Leader Rebecca Perkins Kwoka of New Hampshire is doing what she can to help mothers — and those who want to be mothers — by leading a bipartisan maternal health effort to:
- Expand depression screening for postpartum moms
- Increase access to home visitation programs
- Fund training for rural healthcare services and healthcare professionals
The policy is moving through the Senate, and has a chance of passing in part thanks to TSP’s work in New Hampshire, where we focused on elevating and professionalizing campaigns in a state where the sheer number of races can be an obstacle. Only 20 seats were lost across New Hampshire’s 400 House districts, along with two in the Senate. Despite losses in both chambers, our investments powered huge strides in seeding a more effective campaign operation in New Hampshire.
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About The States Project
The States Project connects the importance of state legislatures to every aspect of our lives and brings together communities to help build a healthy, sustainable, and prosperous future for all. Our electoral work focuses on winning governing majorities in the states by making state legislative campaigns more effective and better funded. We do it because we believe that state legislatures are the strongest force for change in this country.
