State Efforts

State Efforts

States have long led the way when it comes to addressing surprise medical bills. Currently, just over half of states have adopted laws to prohibit or limit surprise medical bills.

While most states have taken steps to protect patients, gaps remain. Some states do not protect patients at all and not all state laws are comprehensive. At the same time, states alone cannot protect everyone, and federal protections are critical. Learn more about these issues and federal efforts to address surprise medical bills here.

Commonwealth Fund legislation tracking map

See where your state falls. To date, 28 states have some protections in place to protect patients from surprise medical bills. But these state laws vary dramatically. Some states have comprehensive protections while others have far more limited protections. CHIR created an interactive map for The Commonwealth Fund. Click here to learn more about how your state addresses surprise medical bills.


The latest on state legislation. States continue to lead when it comes to protecting patients from surprise medical bills. In 2019 alone, 5 states have passed new legislation or updated their existing legislation to better protect patients. Read our analysis of these new laws and the latest trends in surprise medical bill legislation for The Commonwealth Fund.

Library books

Information you need. Want to learn more about how to advance protections in your state? We can help. We have compiled all the latest resources that you will need to get started from organizations such as the National Governors Association, Families USA, The Commonwealth Fund, and the Robert Wood Johnson Foundation. Take a look at our resources for state leaders.

Meeting at a table

Considerations for policymakers. Not all state laws are created equal when it comes to protecting patients from surprise medical bills. State laws can vary in significant ways by, for instance, only applying to emergency situations or to certain types of health insurance plans. As a result, some states go much further than others in protecting patients from surprise medical bills. Check out these key issues that state policymakers should consider when developing surprise medical bill laws.


Support for state policymakers. Our experts are here to help state policymakers understand and address surprise medical bills. We work closely with state leaders to provide legal and policy technical assistance and help identify solutions that meet each state’s unique needs.  Learn more about how we can help support your policy goals.