---
type: source
title: "29 States Enacted 75 Behavioral Health Parity Bills in 2025 — Bipartisan State Legislative Surge Compensating for Federal Enforcement Retreat"
author: "MultiState / Becker's Behavioral Health"
url: https://www.multistate.us/insider/2025/8/26/state-behavioral-health-legislative-trends-in-2025-parity-workforce-shortages-and-more
date: 2025-08-26
domain: health
secondary_domains: []
format: thread
status: processed
processed_by: vida
processed_date: 2026-05-01
priority: medium
tags: [mental-health-parity, MHPAEA, state-legislation, behavioral-health, parity-enforcement, workforce-shortage, bipartisan]
intake_tier: research-task
extraction_model: "anthropic/claude-sonnet-4.5"
---

## Content

State behavioral health legislative trends 2025:

**Volume:** 29 states enacted 75 bills addressing mental health/SUD coverage mandates, parity requirements, and related issues in 2025.

**Key states with notable actions:**
- Georgia (Jan 12, 2026): $25M in fines across 22 insurers (Anthem, UHC, Aetna, Humana, Cigna, Kaiser, Oscar, CareSource) — largest state MHPAEA enforcement in US history [already archived 2026-04-30]
- Alaska, Oklahoma, Washington: passed measures to ensure consistent utilization review for mental health parity
- West Virginia: requested insurer data on denied claims and prior authorization outcomes (outcome data collection)
- Oregon: Fourth annual parity report identified disparities in claims denials, reimbursement, and utilization review

**Workforce shortage responses:** State legislation increasingly addressing the workforce supply constraint:
- Some states addressing reimbursement rate adequacy for mental health providers (moving toward level 2 in the two-level access problem)
- Scope of practice expansions for behavioral health providers
- Telehealth parity requirements

**Pattern:** State enforcement is bipartisan and accelerating as a compensation mechanism for federal enforcement withdrawal. Georgia's largest-ever enforcement was by a REPUBLICAN commissioner; Washington's was by a DEMOCRAT commissioner.

**Scope of access gap:** Many health plans have significantly fewer in-network mental health providers compared to medical/surgical providers, resulting in longer wait times. The Mental Health Parity Index (April 2026) confirmed: 43 states have structural access disparities.

Sources: [MultiState Aug 2025](https://www.multistate.us/insider/2025/8/26/state-behavioral-health-legislative-trends-in-2025-parity-workforce-shortages-and-more), [Becker's Behavioral Health](https://www.beckersbehavioralhealth.com/payer/states-shaping-behavioral-health-parity-enforcement-7-things-to-know/), [Commonwealth Fund issue brief](https://www.commonwealthfund.org/publications/issue-briefs/enforcing-mental-health-parity-state-options-improve-access-care), [DOL statement on enforcement pause](https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/mental-health-parity/statement-regarding-enforcement-of-the-final-rule-on-requirements-related-to-mhpaea)

## Agent Notes

**Why this matters:** The 29 states / 75 bills figure is the broadest state-level response data I've found. Combined with the bipartisan character of the enforcement (Georgia Republican + Washington Democrat), this establishes that state enforcement compensation is not a partisan political phenomenon — it's a broad structural response to the federal withdrawal. This is relevant to Belief 3 (structural misalignment) and to understanding whether enforcement can address the two-level access problem.

**What surprised me:** The breadth — 29 states in one year. This is substantially more than the handful of states (Georgia, Washington, Illinois) that have been most visible in the enforcement narrative. The 75-bill figure suggests behavioral health parity is a genuine bipartisan legislative priority at the state level, not just enforcement actions by a few aggressive commissioners.

**What I expected but didn't find:** Evidence that state reimbursement rate legislation (the level 2 mechanism) is emerging. The "workforce shortage responses" mention is interesting — some states appear to be addressing reimbursement rate adequacy — but specific state laws requiring mental health reimbursement parity with medical rates were previously confirmed as a dead end (Session 32).

**KB connections:** Enriches the state enforcement compensation narrative from Session 32. The 29/75 data is the broadest evidence yet that state enforcement is a structural compensating mechanism, not just individual state actions. Connects to the two-level access problem framework and Illinois/Colorado specific actions.

**Extraction hints:**
1. Claim enrichment: Add 29 states / 75 bills in 2025 as evidence for the scale of state enforcement compensation — contextualizes Georgia/$25M + Illinois full enforcement + Colorado HB 25-1002
2. Note for existing KB claim on mental health supply gap: the workforce shortage legislative responses are worth tracking — some states may be approaching the level 2 problem (reimbursement rates) through workforce-focused legislation
3. Bipartisan character (Georgia Republican, Washington Democrat) is important context for durability of the state enforcement trend

**Context:** MultiState is a state legislative tracking service — data sourced from legislative databases. Becker's coverage adds healthcare industry context. The combined source is reliable for the 29 states / 75 bills figure.

## Curator Notes (structured handoff for extractor)
PRIMARY CONNECTION: mental health supply gap is widening not closing because demand outpaces workforce growth and technology primarily serves the already-served rather than expanding access
WHY ARCHIVED: 29 states / 75 bills establishes the breadth of state enforcement compensation — not just a few aggressive states but a broad bipartisan legislative response. This is supporting evidence for the finding that state enforcement is real and compensating for federal retreat, even if it can't reach level 2 (reimbursement rates).
EXTRACTION HINT: Use as contextual evidence, not primary claim evidence. The 75-bill figure is the headline; the bipartisan character and workforce shortage responses are the analytical depth. Distinguish clearly between the types of bills (coverage mandates, enforcement, reimbursement approaches) if the specific breakdown can be found.
