Menopause coverage bills meet mixed fates in state legislatures; Colorado bill would have required plans to provide coverage for hormone replacement therapy

A handful of states are considering legislation this session related to menopause and perimenopause, including proposals to mandate coverage and others to include work protections for people experiencing symptoms related to the conditions. Others have already said no to similar bills.

Menopause typically occurs between the ages of 45 and 55, according to the National Institute on Aging, with an average age of 52. The hormonal changes associated with menopause — when a woman stops having menstrual periods — can cause hot flashes, night sweats, joint problems, insomnia, mood changes and more. For several years leading up to menopause, women may also experience symptoms classified as perimenopause, when menstrual cycles become more irregular and hormones fluctuate, leading to some symptoms that mimic menopause.

Bills are pending in Massachusetts, New York, Pennsylvania and Virginia, while others have already failed. One bill, already passed in New Jersey, mandates coverage for the diagnosis and treatment of menopause-related health issues, which includes treatment for brittle bones, pelvic floor physical therapy, hormonal therapies and behavioral health care services. It's now law, after Democratic Gov. Phil Murphy signed it before leaving office in January.

N.J. Assemblyman Roy Freiman, a Democrat, told States Newsroom the main sponsor of the bill was his Democratic colleague, Assemblywoman Heather Simmons, but he supported its passage and co-sponsored it.

"There's things we (men) will never experience, and we don't know, and we have to be supportive," Freiman said.

The fiscal impact of the bill was unclear based on the state office analysis, but Freiman said it's not just about the up-front costs. Factors like quality of life, life longevity, and lost productivity from work are harder to measure, including the long-term complications that can come with certain conditions.

According to a Mayo Clinic study published in 2023, menopause-related symptoms cost an estimated $1.8 billion in lost work time each year, and the medical expenses cost more than $26 billion per year.

"You can extrapolate someone feeling better to economics, if you really just want to think about it from a spreadsheet perspective," he said.

Four other states mandate insurance coverage for menopause treatments — Illinois, Louisiana, Oregon and Washington. California has authorized providers to be professionally licensed for menopause education, but Democratic Gov. Gavin Newsom has vetoed two bills that would have required health insurance plans to cover diagnosis and treatment costs, saying it would increase health care costs. Newsom did include expansion of perimenopause, menopause and postmenopausal health care as part of his budget proposal for the 2026-27 fiscal year after criticism of the vetoes, including from actress Halle Berry.

Maine passed a bill in 2025 directing the state health department to create informational materials on the issue, providing $40,000 through 2027 for the effort. Still other states, including those with Democratic majorities, aren't ready to make the change just yet.

Colorado

House Bill 26: Would have required all health benefit plans in the state and the Medicaid program to provide coverage for hormone replacement therapy as directed by licensed physicians for women experiencing menopause or perimenopause.

Status: Failed after House Committee on Health & Human Services postponed it indefinitely on Feb. 24

Sponsor: Republican Rep. Rebecca Keltie

Florida

House Bill 161: This bill, along with an identical version in the Senate, would have required the Florida Department of Health to establish a perimenopause and menopause policy workgroup to develop communications strategies for a public education effort.

Status: Failed in Health Professions & Programs Subcommittee on March 13

Sponsor: Democratic Rep. Yvonne Hayes Hinson

Georgia

House Bill 988: This Republican-sponsored bill would require the state employee health insurance plan to cover hormone replacement therapy for biological women experiencing menopause and perimenopause.

Status: Awaiting a vote from the Georgia House of Representatives since January

Sponsors: Republican Reps. Beth Camp, Jan Jones, Leesa Hagan, Bethany Ballard, Kimberly New and Carmen Rice

Michigan

House Bill 4791: A bipartisan bill that requires the state health department to adopt and implement a menopause transition awareness education program, including symptoms, the range of treatment options that may be prescribed by a professional, and any other information considered appropriate for an education program.

Status: Passed the House on March 10, pending in the Senate Committee on Health Policy

Sponsors: Democratic Rep. Samantha Steckloff and Republican Reps. Joseph Pavlov, Jamie Thompson, Douglas Wozniak, Kathy Schmaltz and William Bruck

Missouri

Senate Bill 1569: This bill would require health benefit plans to cover the treatment of menopause before, during and after, including hormone therapy, depression medications, drugs to prevent and treat osteoporosis and topical hormone therapy.

Status: Pending in the Senate Insurance and Banking Committee as of Feb. 5

Sponsor: Democratic Sen. Patty Lewis

Ohio

House Bill 767: Two Democrats, Reps. Ashley Bryant Bailey and Anita Somani, introduced this bill to require insurance and Medicaid coverage of the diagnosis and treatment of menopause, perimenopause and its associated symptoms. Bryant Bailey said the average cost of hormone therapy treatments can range between $500 to $1,000, and without mandated coverage many menopause treatments are considered elective or cosmetic, Ohio Capital Journal reported.

Status: Pending in House Insurance Committee

Sponsors: Democratic Reps. Ashley Bryant Bailey and Anita Somani

Rhode Island

Senate Bill 2890: This bill would mandate health insurance coverage for hormonal and non-hormonal therapy to treat menopausal symptoms as recommended by a qualified health care provider. This bill includes menopause when it is induced by a hysterectomy, when the uterus is surgically removed for medical reasons.

Status: Pending after being held in committee for further study on April 9

Sponsors: Democratic Sens. Lori Urso, Melissa Murray, Linda Ujifusa, Lammis Vargas, Pamela Lauria, Bridged Valverde and Peter Appollonio, and Republican Sen. Gordon Rogers

Virginia

Senate Bill 258: In its original form, this bill prohibited discrimination under the Virginia Human Rights Act on the basis of menopause and perimenopause. On April 13, Democratic Gov. Abigail Spanberger proposed a substitute bill that would instead direct the Commissioner of Labor and Industry to conduct a study on menopause and perimenopause in the workforce.

Status: Spanberger's substitute proposal passed the Senate on Wednesday, April 22, and awaits approval by the House

Sponsors: Democratic Sens. Stella Pekarsky and Angelia Williams Graves