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Vote Smart provides easy access to congressional and state voting records and maintains a collection of key votes grouped by issue. Vote Smart uses the following criteria to select key votes:

  1. The vote should be helpful in portraying how a member stands on a particular issue
  2. The vote should be clear for any person to understand
  3. The vote has received media attention
  4. The vote was passed or defeated by a very close margin
  5. Occasionally, if a specific bill is consistently inquired about on the Voter's Research Hotline, the vote will be added

Vote Smart provides a summary of the version of the bill text associated with each selected key vote. Our summaries are written by Vote Smart's staff and interns, who adhere to our strict policies and procedures in order to guarantee absolute impartiality and accuracy. They do not necessarily reflect the content of the final version of the bill, but rather the version voted on in that stage. While many procedural votes take place before a full chamber vote, our voting stages reflect the final reading of each chamber vote. Each key vote selection is reviewed by the project's community of advisors, who are political scientists and journalists from all fifty states.

For more information about the legislative process, see here.

results per page:
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Date State Bill No. Title Outcome
Oct. 14, 2025 WI SB 264 Requires Health Insurance Policies to Provide Coverage for Diagnostic Breast Examinations Bill Passed - Senate (32 - 1)
Sept. 22, 2025 NC HB 562 Appropriates Funding for Medicaid Insurance to Avoid Threatened Payment Reductions to a Broad Range of Healthcare Providers Bill Passed - Senate (47 - 0)
Sept. 11, 2025 CA SB 418 Prohibits Discrimination in Health Insurance Enrollment Concurrence Vote Passed - Senate (29 - 10)
Sept. 9, 2025 CA SB 306 Prohibits Insurers from Requiring Prior Authorization for Services Concurrence Vote Passed - Senate (40 - 0)
Sept. 9, 2025 CA SB 40 Prohibits Health Care Service Plans or Health Insurance Policies from Imposing Copays of Over $35 for a 30-Day Supply of Insulin Concurrence Vote Passed - Senate (40 - 0)
July 10, 2025 CA AB 951 Prohibits Health Care Plans From Requiring Re-diagnosis for Continued Coverage of Behavioral Health Conditions Bill Passed - Senate (37 - 0)
June 25, 2025 OR HB 3064 Requires All Health Insurance Plans to Cover the Treatment of Perimenopause, Menopause, and Postmenopause Bill Passed - Senate (27 - 0)
June 23, 2025 CA AB 1297 Prohibits Both Parties in a Divorce from Allowing an Insurance Plan to Lapse for Nonpayment of Premiums or for Failing to Renew Insurance Bill Passed - Senate (37 - 0)
June 23, 2025 OR SB 296 Requires the Department of Human Services to Measure and Streamline the Approval Process for Long-Term Care Services Provided Through Medicaid Bill Passed - Senate (29 - 0)
June 23, 2025 OR SB 692 Requires Health Insurance Plans That Cover Pregnancy and Childbirth Expenses to Cover Doula Services Bill Passed - Senate (26 - 3)
June 17, 2025 ME LD 93 Expands the Universal Childhood Immunization Program to Cover Vaccines for Adults "Ought to Pass as Amended" Report Adopted - Senate (20 - 13)
June 10, 2025 LA SB 231 Reduces the Monetary Amount Plaintiffs Can Recover for Medical Expenses In An Auto Accident Lawsuit Concurrence Vote Passed - Senate (30 - 6)
June 9, 2025 MN HF 1 Repeals MinnesotaCare Eligibility for Undocumented Immigrants Age 18 or Older Bill Passed - Senate (48 - 16)
June 8, 2025 LA HB 496 Establishes Protections for Policyholders Against Any Rate Increases Tied to a Lapse in Auto Coverage Bill Passed - Senate (34 - 3)
June 2, 2025 NV AB 463 Requires Health Insurers and Medicaid to Respond Quickly to Prior Authorization Requests Bill Passed - Senate (20 - 0)
June 1, 2025 TX SB 268 Amends the Procedure for Certain Complaints Against Healthcare Practitioners Conference Report Adopted - Senate (19 - 12)
May 30, 2025 NE LB 275 Requires the Nebraska Department of Health and Human Services to Screen State Wards for Social Security Benefit Eligibility Bill Passed - Senate (29 - 19)
May 29, 2025 OK HB 1389 Requires Mammograms and Other Breast Cancer Screenings to Be Covered by Health Insurance Veto Override Passed - Senate (42 - 2)
May 29, 2025 NV AB 555 Establishes Price Cap Provisions on Insulin Bill Passed - Senate (18 - 2)
May 28, 2025 CA SB 418 Prohibits Discrimination in Health Insurance Enrollment Bill Passed - Senate (28 - 10)
May 25, 2025 TX HB 18 Establishes Certain Programs and Services Providing Health Care Services to Rural Counties Bill Passed - Senate (26 - 5)
May 21, 2025 LA HB 434 Limits Bodily Injury Claims by Plaintiffs Who Did Not Carry Auto Insurance At The Time Of The Accident Bill Passed - Senate (28 - 9)
May 21, 2025 LA HB 450 Repeals the Housley Presumption that says Courts Should Assume a Plaintiff's Injuries Resulted from the Accident in Question Bill Passed - Senate (28 - 9)
May 21, 2025 LA SB 231 Reduces the Monetary Amount Plaintiffs Can Recover for Medical Expenses In An Auto Accident Lawsuit Bill Passed - Senate (27 - 8)
May 20, 2025 OK SB 889 Requires Oklahoma Hospitals to Make Public Standard Treatment Costs Concurrence Vote Passed - Senate (35 - 8)
May 14, 2025 IA HF 1049 Increases Medicaid Beneficiaries' Monthly Personal Needs Allowance from $50 to $55 Each Month Bill Passed - Senate (31 - 15)
May 13, 2025 IA SF 615 Extends and Expands Medicaid Work Requirements Concurrence Vote Passed - Senate (33 - 13)
May 6, 2025 CO SB 25-048 Requires Large-Group Health Insurance Plans in Colorado to Offer Consumers Plans that Cover Glucagon-like Peptide-1 medications, Known as GLP-1 Drugs, to Treat Obesity and Pre-Diabetes Concurrence Vote Passed - Senate (25 - 10)
May 6, 2025 CO HB 25-1309 Defines "Gender-Affirming Care" Into State Statute and Prohibits Health Insurance Providers from Denying or Limiting Such Care Bill Passed - Senate (23 - 12)
May 1, 2025 ND SB 2160 Amends the State's Insurance to a Plan that Offers Benefits to be Compliant with the Federal Affordable Care Act Veto Override Failed - Senate (31 - 15)
April 30, 2025 NC SB 405 Increases Funding to the Department of Health and Human Services for Medicaid Bill Passed - Senate (35 - 11)
April 28, 2025 IA SF 383 Establishes New Standards for Pharmacy Benefit Managers Bill Passed - Senate (36 - 14)
April 24, 2025 IN SB 140 Requires PBMs to Provide Adequate Coverage Networks, Prohibits Them From Steering Business to Their Own Affiliated Pharmacies, and Requires PBMs to Reimburse Independent Pharmacies at Cost, Plus a Dispensing Fee Conference Report Adopted - Senate (39 - 10)
April 24, 2025 TX SB 1257 Requires Health Benefit Plans That Provide Coverage for Gender Transition Procedures to Additionally Cover All Possible Adverse Consequences of the Procedure, Follow-Up Testing, and Any Procedures to Reverse the Procedure Bill Passed - Senate (20 - 11)
April 24, 2025 NE LB 275 Requires the Nebraska Department of Health and Human Services to Screen State Wards for Social Security Benefit Eligibility Bill Passed - Senate (34 - 0)
April 23, 2025 IA HF 933 Establishes Pediatric Hospice Centers Bill Passed - Senate (47 - 0)
April 22, 2025 NV SB 128 Prohibits Health Insurers from Using or Relying on Artificial Intelligence to Deny a Request for Prior Authorization Bill Passed - Senate (16 - 5)
April 22, 2025 WI SB 23 Extends Postpartum Healthcare for One Year After Giving Birth for Individuals Who are Medicaid Eligible Bill Passed - Senate (32 - 1)
April 21, 2025 ND SB 2160 Amends the State's Insurance to a Plan that Offers Benefits to be Compliant with the Federal Affordable Care Act Concurrence Vote Passed - Senate (39 - 8)
April 17, 2025 IN SB 2 Establishes State Medicaid Restrictions Concurrence Vote Passed - Senate (37 - 10)
April 17, 2025 MI SB 32 Requires Certain Reviews of Insurance Policies Related to Perinatal Care to Be Provided to the Department of Insurance and Financial Services Bill Passed - Senate (36 - 0)
April 17, 2025 MI SB 37 Amends Provisions Related to Insurance Companies that Cover Gynecological and Pregnancy Services Bill Passed - Senate (27 - 9)
April 16, 2025 AZ HB 2693 Authorizes Insurance Companies and the Arizona Health Care Cost Containment System (AHCCCS) to Limit Coverage for Genetic Sequencing Bill Passed - Senate (16 - 14)
April 9, 2025 AZ HB 2449 Establishes New Enrollment Verification Requirements and Presumptive Eligibility Determinations for Arizona Health Care Cost Containment System (AHCCCS) Bill Passed - Senate (17 - 13)
April 9, 2025 AZ HB 2076 Amends Statutes Related to Life Insurance Policies to Redefine the Term "Illustration" Bill Passed - Senate (28 - 2)
April 4, 2025 WA HB 1114 Authorizes Licensed Respiratory Care Practitioners to Practice in Any of the States Within the Compact Bill Passed - Senate (49 - 0)
April 3, 2025 AR SB 444 Amends the Medical Ethics and Diversity Act Bill Passed - Senate (28 - 5)
April 2, 2025 OH SB 100 Exempts Nonprofit Agricultural Membership Organizations From Insurance Regulations Bill Passed - Senate (32 - 0)
March 27, 2025 MO SB 79 Exempts Certain Health Insurance Plans From Federal Protections Bill Passed - Senate (24 - 6)
March 26, 2025 CO SB 25-071 Prohibits Pharmaceutical Companies from Restricting Hospitals' Use of the Federal 340B Prescription Drug Discount Program Bill Passed - Senate (30 - 4)
March 25, 2025 ND HB 1114 Limits Out-of-Pocket Costs for a Monthly Supply of Insulin to $25 Bill Passed - Senate (39 - 7)
March 25, 2025 IA SF 615 Extends and Expands Medicaid Work Requirements Bill Passed - Senate (33 - 15)
March 21, 2025 NM HB 78 Prohibits Discrimination Against 340B Entities Bill Passed - Senate (26 - 14)
March 20, 2025 NH SB 134 Establishes Medicaid Work Requirements "Ought to Pass" Report Adopted - Senate (15 - 8)
March 15, 2025 NM SB 120 Prohibits Group Health Coverage that Offers Coverage of Behavioral Health Services from Imposing Cost Sharing on those Behavioral Health Services in Network Bill Passed - Senate (19 - 14)
March 10, 2025 ID H 59 Authorizes Medical Practitioners to Refuse Services and Procedures they Don't Morally Agree With Bill Passed - Senate (28 - 6)
March 8, 2025 NM SB 39 Prohibits Prior Authorization or Step Therapy Bill Passed - Senate (34 - 0)
March 7, 2025 WA SB 5041 Establishes Unemployment Insurance for Workers on Strike Bill Passed - Senate (28 - 21)
Feb. 26, 2025 CO HB 25-1002 Requires Health Insurance Companies Cover Behavioral Health, Mental Health and Substance Use Disorder Treatment Bill Passed - Senate (32 - 1)
Feb. 25, 2025 NM SB 92 Establishes the Horse Racing Integrity and Safety Authority and Jockey and Exercise Rider Insurance Fund Bill Passed - Senate (36 - 1)
Feb. 19, 2025 MT SB 244 Requires Insurance Coverage for Standardized, Evidence-Based Behavioral and Mental Health Screenings and Assessments Bill Passed - Senate (40 - 8)
Feb. 18, 2025 IN SB 2 Establishes State Medicaid Restrictions Bill Passed - Senate (40 - 9)
Feb. 12, 2025 NC SB 24 Requires Any New Benefits Mandated by State Law to Also Apply to the State Health Plan Bill Passed - Senate (30 - 15)
Feb. 11, 2025 GA SB 39 Prohibits State Employees From Receiving Gender Affirming Health Care Services (32 - 18)
Jan. 21, 2025 NY S 929 Establishes the Health Information Privacy Act Bill Passed - Senate (49 - 10)
Date No. Title Outcome
10/14 SB 264 Requires Health Insurance Policies to Provide Coverage for Diagnostic Breast Examinations Bill Passed - Senate (32 - 1)
9/22 HB 562 Appropriates Funding for Medicaid Insurance to Avoid Threatened Payment Reductions to a Broad Range of Healthcare Providers Bill Passed - Senate (47 - 0)
9/11 SB 418 Prohibits Discrimination in Health Insurance Enrollment Concurrence Vote Passed - Senate (29 - 10)
9/09 SB 306 Prohibits Insurers from Requiring Prior Authorization for Services Concurrence Vote Passed - Senate (40 - 0)
9/09 SB 40 Prohibits Health Care Service Plans or Health Insurance Policies from Imposing Copays of Over $35 for a 30-Day Supply of Insulin Concurrence Vote Passed - Senate (40 - 0)
7/10 AB 951 Prohibits Health Care Plans From Requiring Re-diagnosis for Continued Coverage of Behavioral Health Conditions Bill Passed - Senate (37 - 0)
6/25 HB 3064 Requires All Health Insurance Plans to Cover the Treatment of Perimenopause, Menopause, and Postmenopause Bill Passed - Senate (27 - 0)
6/23 AB 1297 Prohibits Both Parties in a Divorce from Allowing an Insurance Plan to Lapse for Nonpayment of Premiums or for Failing to Renew Insurance Bill Passed - Senate (37 - 0)
6/23 SB 296 Requires the Department of Human Services to Measure and Streamline the Approval Process for Long-Term Care Services Provided Through Medicaid Bill Passed - Senate (29 - 0)
6/23 SB 692 Requires Health Insurance Plans That Cover Pregnancy and Childbirth Expenses to Cover Doula Services Bill Passed - Senate (26 - 3)
6/17 LD 93 Expands the Universal Childhood Immunization Program to Cover Vaccines for Adults "Ought to Pass as Amended" Report Adopted - Senate (20 - 13)
6/10 SB 231 Reduces the Monetary Amount Plaintiffs Can Recover for Medical Expenses In An Auto Accident Lawsuit Concurrence Vote Passed - Senate (30 - 6)
6/09 HF 1 Repeals MinnesotaCare Eligibility for Undocumented Immigrants Age 18 or Older Bill Passed - Senate (48 - 16)
6/08 HB 496 Establishes Protections for Policyholders Against Any Rate Increases Tied to a Lapse in Auto Coverage Bill Passed - Senate (34 - 3)
6/02 AB 463 Requires Health Insurers and Medicaid to Respond Quickly to Prior Authorization Requests Bill Passed - Senate (20 - 0)
6/01 SB 268 Amends the Procedure for Certain Complaints Against Healthcare Practitioners Conference Report Adopted - Senate (19 - 12)
5/30 LB 275 Requires the Nebraska Department of Health and Human Services to Screen State Wards for Social Security Benefit Eligibility Bill Passed - Senate (29 - 19)
5/29 HB 1389 Requires Mammograms and Other Breast Cancer Screenings to Be Covered by Health Insurance Veto Override Passed - Senate (42 - 2)
5/29 AB 555 Establishes Price Cap Provisions on Insulin Bill Passed - Senate (18 - 2)
5/28 SB 418 Prohibits Discrimination in Health Insurance Enrollment Bill Passed - Senate (28 - 10)
5/25 HB 18 Establishes Certain Programs and Services Providing Health Care Services to Rural Counties Bill Passed - Senate (26 - 5)
5/21 HB 434 Limits Bodily Injury Claims by Plaintiffs Who Did Not Carry Auto Insurance At The Time Of The Accident Bill Passed - Senate (28 - 9)
5/21 HB 450 Repeals the Housley Presumption that says Courts Should Assume a Plaintiff's Injuries Resulted from the Accident in Question Bill Passed - Senate (28 - 9)
5/21 SB 231 Reduces the Monetary Amount Plaintiffs Can Recover for Medical Expenses In An Auto Accident Lawsuit Bill Passed - Senate (27 - 8)
5/20 SB 889 Requires Oklahoma Hospitals to Make Public Standard Treatment Costs Concurrence Vote Passed - Senate (35 - 8)
5/14 HF 1049 Increases Medicaid Beneficiaries' Monthly Personal Needs Allowance from $50 to $55 Each Month Bill Passed - Senate (31 - 15)
5/13 SF 615 Extends and Expands Medicaid Work Requirements Concurrence Vote Passed - Senate (33 - 13)
5/06 SB 25-048 Requires Large-Group Health Insurance Plans in Colorado to Offer Consumers Plans that Cover Glucagon-like Peptide-1 medications, Known as GLP-1 Drugs, to Treat Obesity and Pre-Diabetes Concurrence Vote Passed - Senate (25 - 10)
5/06 HB 25-1309 Defines "Gender-Affirming Care" Into State Statute and Prohibits Health Insurance Providers from Denying or Limiting Such Care Bill Passed - Senate (23 - 12)
5/01 SB 2160 Amends the State's Insurance to a Plan that Offers Benefits to be Compliant with the Federal Affordable Care Act Veto Override Failed - Senate (31 - 15)
4/30 SB 405 Increases Funding to the Department of Health and Human Services for Medicaid Bill Passed - Senate (35 - 11)
4/28 SF 383 Establishes New Standards for Pharmacy Benefit Managers Bill Passed - Senate (36 - 14)
4/24 SB 140 Requires PBMs to Provide Adequate Coverage Networks, Prohibits Them From Steering Business to Their Own Affiliated Pharmacies, and Requires PBMs to Reimburse Independent Pharmacies at Cost, Plus a Dispensing Fee Conference Report Adopted - Senate (39 - 10)
4/24 SB 1257 Requires Health Benefit Plans That Provide Coverage for Gender Transition Procedures to Additionally Cover All Possible Adverse Consequences of the Procedure, Follow-Up Testing, and Any Procedures to Reverse the Procedure Bill Passed - Senate (20 - 11)
4/24 LB 275 Requires the Nebraska Department of Health and Human Services to Screen State Wards for Social Security Benefit Eligibility Bill Passed - Senate (34 - 0)
4/23 HF 933 Establishes Pediatric Hospice Centers Bill Passed - Senate (47 - 0)
4/22 SB 128 Prohibits Health Insurers from Using or Relying on Artificial Intelligence to Deny a Request for Prior Authorization Bill Passed - Senate (16 - 5)
4/22 SB 23 Extends Postpartum Healthcare for One Year After Giving Birth for Individuals Who are Medicaid Eligible Bill Passed - Senate (32 - 1)
4/21 SB 2160 Amends the State's Insurance to a Plan that Offers Benefits to be Compliant with the Federal Affordable Care Act Concurrence Vote Passed - Senate (39 - 8)
4/17 SB 2 Establishes State Medicaid Restrictions Concurrence Vote Passed - Senate (37 - 10)
4/17 SB 32 Requires Certain Reviews of Insurance Policies Related to Perinatal Care to Be Provided to the Department of Insurance and Financial Services Bill Passed - Senate (36 - 0)
4/17 SB 37 Amends Provisions Related to Insurance Companies that Cover Gynecological and Pregnancy Services Bill Passed - Senate (27 - 9)
4/16 HB 2693 Authorizes Insurance Companies and the Arizona Health Care Cost Containment System (AHCCCS) to Limit Coverage for Genetic Sequencing Bill Passed - Senate (16 - 14)
4/09 HB 2449 Establishes New Enrollment Verification Requirements and Presumptive Eligibility Determinations for Arizona Health Care Cost Containment System (AHCCCS) Bill Passed - Senate (17 - 13)
4/09 HB 2076 Amends Statutes Related to Life Insurance Policies to Redefine the Term "Illustration" Bill Passed - Senate (28 - 2)
4/04 HB 1114 Authorizes Licensed Respiratory Care Practitioners to Practice in Any of the States Within the Compact Bill Passed - Senate (49 - 0)
4/03 SB 444 Amends the Medical Ethics and Diversity Act Bill Passed - Senate (28 - 5)
4/02 SB 100 Exempts Nonprofit Agricultural Membership Organizations From Insurance Regulations Bill Passed - Senate (32 - 0)
3/27 SB 79 Exempts Certain Health Insurance Plans From Federal Protections Bill Passed - Senate (24 - 6)
3/26 SB 25-071 Prohibits Pharmaceutical Companies from Restricting Hospitals' Use of the Federal 340B Prescription Drug Discount Program Bill Passed - Senate (30 - 4)
3/25 HB 1114 Limits Out-of-Pocket Costs for a Monthly Supply of Insulin to $25 Bill Passed - Senate (39 - 7)
3/25 SF 615 Extends and Expands Medicaid Work Requirements Bill Passed - Senate (33 - 15)
3/21 HB 78 Prohibits Discrimination Against 340B Entities Bill Passed - Senate (26 - 14)
3/20 SB 134 Establishes Medicaid Work Requirements "Ought to Pass" Report Adopted - Senate (15 - 8)
3/15 SB 120 Prohibits Group Health Coverage that Offers Coverage of Behavioral Health Services from Imposing Cost Sharing on those Behavioral Health Services in Network Bill Passed - Senate (19 - 14)
3/10 H 59 Authorizes Medical Practitioners to Refuse Services and Procedures they Don't Morally Agree With Bill Passed - Senate (28 - 6)
3/08 SB 39 Prohibits Prior Authorization or Step Therapy Bill Passed - Senate (34 - 0)
3/07 SB 5041 Establishes Unemployment Insurance for Workers on Strike Bill Passed - Senate (28 - 21)
2/26 HB 25-1002 Requires Health Insurance Companies Cover Behavioral Health, Mental Health and Substance Use Disorder Treatment Bill Passed - Senate (32 - 1)
2/25 SB 92 Establishes the Horse Racing Integrity and Safety Authority and Jockey and Exercise Rider Insurance Fund Bill Passed - Senate (36 - 1)
2/19 SB 244 Requires Insurance Coverage for Standardized, Evidence-Based Behavioral and Mental Health Screenings and Assessments Bill Passed - Senate (40 - 8)
2/18 SB 2 Establishes State Medicaid Restrictions Bill Passed - Senate (40 - 9)
2/12 SB 24 Requires Any New Benefits Mandated by State Law to Also Apply to the State Health Plan Bill Passed - Senate (30 - 15)
2/11 SB 39 Prohibits State Employees From Receiving Gender Affirming Health Care Services (32 - 18)
1/21 S 929 Establishes the Health Information Privacy Act Bill Passed - Senate (49 - 10)
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