New abortion and health coverage laws taking effect in 2025

Healthcare was a major issue in the 2024 election and likely will feature in the legislative agenda at the federal level under President-elect Donald Trump‘s second administration. At the state level, Democratic legislatures across the country enacted bills aimed at widening insurance coverage and increasing workers’ ability to take time off to see a healthcare provider.

Delaware joined 17 other states in 2024 to mandate that its Medicaid program cover all abortion-related services, while Pennsylvania enacted legislation requiring Medicaid coverage for birthing and postpartum doulas.

In New York, a first-of-its-kind paid prenatal care leave policy will take effect in 2025, allowing pregnant women to take an extra 20 hours of paid sick leave to receive pregnancy care and abortions.

Along similar lines, both Connecticut and Washington state strengthened existing mandatory sick leave policies, in part as reforms following the COVID-19 pandemic, which began five years ago and fundamentally changed the workforce landscape.

Here is everything to know about the specifics of each state law.

Connecticut 

In May, Gov. Ned Lamont (D-CT) signed legislation broadening the state’s existing statute requiring companies to provide paid sick leave for their employees.

Under the old law, employers with more than 50 workers, mostly in retail and service occupations, were required to provide 40 hours of paid sick leave annually.

As of Wednesday, employers in all industries with more than 25 employees will have to provide 40 hours of paid sick leave to their employees.

The threshold for providing the leave is slated to decrease to 11 employees in 2026 and only one employee in 2027.

When he signed the bill, Lamont said that reevaluating mandatory sick leave policy became a higher priority for his administration after the COVID-19 pandemic.

“Our existing paid sick days laws include important protections for certain workers,” Lamont said at the time. “However, there are broad categories left unprotected, and this update will expand this coverage to help ensure that people do not have to choose between going to work sick and sacrificing a day’s wage.”

Delaware

In October, Gov. John Carney (D-DE) signed a law requiring all health insurance plans in the state to cover abortion services.

Medicaid and state employee insurance coverage of abortion services will take effect Wednesday in the state, but private insurance plans have until December 2025 to implement the same type of coverage.

Insurance plans under the law are banned from charging copays, applying deductibles, or adding any other cost-sharing requirements for abortion-related services.

For fiscal 2023, Delaware Planned Parenthood reported that half of its self-pay patients reported incomes within 250% of the federal poverty line. Nearly a quarter of patients had Medicaid coverage.

There is a provision in the legislation that allows for religious employers to be exempted from offering abortion coverage.

“While federal law has played a role in limiting the coverage for abortion in our state, it’s clear time and time again that insurers simply do not voluntarily cover women’s healthcare the way they do for others, and it severely hinders access and affordability,” Delaware Department of Insurance senior adviser Chris Haas said at the time of the law’s passage.

Pennsylvania

As of Wednesday, doulas will be able to receive Medicaid reimbursement in Pennsylvania.

A doula, the Greek word for a woman’s servant, provides physical and emotional support before, during, and after birth. Birth doulas offer nonmedical support techniques during labor and delivery, while postpartum doulas offer a range of services, including caring for the infant, lactation assistance, and mental health support.

Unlike similar services offered by traditional midwives, doulas do not have formal medical or healthcare training. Both midwives and doulas have certification processes for their respective crafts.

Research indicates that low-income and racial minority populations, in particular black mothers, are more likely to use doula services and are more likely to have more favorable health outcomes with a doula in the delivery room than without one.

The bill, signed by Gov. Josh Shapiro (D-PA) in October, was introduced by Philadelphia area Rep. Morgan Cephas, co-chairwoman of the Pennsylvania Black Maternal Health Caucus. 

“Lack of coverage for doula services in Medicaid leads to a vast disparity in care for women who are already statistically at risk for adverse pregnancy outcomes, with Black birthing people at the highest risk of maternal and infant mortality and morbidity compared to other racial and ethnic groups,” Cephas said when the law was signed. “This new law will give these parents a proven network of support needed to produce better mental and physical health outcomes during their birthing journey.”

Doulas in Pennsylvania must be certified by the new Doula Advisory Board established by the law and have a National Provider Identifier number to receive state reimbursement.

New York

As of Wednesday, pregnant women employed in New York will be eligible to receive an additional 20 hours of paid sick leave for pregnancy-related services, including physical exams, testing, fertility treatment, and abortions.

Gov. Kathy Hochul (D-NY) proposed the measure during her 2024 State of the State address in January and signed the legislation into law in April. It is the first of its kind to pass in any state.

“No pregnant woman in New York should be forced to choose between a paycheck and a check-up — and that’s why I pushed to create the nation’s first paid prenatal leave policy,” Hochul said earlier this month, raising awareness about the law taking effect.

Approximately 130,000 pregnant women in the Empire State will be eligible for these benefits, according to estimates from the New York State Department of Labor.

Infants born to mothers who do not receive prenatal care are five times more likely to die during infancy than those who received prenatal care and are also more likely to be born weighing less than 5.5 pounds.

Women who do not receive prenatal care are also three to four times more likely to die from complications related to pregnancy.

Washington 

Earlier this year, Washington state enacted legislation to expand the reasons why an employee can use paid sick leave.

The extant paid sick leave policy was one of the several provisions in the state’s workers’ rights ballot Initiative 1433 of 2016, which also increased the state’s minimum wage to $13.50 per hour.

Current sick leave law allows employees to take paid time off to care for a family member, but the new law updates the definition of family member to anyone who lives in the same household or has a relationship with the employee that “creates an expectation that the employee care for the person, and that individual depends on the employee for care.”

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The new law also allows a worker to take paid sick leave should their child’s school or daycare be closed due to an emergency.

State law still requires employers to allow employees to earn one hour of paid sick leave for every 40 hours worked, beginning 90 calendar days after starting the job. As many as 40 hours can be rolled over into the next year.