As the 2025 legislative session swings into full gear, the Alabama Academy of Family Physicians (AAFP) has set its sights on a cadre of pivotal bills set to shape the healthcare landscape for years to come. Running from February 4 to May 15, this session promises to bring substantial changes to medical consent laws, Medicaid coverage, rural hospital funding, taxation on essential goods, and the transparency of healthcare costs. Here’s a brief overview of the key pieces of legislation that AAFP is diligently monitoring.

HB 2 – Vaccine Consent

What’s in the Bill: Sponsored by Rep. Chip Brown, HB 2 proposes a change to existing law regarding the consent process for medical procedures involving minors. Under current law, minors aged 14 or older are permitted to consent to vaccines (excluding the Covid Vaccine) for themselves without parental consent. This bill would mandate written consent from a parent or legal guardian for any minor to receive a vaccination, unless the minor is living independently from his or her parent or legal guardian.

What Happened: Passed out of the House of Representatives

HB 45 – Medicaid Coverage for Cologuard Test

What’s in the Bill: Sponsored by Rep. Ed Oliver, HB 45 would require the Alabama Medicaid Agency to cover any noninvasive colorectal cancer screening test assigned a grade A or B under the recommendations of the United States Preventive Services Task Force. This bill would also require the Alabama Medicaid Agency to cover a colonoscopy based on a positive test result.

What Happened: Passed out of the House of Representatives

HB 46 – Rural Physicians Tax Credit

What’s in the Bill: HB 46 terminates the existing Rural Physician Tax Credit program in Alabama, which provided tax credits to physicians practicing in rural areas, effective December 31, 2025. It then establishes a new Rural Physician Income Tax Credit program, effective January 1, 2026, that provides a $10,000 annual tax credit to qualifying rural physicians for up to four tax years. The new program has additional eligibility requirements, including that the physician must have practiced outside of a rural community for at least three years before returning to a rural area. The bill also requires the Alabama Statewide Area Health Education Center Program Office to administer and verify the eligibility of physicians claiming the credit and mandates an evaluation of the program’s success during the 2030 fiscal year.

What Happened: Pending Action in the House Ways and Means Education Committee

HB 86 – Rural Hospital Investment Fund Bill

What’s in the Bill: Sponsored by Rep. Terri Collins, HB 86 proposes the establishment of a Rural Hospital Investment Program in Alabama, which would serve as a conduit for financial support from the public directed towards rural hospitals in the state. To incentivize donations to these hospitals, the bill suggests creating a tax credit for individuals and entities to offset their state income tax liability. Under this program, qualifying hospitals would receive gifts to support their provision of acute care services to rural populations. These funds could be utilized for various purposes, including direct care, operational expenses, and facility maintenance or upgrades. To oversee the implementation and operation of the program, the bill would establish a board within the Office of State Treasurer. This board would determine the eligibility of qualifying rural hospitals to receive donations eligible for the tax credit and would administer the program with support from the Department of Revenue.

HB 152 – Pink Tax Bill

What’s in the Bill: Sponsored by Rep. Neil Rafferty, HB 152 aims to eliminate sales tax on a range of items, including baby bottles, baby wipes, breast milk pumping equipment, diapers, maternity clothing, and menstrual hygiene products.

HB 86 – Rural Hospital Investment Fund Bill

What’s in the Bill: Sponsored by Rep. Terri Collins, HB 86 proposes the establishment of a Rural Hospital Investment Program in Alabama, which would serve as a conduit for financial support from the public directed towards rural hospitals in the state. To incentivize donations to these hospitals, the bill suggests creating a tax credit for individuals and entities to offset their state income tax liability. Under this program, qualifying hospitals would receive gifts to support their provision of acute care services to rural populations. These funds could be utilized for various purposes, including direct care, operational expenses, and facility maintenance or upgrades. To oversee the implementation and operation of the program, the bill would establish a board within the Office of State Treasurer. This board would determine the eligibility of qualifying rural hospitals to receive donations eligible for the tax credit and would administer the program with support from the Department of Revenue.

Senate

SB 43 – Patient Price Transparency Bill

What’s in the Bill: Sponsored by Sen. Tim Melson SB 43 protects patient access to cost and treatment information by prohibiting health insurers from restricting physicians, health care providers, and pharmacists from discussing the cost of treatments or medications, including lower-cost alternatives. Any contractual clause that limits or penalizes providers for sharing this information would be unenforceable. Additionally, health insurers would be barred from taking adverse action against providers for providing cost transparency. The bill also allows providers and pharmacists to seek damages if an insurer retaliates against them for sharing this information.

SB 58 & 101 – Age of Medical Consent Bill

What’s in the Bill: Sponsored by Sen. Sam Givhan and Larry Stutts, these bills raise the age to 18, with exceptions only for married, divorced, pregnant, emancipated, or independent minors. While minors could still consent to care for pregnancy, STIs, and substance abuse, parental consent would be required for other medical care, mental health counseling (including school counseling), vaccinations, and bone marrow donation. The bill also addresses parental access to health information and parental rights.

What Happened: Passed out of Youth & Children Health Committee

SB 87 – Freestanding Birth Center Bill

What’s in the Bill: Sponsored by Rep. Sen Arthur Orr, SB 87 proposes significant reforms to enhance midwifery services and birth center regulations. It expands definitions, allowing midwifery services in freestanding birth centers, while also permitting the acceptance of gifts and grants by the board.

SB 93 – PBM Bill

What’s in the Bill: SB 93, sponsored by Sen. Andrew Jones, would prohibit pharmacy benefits managers from reimbursing a pharmacy less than the actual acquisition cost paid by the pharmacy and would prohibit pharmacy benefits managers from charging pharmacies or pharmacists miscellaneous fees related to network participation and claims processing. This bill would permit pharmacists to disclose information to consumers about drug prices and alternative drugs for treatment. This bill would recognize the right of a pharmacy to refuse to dispense a drug when the pharmacy would be reimbursed less than a pharmacy’s dispensing cost, and would further prohibit a pharmacy benefits manager from recovering the pharmacy’s dispensing cost by requiring a consumer to pay a higher deductible or copayment. This bill would specify that the Commissioner of Insurance may enforce violations of the Alabama Pharmacy Benefits Manager Licensure and Regulation Act committed by a pharmacy benefits manager during an audit of a pharmacy, and may also enforce the Pharmacy Audit Integrity Act in relation to auditing of a pharmacy by a pharmacy benefits manager.

SB 99 – PBM Bill #2

What’s in the bill: Sponsored by Sen. Stutts, SB 99 would expand oversight by the Department of Insurance by setting benchmarks for the amounts that pharmacy benefits managers reimburse pharmacies, and by regulating how they process claims, determine payment amounts, and use manufacturer rebates. This bill would prohibit pharmacy benefits managers from requiring or influencing health insurance beneficiaries to purchase a particular variant of a prescription drug or only use certain pharmacies within a health plan network. This bill would authorize a health insurance plan, a plan beneficiary, or a pharmacy to bring a cause of action against a pharmacy benefits manager for damages due to a violation of this act. This bill would also further regulate the audit of a pharmacy by a pharmacy benefits manager under The Pharmacy Audit Integrity Act by specifying the circumstances under which a pharmacy benefits manager may recoup funds from a pharmacy that was overpaid for claims.