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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.

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Date State Bill No. Title Outcome
May 13, 2025 IA SF 615 Extends and Expands Medicaid Work Requirements Concurrence Vote Passed - Senate (33 - 13)
May 13, 2025 WI AB 23 Establishes a Palliative Care Council to Advise the Department of Health Services on Palliative Care Issues Bill Passed - House (96 - 1)
May 13, 2025 IA HF 1049 Increases Medicaid Beneficiaries' Monthly Personal Needs Allowance from $50 to $55 Each Month Bill Passed - House (63 - 28)
May 12, 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 - House (87 - 58)
May 12, 2025 IA SF 383 Establishes New Standards for Pharmacy Benefit Managers Bill Passed - House (75 - 15)
May 8, 2025 IA HF 933 Establishes Pediatric Hospice Centers Concurrence Vote Passed - House (84 - 0)
May 7, 2025 CO HB 25-1309 Defines "Gender-Affirming Care" Into State Statute and Prohibits Health Insurance Providers from Denying or Limiting Such Care Concurrence Vote Passed - House (39 - 24)
May 7, 2025 OK SB 889 Requires Oklahoma Hospitals to Make Public Standard Treatment Costs Bill Passed - House (51 - 38)
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 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 Bill Passed - House (41 - 24)
May 6, 2025 CO SB 25-071 Prohibits Pharmaceutical Companies from Restricting Hospitals' Use of the Federal 340B Prescription Drug Discount Program Bill Passed - House (57 - 8)
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)
May 1, 2025 CO HB 25-1213 Amends Regulations Regarding Funding, Billing, and Reporting for Certain Healthcare and Managed Care Entities Concurrence Vote Passed - House (58 - 7)
April 30, 2025 NC SB 405 Increases Funding to the Department of Health and Human Services for Medicaid Bill Passed - Senate (35 - 11)
April 29, 2025 AZ HB 2076 Amends Statutes Related to Life Insurance Policies to Redefine the Term "Illustration" Concurrence Vote Passed - House (41 - 14)
April 28, 2025 AZ HB 2693 Authorizes Insurance Companies and the Arizona Health Care Cost Containment System (AHCCCS) to Limit Coverage for Genetic Sequencing Concurrence Vote Passed - House (32 - 23)
April 28, 2025 AZ HB 2449 Establishes New Enrollment Verification Requirements and Presumptive Eligibility Determinations for Arizona Health Care Cost Containment System (AHCCCS) Concurrence Vote Passed - House (32 - 23)
April 28, 2025 IA SF 383 Establishes New Standards for Pharmacy Benefit Managers Bill Passed - Senate (36 - 14)
April 28, 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 - House (68 - 24)
April 28, 2025 LA HB 496 Establishes Protections for Policyholders Against Any Rate Increases Tied to a Lapse in Auto Coverage Bill Passed - House (87 - 3)
April 28, 2025 LA HB 434 Limits Bodily Injury Claims by Plaintiffs Who Did Not Carry Auto Insurance At The Time Of The Accident Bill Passed - House (76 - 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 - House (84 - 1)
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 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 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 TX HB 18 Establishes Certain Programs and Services Providing Health Care Services to Rural Counties Bill Passed - House (119 - 24)
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 37 Amends Provisions Related to Insurance Companies that Cover Gynecological and Pregnancy Services Bill Passed - Senate (27 - 9)
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 16, 2025 ND SB 2160 Amends the State's Insurance to a Plan that Offers Benefits to be Compliant with the Federal Affordable Care Act Bill Passed - House (55 - 37)
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 16, 2025 AZ SB 1626 Requires Health Insurance Companies to Notify Enrollees About Their Right to Dispute Surprise Out-of-Network Bills Bill Passed - House (50 - 5)
April 16, 2025 AR SB 444 Amends the Medical Ethics and Diversity Act Bill Passed - House (82 - 13)
April 14, 2025 MT HB 442 Repeals the Mandate to Automatically Report Medical Malpractice Cases and Insurance Payouts to the State Licensure Board Bill Passed - Senate (30 - 18)
April 9, 2025 AZ HB 2076 Amends Statutes Related to Life Insurance Policies to Redefine the Term "Illustration" Bill Passed - Senate (28 - 2)
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 IL HB 35 Prohibits Health Insurance Companies from Relying Only on AI to Deny, Reduce, or Terminate Coverage for Patients Receiving Care Bill Passed - House (79 - 35)
April 8, 2025 IN SB 2 Establishes State Medicaid Restrictions Bill Passed - House (66 - 28)
April 8, 2025 IL HB 2805 Prohibits Insurance Co-Pays for Sexual Assault Exams Bill Passed - House (114 - 0)
April 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 - House (40 - 20)
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 KS SB 250 Establishes the Right to Try for Individualized Treatments Act Conference Report Adopted - House (119 - 3)
Date No. Title Outcome
5/13 SF 615 Extends and Expands Medicaid Work Requirements Concurrence Vote Passed - Senate (33 - 13)
5/13 AB 23 Establishes a Palliative Care Council to Advise the Department of Health Services on Palliative Care Issues Bill Passed - House (96 - 1)
5/13 HF 1049 Increases Medicaid Beneficiaries' Monthly Personal Needs Allowance from $50 to $55 Each Month Bill Passed - House (63 - 28)
5/12 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 - House (87 - 58)
5/12 SF 383 Establishes New Standards for Pharmacy Benefit Managers Bill Passed - House (75 - 15)
5/08 HF 933 Establishes Pediatric Hospice Centers Concurrence Vote Passed - House (84 - 0)
5/07 HB 25-1309 Defines "Gender-Affirming Care" Into State Statute and Prohibits Health Insurance Providers from Denying or Limiting Such Care Concurrence Vote Passed - House (39 - 24)
5/07 SB 889 Requires Oklahoma Hospitals to Make Public Standard Treatment Costs Bill Passed - House (51 - 38)
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)
5/06 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 Bill Passed - House (41 - 24)
5/06 SB 25-071 Prohibits Pharmaceutical Companies from Restricting Hospitals' Use of the Federal 340B Prescription Drug Discount Program Bill Passed - House (57 - 8)
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)
5/01 HB 25-1213 Amends Regulations Regarding Funding, Billing, and Reporting for Certain Healthcare and Managed Care Entities Concurrence Vote Passed - House (58 - 7)
4/30 SB 405 Increases Funding to the Department of Health and Human Services for Medicaid Bill Passed - Senate (35 - 11)
4/29 HB 2076 Amends Statutes Related to Life Insurance Policies to Redefine the Term "Illustration" Concurrence Vote Passed - House (41 - 14)
4/28 HB 2693 Authorizes Insurance Companies and the Arizona Health Care Cost Containment System (AHCCCS) to Limit Coverage for Genetic Sequencing Concurrence Vote Passed - House (32 - 23)
4/28 HB 2449 Establishes New Enrollment Verification Requirements and Presumptive Eligibility Determinations for Arizona Health Care Cost Containment System (AHCCCS) Concurrence Vote Passed - House (32 - 23)
4/28 SF 383 Establishes New Standards for Pharmacy Benefit Managers Bill Passed - Senate (36 - 14)
4/28 HB 450 Repeals the Housley Presumption that says Courts Should Assume a Plaintiff's Injuries Resulted from the Accident in Question Bill Passed - House (68 - 24)
4/28 HB 496 Establishes Protections for Policyholders Against Any Rate Increases Tied to a Lapse in Auto Coverage Bill Passed - House (87 - 3)
4/28 HB 434 Limits Bodily Injury Claims by Plaintiffs Who Did Not Carry Auto Insurance At The Time Of The Accident Bill Passed - House (76 - 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 - House (84 - 1)
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 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)
4/24 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 HB 18 Establishes Certain Programs and Services Providing Health Care Services to Rural Counties Bill Passed - House (119 - 24)
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 37 Amends Provisions Related to Insurance Companies that Cover Gynecological and Pregnancy Services Bill Passed - Senate (27 - 9)
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)
4/16 SB 2160 Amends the State's Insurance to a Plan that Offers Benefits to be Compliant with the Federal Affordable Care Act Bill Passed - House (55 - 37)
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)
4/16 SB 1626 Requires Health Insurance Companies to Notify Enrollees About Their Right to Dispute Surprise Out-of-Network Bills Bill Passed - House (50 - 5)
4/16 SB 444 Amends the Medical Ethics and Diversity Act Bill Passed - House (82 - 13)
4/14 HB 442 Repeals the Mandate to Automatically Report Medical Malpractice Cases and Insurance Payouts to the State Licensure Board Bill Passed - Senate (30 - 18)
4/09 HB 2076 Amends Statutes Related to Life Insurance Policies to Redefine the Term "Illustration" Bill Passed - Senate (28 - 2)
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 35 Prohibits Health Insurance Companies from Relying Only on AI to Deny, Reduce, or Terminate Coverage for Patients Receiving Care Bill Passed - House (79 - 35)
4/08 SB 2 Establishes State Medicaid Restrictions Bill Passed - House (66 - 28)
4/08 HB 2805 Prohibits Insurance Co-Pays for Sexual Assault Exams Bill Passed - House (114 - 0)
4/06 HB 25-1309 Defines "Gender-Affirming Care" Into State Statute and Prohibits Health Insurance Providers from Denying or Limiting Such Care Bill Passed - House (40 - 20)
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 250 Establishes the Right to Try for Individualized Treatments Act Conference Report Adopted - House (119 - 3)
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