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Bill

SB 2038

Health Insurance; prohibiting issue of outcomes with AI; requiring decisions to be made by provider; requiring disclosures. Emergency.

2026 Regular Session Introduced by Regina Goodwin

SB 2038 bans AI-only health insurance coverage decisions, requires human provider approval, and mandates disclosure of AI use in coverage determinations.

Second Reading referred to Business and Insurance
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WeVote Research Nonpartisan
Bill Summary · SB 2038

Legislative bill overview

SB 2038 would prohibit health insurance companies from issuing coverage decisions based solely on AI-generated outcomes and require that final determinations be made by human healthcare providers. The bill also mandates disclosure requirements to patients about any AI involvement in their coverage decisions.

Why is this important

As insurers increasingly use artificial intelligence to determine coverage and claims denials, this bill addresses growing concerns about algorithmic bias, lack of transparency, and patients losing appeal rights when decisions appear automated rather than clinically reasoned. The requirement for human provider involvement aims to ensure medical judgment remains central to coverage determinations that directly affect patient access to care.

Potential points of contention

  • Implementation costs: Requiring human review of AI-flagged cases could significantly increase insurer operational expenses, potentially raising premiums or reducing coverage options
  • Definition ambiguity: The bill doesn't clearly define what constitutes an "AI outcome" versus AI as a tool supporting human decision-making, creating enforcement challenges
  • Healthcare provider liability: Requiring providers to "make decisions" on coverage could blur roles and expose providers to liability for insurance determinations outside their control, potentially creating friction between payers and physicians

Compiled from official sources — confirm details with the bill’s official record.

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