Healthcare AI Has Outrun Its Regulators. States Are Filling the Gap.

Artificial intelligence has moved from the edges of healthcare to its operational core. It is embedded in clinical decision support, diagnostics, administrative workflows, and increasingly in coverage determinations by health insurers. The regulatory infrastructure that governs it has not kept pace.

According to a legal alert published by Holland and Knight LLP, federal legislation has not caught up with the pace of AI deployment in healthcare. Congress has not passed any significant legislation directly addressing AI in healthcare, leaving state legislatures to act first.

More than 250 AI-related healthcare bills were introduced across state legislatures in 2025, with a consistent focus on patient disclosure, bias prevention, clinician accountability, and restrictions on AI use in insurance coverage decisions.

The risk of that state-level activity is fragmentation. Different bias and discrimination requirements across jurisdictions create a compliance environment that could constrain healthcare organisations operating nationally, forcing them to maintain different standards for the same technology depending on where it is deployed.