New State Laws Take Effect in 2026 on AI, Deepfakes, Paid Leave and Rising Obamacare Costs

As 2026 begins, dozens of state laws addressing artificial intelligence, deepfakes, paid family and medical leave, and rising health insurance premiums will take effect across the United States. With federal legislation stalled in several areas, states have stepped in to set rules that could shape elections, health care and the 2026 midterm debate.

States Move on AI and Deepfakes

Lawmakers in 38 states passed AI-related measures this year, according to the National Conference of State Legislatures (NCSL). Many of these laws target how AI is used in sensitive arenas such as health care and elections. The state push continued after President Donald Trump issued an executive order in December encouraging a lighter-touch national approach to AI and discouraging a patchwork of state rules — but experts say state-level action is likely to persist because an executive order cannot pre-empt state law the way federal legislation can.

Several states passed specific limits on AI in medicine: California barred developers and companies from giving patients the impression they are interacting with licensed health professionals when they are actually speaking with chatbots, and Oregon prohibited AI tools from using the title "nurse" when dispensing medical advice.

States also addressed so-called deepfakes — altered audio, video or images intended to mislead — with Montana and South Dakota requiring disclosures when deepfakes are used in election communications. Deepfakes have already surfaced in recent campaigns; during the 2024 presidential contest, NBC News reported that a political consultant used AI to create a robocall that impersonated President Joe Biden urging New Hampshire Democrats not to vote in a primary. Congress has not yet enacted nationwide rules targeting deceptive deepfake content in elections, leaving states to fill the gap.

Paid Family And Medical Leave Expands

Maine, Delaware and Minnesota will implement paid family and medical leave programs in 2026, joining other states that already offer wage replacement for workers caring for themselves or family members, giving birth, or bonding with a new child. Maryland, Vermont and Washington also passed laws this year that expand or modify existing paid-leave systems, with some changes taking effect next year.

Minnesota’s law, passed in 2023 and taking effect in 2026, was championed by state Sen. Alice Mann, a physician who said she sponsored the bill after seeing patients forced to choose between caregiving and paychecks. Minnesota lawmakers allocated $5 million for a public information campaign so employers and community groups understand the program.

At the federal level, workers who qualify may receive up to 12 weeks of unpaid job protection under existing law, but the United States remains one of the few developed countries without guaranteed national paid parental or medical leave.

Rising Obamacare Premiums And State Responses

All 50 states face higher individual market premiums in 2026 after Congress failed to extend expiring Affordable Care Act (ACA) premium subsidies. Federal research group KFF projects premiums could more than double nationally without renewed subsidies.

Some states moved to blunt the shock. In August, Colorado lawmakers approved a $100 million package intended as a temporary "bridge" to offset premium increases in the state insurance exchange. State Rep. Kyle Brown, who sponsored the bill, said the funding reduced projected average premium increases in Colorado from about 175% to roughly 100% — still a sharp rise but less severe than expected. Colorado estimates approximately 225,000 residents will see average premium increases near 101%.

With federal action stalled amid partisan deadlock in Washington, state leaders say they are trying to protect residents from sudden cost spikes that could become a major political issue in the 2026 midterms.

Voting Laws: Competing Moves By States

Election law was another hot area for state legislatures. The Voting Rights Lab reports 20 states passed 37 measures this year that restrict some aspects of voting access — the most since 2021 — while 23 states passed 51 bills intended to expand or protect voting, the fewest such measures the group has tracked.

Examples of tighter rules include Kansas and North Dakota eliminating mail-ballot grace periods that previously accepted items postmarked by Election Day but received later, and eight states narrowing or removing alternatives to photo ID. Analysts say the wave of activity was influenced in part by a March executive order from President Trump proposing changes such as proof-of-citizenship requirements and stricter mail-ballot rules. The proof-of-citizenship idea was blocked by a U.S. district court in Washington, judged an executive overreach, but related state proposals emerged anyway.

Chris Vasquez, director of legislative tracking at the Voting Rights Lab, said he will watch 2026 developments closely — including state redistricting fights and a pending Supreme Court case that could limit the scope of the Voting Rights Act — because those rulings could affect both efforts to protect voting access and efforts to impose new restrictions.

What Comes Next

With federal legislation limited in key areas, state actions in 2026 will likely have significant impacts on how AI is governed, how health care costs affect consumers, and how elections are run. Voters and policymakers will watch closely as these state laws take effect ahead of a consequential midterm year.

Note: This article was originally published on NBCNews.com.