health insurance; reimbursement rates; vaccines

Plain English Breakdown

The bill summary and text do not provide specific details on how existing contracts will be affected before January 1, 2027.

Insurance Reimbursement for Vaccine Refusal

This bill stops insurance companies from paying doctors differently based on whether a patient refuses vaccines, starting January 1, 2027.

What This Bill Does

• Prohibits health care insurers from reimbursing health professionals at different rates based on a covered individual's decision to refuse one or more vaccines beginning January 1, 2027.

Who It Names or Affects

• Health care insurers
• Health professionals such as doctors, nurses, and dentists
• Patients or insured individuals

Terms To Know

Covered individual

An insured person who has a health insurance plan.

Health care insurer

A company that provides health insurance policies to people or groups, including disability insurers and medical service corporations.

Health professional

Doctors, nurses, dentists, and other medical professionals who provide healthcare services as defined in A.R.S. § 32-3201.

Limits and Unknowns

• The bill does not specify what happens if a patient refuses vaccines after January 1, 2027.
• It is unclear how this will affect existing insurance contracts before the effective date.

Official Summary Text

SB1212 - 572R - Senate Fact Sheet

Assigned to
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PASSED BY COW

ARIZONA STATE SENATE

Fifty-Seventh
Legislature, Second Regular Session

AMENDED

FACT SHEET FOR
S.B. 1212

health insurance;
reimbursement rates; vaccines

Purpose

Prohibits a health care insurer, beginning January 1, 2027, from
reimbursing a health professional at a different rate based on a covered
individual's decision to refuse one or more vaccines.

Background

The Department of Insurance and Financial Institutions regulates
policies, certificates, evidences of coverage and contracts of insurance that
are issued or delivered by health care insurers (
A.R.S.
� 20-1379
).

Health care service reimbursement
rates are governed by a complex mix of federal regulation,
state
policies and private contract negotiations designed to balance cost control
with access to care.

The federal Health Insurance Portability and Accountability Act (HIPAA) generally
prohibits health care insurers from discriminating on the basis of health
factors. Under HIPAA,
health factors
include eight health status related
factors that may not be used to discriminate in health coverage among
individuals, such as medical history, evidence of insurability and disability.
Provided benefits must be uniformly available to all similarly situated
individuals. Any benefits restriction must be uniformly applied and not be
directed at individual participants or beneficiaries based on a health factor (
29
C.F.R. � 2590.702
).

Health professionals
include: 1) podiatrists; 2) chiropractors; 3)
dentists; 4) medical physicians and surgeons; 5) naturopathic physicians; 6)
nurses; 7) dispensing opticians;

8) optometrists; 9) osteopathic physicians and surgeons; 10) pharmacists; 11)
physical therapists; 12) psychologists; 13) veterinarians; 14) physician
assistants; 15) radiologic technologists;

16) homeopathic physicians; 17) behavioral health professionals; 18)
occupational therapists;

19) respiratory therapists; 20) acupuncturists; 21) athletic trainers; 22)
massage therapists;

23) nursing care institution administrators;24) assisted living facilities
managers; 25) midwifes; 26) audiologists; and 27) speech pathologists (
A.R.S.
� 32-3201
).

There is no anticipated fiscal impact
to the state General Fund associated with this legislation.

Provisions

1.

Prohibits a health care insurer, beginning January
1, 2027, from reimbursing a health professional
at a different rate
based on a covered individual's decision to refuse one or more vaccines.

2.

Defines
terms.

3.

Becomes
effective on the general effective date.

Amendments
Adopted by Committee of the Whole

�

Replaces the prohibition against a health insurer reimbursing a
health professional at a different rate based on a covered individual's
vaccination status with a prohibition against a health insurer reimbursing a
health professional at a different rate based on a covered individual's
decision to refuse one or more vaccines.

Senate
Action

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Prepared by Senate Research

March 3, 2026

MG/hk

Current Bill Text

SB1212 - 572R - S Ver

Senate Engrossed

health insurance;
reimbursement rates; vaccines

State of Arizona

Senate

Fifty-seventh Legislature

Second Regular Session

2026

SENATE BILL 1212

AN
ACT

amending title 20, chapter 2, article 1, Arizona
Revised Statutes, by adding section 20-243; relating to health insurance.

(TEXT OF BILL BEGINS ON NEXT PAGE)

Be it
enacted by the Legislature of the State of Arizona:

Section
1.
1. Title
20, chapter 2, article 1, Arizona Revised Statutes, is amended by adding
section 20-243, to read:

START_STATUTE
20-243.

Health care insurer; covered individual; vaccine refusal;
reimbursement rates; definitions

A. Beginning January 1, 2027, a
health care insurer may not reimburse a health professional at a different rate
based on a covered individual's
decision to refuse one or
more vaccines.

B. For the purposes of this section:

1. "Covered individual"
means an insured, enrollee or subscriber of a health care insurer.

2. "Health care insurer"
means a disability insurer, group disability insurer, blanket disability
insurer, health care services organization, hospital services corporation,
medical service corporation or hospital, medical, dental and optometric service
corporation that issues a health plan in this state.

3. "Health professional"
has the same meaning prescribed in section 32-3201.
END_STATUTE