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Where Does Your State Stand? The ALS Association Releases Latest State Policy Report Cards as Legislative Sessions Begin

PR Newswire

Wed, February 11, 2026 at 11:53 PM GMT+9 4 min read

New report highlights where states are making progress and where gaps in care and coverage remain for people living with ALS

ARLINGTON, Va., Feb. 11, 2026 /PRNewswire/ – As many state legislatures across the country begin their 2026 sessions, the ALS Association released its annual ALS State Policy Report Cards, evaluating how all 50 states and Washington, D.C. are using state public policy and legislative initiatives to support people living with amyotrophic lateral sclerosis (ALS) and their families. The report cards assess how well state governments have performed to date across a specific set of public policies that would benefit people living with ALS, and do not directly measure the quality, availability, or performance of ALS care services or clinics within a state**. **Four states averaged a failing grade across the five policies graded; no states received an overall “A” this year.

ALS State Policy Report Cards

The report cards provide a snapshot of where states are stepping up and where they are falling short in policies that directly affect access to care, financial stability and the quality of life for the ALS community. This past year, there has been both meaningful progress and some concerning setbacks. Eleven states passed laws that improved their grades in at least one policy area. This honor roll includes Alaska, Iowa, Illinois, Indiana, Massachusetts, Maryland, Montana, North Dakota, Nebraska, Nevada and Texas. At the same time, three states – Indiana, Michigan and South Carolina – did not renew funding for care services, which is reflected in their grades.

“These report cards are about accountability,” said Alex Meixner, vice president of state policy at the ALS Association. “State policy decisions have real, immediate consequences for people living with ALS. When states invest in care, remove barriers to coverage, and support caregivers, families are better able to navigate a devastating disease. With legislative sessions underway, lawmakers in every state have opportunities to improve the lives of constituents living with ALS.”

Measuring Policies That Matter

The ALS State Policy Report Cards are the only report of their kind that evaluates state-level public policies through the specific lens of how they impact people living with ALS. Each state received letter grades based on whether it has enacted policies across five key ALS priorities, including state funding for ALS clinics and care services, access to affordable Medicare supplemental (Medigap) insurance, and reforms to insurance prior-authorization practices that delay or deny care.

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This year’s report cards also include two new policy measures: Protections against genetic discrimination, and policies that support family caregivers.

These criteria reflect the ALS Association’s core state-level priorities to help make ALS livable until a cure is found.

A Tool for Advocacy and Action

The ALS State Policy Report Cards go beyond grading. They provide a clear roadmap for identifying policy gaps, highlighting where states stand and actionable steps lawmakers can take to improve outcomes for people living with ALS.

In 2026, the ALS Association will use this framework to engage legislators, inform advocates and people affected by ALS, and to push for stronger policies around care, coverage, and support. This push for stronger ALS-focused legislation will also include complimentary policies that didn’t make it onto the report card, such as legislation expanding biomarker testing access, providing medical debt relief, banning copay accumulator programs, and eliminating step therapy requirements.

Individuals can view their state’s report card and sign up to become an ALS advocate by visiting our ALS State Policy Report Card page.

“Whether a state is leading the way or has significant room to improve, there is always an opportunity to act,” Meixner added. “By working together, we can help ensure every state adopts policies that truly support people living with ALS.”

**About the ALS Association ** 
The ALS Association is the largest ALS organization in the world. The ALS Association funds global research collaborations, assists people with ALS and their families through its nationwide network of care and certified clinical care centers, and advocates for better public policies for people with ALS. The mission of the ALS Association is to make ALS livable and cure it. For more information about the ALS Association, visit our website at www.als.org.

About ALS
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that affects nerve cells in the brain and spinal cord. Over the course of the disease, people lose the ability to move, to speak, and eventually, to breathe. The disease is always fatal, usually within five years of diagnosis. Few treatment options exist, resulting in a high unmet need for new therapies to address functional deficits and disease progression.

ALS Association Logo (PRNewsfoto/The ALS Association)

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