SB 238 Delaware Senate · 153rd General Assembly (2025-2026)

AN ACT TO AMEND TITLE 24, TITLE 29, AND TITLE 31 OF THE DELAWARE CODE RELATING TO INSURANCE COVERAGE FOR CHIROPRACTIC THERAPY AND PHYSICAL THERAPY.

Summary
In Delaware, all individual health insurance policies, all group and blanket health insurance policies, the State employee health insurance plan, and Medicaid are required to cover chiropractic and physical therapy treatment for chronic back pain without annual or lifetime numerical limits on physical therapy or chiropractic care visits. To evaluate the effectiveness of this coverage requirement, the Patient Centered Care Subcommittee of the Addiction Action Committee, under the Delaware Department of Health and Social Services, sent a survey to chiropractic therapy and physical therapy providers in Delaware. Although the survey showed that the coverage requirement has improved treatment of chronic pain patients, the survey also showed that the coverage requirement provides supportive chronic pain treatment for only the thoracic region of the spine, which is the middle of the spine from the base of the neck to the bottom of the ribs, and the lumbar region of the spine, which is the lower back. The treatment of chronic pain through chiropractic supportive care, physical therapy, or both, can prevent a patient from requiring opioid pain medications or more expensive treatments, but excluding vital areas of the spine and body from coverage may limit the effectiveness of chiropractic therapy and physical therapy treatment and limits a chronic pain patient’s potential for improvement. This Act encourages treatment of chronic pain patients without opioids by updating the required health insurance coverage to prohibit annual or lifetime numerical visits on physical therapy or chiropractic care visits that are for the purpose of treating the spine and other neuromusculoskeletal structures, including extremities. The updated coverage required under this Act applies to all policies, contracts, or certificates issued, renewed, modified, altered, amended, or reissued after December 31, 2026. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual.
Bill status signed all 5 stages cleared
Introduction
Feb 2026
Committee Review
Apr 2026
Senate Passage
Apr 2026
House Passage
Apr 2026
Signed into Law
Apr 2026
Introduced Feb 19, 2026 Signed Apr 28, 2026
Maddy AI version diff · 2 comparisons

What changed between versions

HA 1 to SB 238 Bill Text · 5 edits
MODERATE
The final bill text restores applicability to the state employee group health insurance plan (which had been removed by House Amendment 1) and expands the scope of covered conditions from 'back pain' to 'the spine and other neuromusculoskeletal structures, including extremities' across all four sections. The expanded coverage applies to chiropractic and physical therapy services under individual policies, group policies, the state employee plan, and Medicaid. An effective date of December 31, 2026 is set for when the updated requirements take effect.
SCOPE

Restored Section 3 (amending Title 29, Section 5203) so that the state employee group health insurance plan is again subject to the no-visit-limit requirement. House Amendment 1 had removed this section entirely.

Expanded the covered condition from 'back pain' to 'the spine and other neuromusculoskeletal structures, including extremities' in all four sections (chiropractic coverage, physical therapy coverage, state employee plan, and Medicaid). This broadens which body regions qualify for unlimited visits.

Changed the bill from a House Amendment removing a section to a full Senate Bill with all four sections intact, changing the chamber of origin from House of Representatives to Delaware State Senate with new primary sponsors (Sen. Townsend and Sen. Hansen).

TIMELINE

Added Section 5 establishing that the Act applies to all policies, contracts, or certificates issued, renewed, modified, altered, amended, or reissued after December 31, 2026.

TECHNICAL

Made technical corrections in Section 4 (Medicaid) to conform to the Delaware Legislative Drafting Manual, including expanding 'Department' to 'Department of Health and Social Services' and restructuring the Medicaid eligibility language.

Floor votes · Senate Mar 26, 2026 · House Apr 23, 2026

How they voted

200
Passed · 1 other
Total votes 21
Mar 26, 2026
D Democratic15
14 Yea 1
93% Yea
R Republican6
6 Yea
100% Yea
Vote distribution
All Yea All Nay Mixed No data
Full legislative history

Actions timeline

Total actions
13
Key actions
8
Committee
2
Amendments
4
Apr 28, 2026
Signed into law
Signed by Governor
executive
Apr 23, 2026
Upper · Passed
Passed By Senate. Votes: 16 YES 5 ABSENT
upper
Apr 23, 2026
Lower · Passed
Passed By House. Votes: 33 YES 3 NO 5 ABSENT
lower
Apr 23, 2026
Lower · Passed
Amendment HA 1 to SB 238 - Passed In House by Voice Vote
lower
Apr 23, 2026
Introduced
Amendment HA 1 to SB 238 - Introduced and Placed With Bill
upper
Apr 21, 2026
Lower · Passed
Reported Out of Committee (Economic Development/Banking/Insurance & Commerce) in House with 12 On Its Merits
lower
Apr 9, 2026
Introduced
Assigned to Economic Development/Banking/Insurance & Commerce Committee in House
lower
Mar 26, 2026
Upper · Passed
Passed By Senate. Votes: 20 YES 1 ABSENT
upper
Mar 26, 2026
Upper · Passed
Amendment SA 1 to SB 238 - Passed By Senate. Votes: 19 YES 2 ABSENT
upper
Mar 11, 2026
Introduced
Amendment SA 1 to SB 238 - Introduced and Placed With Bill
upper
Mar 11, 2026
Upper · Passed
Reported Out of Committee (Health & Social Services) in Senate with 7 Favorable, 1 On Its Merits
upper
Feb 19, 2026
Introduced
Introduced and Assigned to Health & Social Services Committee in Senate
upper
18 primary · 0 co-sponsors

Sponsors