The Menopause Workplace Mandate: Rhode Island, Philadelphia, Illinois, and the National Wave

Menopause workplace accommodation is no longer a future concept. It is a menopause workplace mandate, a law in Rhode Island and Philadelphia, one signature away in Illinois, pending in ten more states, and moving faster than any employment-law trend in a decade.

In June 2025, Rhode Island became the first state in the country to mandate workplace accommodations for menopause. Six months later Philadelphia became the first major American city to do the same. In May 2026, Illinois passed its own workplace bill through both chambers. What began as a single statute in the smallest state in the union is now a structural shift in U.S. employment law — and most employers have no policy for it at all.

The gap between what employees need and what employers provide is now closing through legislation rather than voluntary action. A 2023 Bank of America survey of 2,000 working women found that 64% want menopause-specific benefits, while only 14% say their employer recognizes the need for them. The same study documented a 73-point gap between HR managers who say they discuss menopause with employees (76%) and women who say they have actually raised it with HR (3%). Legislatures are filling a vacuum.

Rhode Island: The First State Mandate

On June 24, 2025, Governor Daniel McKee signed Senate Bill S0361, amending the Rhode Island Fair Employment Practices Act at § 28-5-7.4 to require workplace accommodations for menopause and related conditions. The law took effect immediately on signing.

Under the statute it is an unlawful employment practice for an employer to refuse to reasonably accommodate an employee’s condition related to pregnancy, childbirth, menopause or a related medical condition unless the employer can demonstrate undue hardship; to require an employee to take leave if another reasonable accommodation can be provided; to deny employment opportunities based on a refusal to accommodate; or to fail to provide the required written notice.

The notice obligations are the part employers most often miss, because they are affirmative and clock-driven rather than reactive:

Accommodations contemplated by the law include more frequent or longer breaks, modified schedules, equipment modification, seating, temporary transfers, job restructuring, light duty and assistance with manual labor. Critically, the employer bears the burden of proving undue hardship, and a rebuttable presumption applies where similar accommodations already exist.

Menopause is not something that women choose to experience and its effects on a woman’s mind and body can pose significant challenges in daily life and the workplace. Women should not have to risk being penalized or discriminated against at their job due to a naturally occurring phenomenon they have no control over.

Rep. Karen Alzate (D-Dist. 60, Pawtucket, Central Falls), primary sponsor, HB 6161

Our current lack of workplace protections for women going through the menopause transition is both an equity issue and an economic drag on our state’s businesses and agencies, as employers risk losing female workers at the height of their institutional knowledge and skill.

Sen. Lori Urso (D-Dist. 8, Pawtucket)

Philadelphia: The First Major City to Act

On November 20, 2025, the Philadelphia City Council unanimously approved Bill No. 250849, amending Chapter 9-1100 of the Philadelphia Code — the city’s Fair Practices Ordinance — to add menstruation, perimenopause and menopause as protected categories. Mayor Cherelle Parker signed it into law on December 3, 2025. It takes effect January 1, 2027.

The ordinance applies to every employer with one or more employees working in Philadelphia. It prohibits discrimination across all employment decisions, prohibits retaliation against employees who request accommodations, and requires employers to engage in a confidential interactive process. Accommodations must be provided on request where symptoms “substantially interfere with an employee’s ability to perform one or more job functions,” absent undue hardship. The legislative record identifies additional restroom breaks and private space, temperature control, flexible or hybrid scheduling, uniform and dress code adjustments, assistance with manual tasks, temporary duty changes and short-term leave.

Philadelphia does not simply copy Rhode Island. It goes further in scope and narrower in trigger:

Menopause, perimenopause, and menstruation are daily realities for a huge share of our workforce. No one should be mocked, sidelined, or pushed out of a job because of what their body is going through.

Councilmember Nina Ahmad (D-At-Large), Philadelphia — bill sponsor

Illinois: The Second State Mandate

In May 2026, Illinois HB 5284 passed both chambers of the General Assembly and now awaits Governor Pritzker’s signature. Sponsored by Rep. Yolonda Morris (D-District 9), a healthcare professional and former SEIU organizer, it cleared the Senate 54–4 on May 21, 2026. When signed, Illinois becomes the second state after Rhode Island with explicit workplace menopause accommodation requirements.

The bill does two distinct things on two different clocks. Effective January 1, 2027, it adds menopause-related conditions to the Illinois Human Rights Act as a protected category, defines reasonable accommodations to explicitly include flexible or modified hours, a temperature-adjusted workspace, private spaces for symptom management, remote work and light duty where feasible, and requires a workplace notice summarizing those rights. It also directs the Illinois Department of Public Health to produce public educational materials.

Effective January 1, 2028, it requires all group and individual health plans and managed care organizations to cover medically necessary hormonal and non-hormonal therapy for menopausal and perimenopausal symptoms, across all FDA-approved delivery methods — oral, transdermal, topical and vaginal ring — including medications for menopause-related osteoporosis.

It also amends the Human Rights Act to add that it is unlawful to discriminate against an individual due to a menopause-related condition, including in the workplace.

Senate Majority Leader Kimberly Lightford (D-Maywood), Illinois Senate floor, May 21, 2026

Illinois had already moved on the insurance side. HB 5295, enacted in 2024 and effective January 1, 2026, expanded coverage to all FDA-approved hormonal and non-hormonal menopause treatments across group, individual and managed care plans, and added Medicaid coverage for medically necessary hormone therapy.

The National Wave

Since 2023, more than 20 states have introduced menopause-related bills and nine or more are now law. A Bloomberg Government analysis found at least 16 menopause bills introduced in the first quarter of 2026 alone — more than five times the entire 2025 total. The activity spans insurance coverage, clinician training, workplace protections, research mandates and public awareness.

The pending workplace bills matter more than the enacted ones, because they show where the model is going. New York’s A5436B (Rosenthal) follows the Rhode Island structure — adding menstrual- and menopausal-related conditions to the Human Rights Law, requiring accommodations, an informational pamphlet and a posted workplace notice. A separate New York bill, A10296 (Seawright), would require at least five days of paid leave per year for menopause symptoms. New Jersey’s A4487 / S3779 is the first in the country to write these protections in explicitly gender-neutral language, applying to any individual experiencing the symptoms. California’s AB 1940 (Calderon) would add perimenopause, menopause and postmenopause to FEHA’s definition of “sex,” covering employers with five or more employees and requiring a state public education campaign by July 2027; it cleared the Labor and Employment Committee 7–0 in March 2026.

Not every bill survives. Virginia’s legislature passed SB 258 / HB 1173, but the Governor vetoed the accommodation mandate on May 19, 2026 and instead directed the Commissioner of Labor and Industry to conduct a workforce study with best practices due January 1, 2028. The anti-discrimination provision survived. That study is worth watching — it is likely to produce the model framework the next wave of states adapts.

This isn’t a political issue; it’s about recognizing that half our population deserves proper healthcare.

Assemblywoman Rebecca Bauer-Kahan (CA), after her menopause bill passed the California Assembly floor 70–1

Federal Action and the Evidence Base Behind It

In June 2026 Congress introduced H.R. 9090, the Advancing Menopause Care and Mid-Life Women’s Health Act, referred to the House Committee on Energy and Commerce. It would establish NIH research coordination, create federally designated Centers of Excellence for menopause care, fund provider training grants and mandate public health awareness programs. A separate bill, H.R. 219, would require a study of menopause care access and quality for the veteran population.

Running alongside the legislation is an unprecedented flow of research money. Melinda French Gates has committed $100 million to accelerate research in menopause and women’s cardiovascular and brain health; the Gates Foundation announced a $2.5 billion investment in women’s health more broadly. The RAND Corporation’s 2025 analysis establishing the $30.2 billion annual U.S. economic burden of menopause — $5.4 billion in lost productivity plus $24.8 billion in excess medical spend — is now cited directly in state legislative records as the economic justification for employer mandates. AARP put global worker productivity losses at roughly $150 billion annually.

This matters for employers because it closes the evidentiary loop. Legislators no longer have to argue that menopause affects the workforce; they can cite a number, from a source their counterparts already accept, in a fiscal note.

What Employers Should Do Now

Regardless of whether your state has acted, the direction is unambiguous. Organizations that move now are positioned for compliance and for retention; organizations that wait will be doing this under a deadline.

1. Audit and update employment policies to include menopause, perimenopause and menstruation protections — without waiting for a state mandate.
2. Train HR, managers and supervisors to recognize and respond appropriately to accommodation requests.
3. Establish a confidential interactive process, modeled on your existing ADA and pregnancy accommodation frameworks.
4. Review physical workspaces — temperature control, ventilation, private space, break areas.
5. Assess uniform and dress code policies for modifications that reduce symptom burden.
6. Evaluate scheduling flexibility: shift adjustments, remote options, modified start and end times.
7. Update handbooks and post required notices — already required in Rhode Island, required in Philadelphia from January 1, 2027.
8. Document every accommodation request and each step of the interactive process. Documentation is the single most valuable asset in defending a claim.
9. Educate the whole workforce, not only those experiencing symptoms. Stigma is what keeps requests from being made in the first place.
10. Track Illinois HB 5284, California AB 1940 and the Virginia study. Each will significantly expand the number of covered employees or shape the template other states copy.

The Question Is No Longer Whether

Rhode Island and Philadelphia established the precedent. Illinois passed its workplace bill through both chambers and is awaiting the Governor’s signature. More than 20 states have introduced legislation and nine or more laws are enacted. New York, New Jersey, California, Massachusetts and Michigan are advancing bills that follow the same structural model: add menopause to existing anti-discrimination frameworks, require reasonable accommodations, mandate employer notice, and place the burden of proving undue hardship on the employer.

Meanwhile the underlying need has not moved. Only 5% of U.S. employers offer menopause-specific benefits, yet 64% of women want them. Nearly one in four women in leadership have turned down a promotion because of symptoms they were managing. Seventy-two percent hide their symptoms at work.

The question for employers is no longer whether menopause workplace accommodations will be required. It is whether you will be ready when they are.

Sources include: Rhode Island General Laws § 28-5-7.4 / S.B. S0361 (2025); Philadelphia City Council Bill No. 250849 (2025) amending Chapter 9-1100 of The Philadelphia Code; Illinois HB 5284 and HB 5295 (LegiScan, WAND-TV, Crain’s Chicago Business, McDermott Will & Emery); New York A5436B, A10296 and S7495A; New Jersey A4487 / S3779 and the Menopause Coverage Act; California AB 1940; Virginia SB 258 / HB 1173; Louisiana Act 784; H.R. 9090 and H.R. 219; Duane Morris LLP, Littler Mendelson and Jackson Lewis P.C. client alerts (Dec 2025–Jan 2026); Bloomberg Government; CNN (July 2025); Jennifer Weiss-Wolf / Ms. Magazine (Jan 2026); Axios; Mayo Clinic and RAND Corporation; AARP (2025); Bank of America / National Menopause Foundation (2023); WebMD Health Services (2025); Catalyst (2024); NFP/SHRM (2024). Adapted from the TeltraCare white paper The Menopause Workplace Mandate (June 2026). This article is informational and is not legal advice.