iOS 26.6 beta (23G5028e) seems to fix the issue! I tested with an app that had previously requested permissions on 26.5 (but not granted or denied due to the bug), and the BP permission successfully showed in the popup and the app was able to pull BP data from HealthKit. I also tested with an app that had not yet requested BP permissions, and I was able to grant BP permission in the popup and then pull BP data from HealthKit. Thanks!

@DTS Engineer Thanks for your response. I do have a feedback report, ID 22584925. Before filing the report I also tested on the latest iOS 26 beta (26.5b3), and the issue persists.

@DTS Engineer do you know if the issue where samples get recreated multiple times has been fixed in iOS 26.1? I don't see it in the changelog and no one responded to my feedback report (FB20281674).

Yes, that works - I cannot reproduce the bug using that API. That's a much simpler workaround than what I've been doing. Thanks!