Bill > SB535

This bill, known as the Obesity Care Access Act, aims to require health insurance plans and health care service contracts to provide comprehensive coverage for obesity treatment starting January 1, 2026. Specifically, the bill mandates that health plans covering outpatient prescription drugs must include coverage for bariatric surgery and at least one FDA-approved antiobesity medication. The legislation recognizes obesity as a serious chronic disease influenced by genetics, environment, and biology, and highlights its links to numerous health complications, including increased cancer risks and depression. The bill seeks to address health equity gaps by ensuring patients have access to a full range of obesity treatments without facing barriers like stigma, racism, or discriminatory coverage restrictions. The law allows insurers to apply standard medical necessity evaluations to these treatments and ensures that coverage criteria for antiobesity medications align with FDA-approved indications. The bill applies to individual and group health plans, with exceptions for specialized dental, vision, or Medicare supplement plans. By mandating this coverage, the legislation aims to improve treatment options for individuals with obesity and recognize it as a complex medical condition deserving comprehensive medical care.

Budget and Finance, Health and Social Services

https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202520260SB535