CA SB 1037
vetoedHealth care coverage: rate review.
California · 2025-2026 Regular Session · upper
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Quick answers
Did CA SB 1037 pass?
No. CA SB 1037 passed the legislature but was vetoed. Latest recorded action (2026-09-27): In Senate. Consideration of Governor's veto pending.
What is CA SB 1037 about?
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a violation of the act by a health care service plan a misdemeanor. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law defines "unreasonable rate increase," for these purposes, to have the same meaning as in the federal Patient Protection and Affordable Care Act, which is that an unreasonable rate increase exists when the federal Centers for Medicare and Medicaid Services makes a determination that a rate increase is excessive, unjustified, or unfairly discriminatory, among other things. This bill would instead define "unreasonable rate increase," for the above-described purposes, to mean a rate increase that the Director of the Department of Managed Health Care or the Insurance Commissioner, as applicable, determines is excessive, unjustified, unfairly discriminatory, or otherwise unreasonable. Existing law requires a health care service plan or health insurer to submit rates to their regulating entity for review and to demonstrate the impact of any changes in the rate of growth of health care costs resulting from health care cost targets. This bill would instead require a health care service plan or health insurer to demonstrate the impact of health care cost targets and to demonstrate whether a health care service plan's or health insurer's annual rate growth exceeds or will exceed the cost target for the rating period. The bill would require, if a health care service plan's or health insurer's rate growth is expected to exceed the cost target for a rating period, the health care service plan or health insurer to include specified information in its rate filing, including, among other things, a detailed list of any proactive steps it is taking, or plans to take, for annual rate growth to meet the cost targets. Because a willful violation of these provisions by a health care service plan would be a crime, the bill would impose a state-mandated local program. Existing law requires the director or the commissioner, as applicable, in determining if a rate is unreasonable or not justified for purposes of the above-described review, to consider the impact on changes in health care costs as a result of the health care cost targets described above. This bill would delete those provisions and instead require the Department of Managed Health Care and the Department of Insurance to report on if rates, by plan or policy and in aggregate, meet the affordability standard, as defined, for an individual, a couple, and a family of four. The bill would require the report to include the annual change in premiums and cost sharing for the prior 5 years. The bill would, as part of the existing rate submission process, require a health care service plan or health insurer to provide information on premiums, deductibles, cost sharing, and any other factors specified by the department as necessary to complete the reports. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
Who sponsors CA SB 1037?
Weber Pierson is the primary sponsor of CA SB 1037.
Description
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a violation of the act by a health care service plan a misdemeanor. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law defines "unreasonable rate increase," for these purposes, to have the same meaning as in the federal Patient Protection and Affordable Care Act, which is that an unreasonable rate increase exists when the federal Centers for Medicare and Medicaid Services makes a determination that a rate increase is excessive, unjustified, or unfairly discriminatory, among other things. This bill would instead define "unreasonable rate increase," for the above-described purposes, to mean a rate increase that the Director of the Department of Managed Health Care or the Insurance Commissioner, as applicable, determines is excessive, unjustified, unfairly discriminatory, or otherwise unreasonable. Existing law requires a health care service plan or health insurer to submit rates to their regulating entity for review and to demonstrate the impact of any changes in the rate of growth of health care costs resulting from health care cost targets. This bill would instead require a health care service plan or health insurer to demonstrate the impact of health care cost targets and to demonstrate whether a health care service plan's or health insurer's annual rate growth exceeds or will exceed the cost target for the rating period. The bill would require, if a health care service plan's or health insurer's rate growth is expected to exceed the cost target for a rating period, the health care service plan or health insurer to include specified information in its rate filing, including, among other things, a detailed list of any proactive steps it is taking, or plans to take, for annual rate growth to meet the cost targets. Because a willful violation of these provisions by a health care service plan would be a crime, the bill would impose a state-mandated local program. Existing law requires the director or the commissioner, as applicable, in determining if a rate is unreasonable or not justified for purposes of the above-described review, to consider the impact on changes in health care costs as a result of the health care cost targets described above. This bill would delete those provisions and instead require the Department of Managed Health Care and the Department of Insurance to report on if rates, by plan or policy and in aggregate, meet the affordability standard, as defined, for an individual, a couple, and a family of four. The bill would require the report to include the annual change in premiums and cost sharing for the prior 5 years. The bill would, as part of the existing rate submission process, require a health care service plan or health insurer to provide information on premiums, deductibles, cost sharing, and any other factors specified by the department as necessary to complete the reports. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
- Introduced
- 2026-02-11
- Latest action
- 2026-09-27 — In Senate. Consideration of Governor's veto pending.
- Bill type
- bill
- Last updated
- —
Subjects
Sponsors
- Weber Piersonauthor
Committees
Not provided by source.
Action timeline
Newest first
2026-09-27
In Senate. Consideration of Governor's veto pending.
2026-09-27
Vetoed by the Governor.
executive-veto
2026-08-30
Enrolled and presented to the Governor at 6 p.m.
2026-08-25
Assembly amendments concurred in. (Ayes 30. Noes 9.) Ordered to engrossing and enrolling.
2026-08-25
Assembly amendments concurred in. (Ayes 30. Noes 10. Page 5794.) Ordered to engrossing and enrolling.
2026-08-25
Assembly amendments concurred in. (Ayes 30. Noes 10.) Ordered to engrossing and enrolling.
amendment-passage,committee-passage,committee-passage-favorable
2026-08-24
Read third time. Passed. Ordered to the Senate.
2026-08-24
In Senate. Concurrence in Assembly amendments pending.
2026-08-24
Read third time. Passed. (Ayes 59. Noes 15. Page 6392.) Ordered to the Senate.
passage,reading-1,reading-3
2026-08-18
Read third time and amended.
2026-08-18
Ordered to third reading.
2026-08-13
Assembly Rule 63 suspended.
2026-08-13
From committee: Do pass. (Ayes 11. Noes 2.) (August 13).
2026-08-13
Read second time. Ordered to third reading.
2026-08-05
August 5 set for first hearing. Placed on suspense file.
2026-07-02
Read second time and amended. Re-referred to Com. on APPR.
amendment-passage,reading-1,reading-2,referral-committee
2026-07-01
From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 12. Noes 4.) (June 30).
amendment-passage,committee-passage,committee-passage-favorable,referral-committee
2026-06-22
From committee with author's amendments. Read second time and amended. Re-referred to Com. on HEALTH.
amendment-passage,committee-passage,reading-1,reading-2,referral-committee
2026-06-04
Referred to Com. on HEALTH.
referral-committee
2026-05-27
In Assembly. Read first time. Held at Desk.
reading-1
2026-05-27
Read third time. Passed. (Ayes 30. Noes 9. Page 4507.) Ordered to the Assembly.
passage,reading-1,reading-3
2026-05-18
Read second time. Ordered to third reading.
reading-1,reading-2,reading-3
2026-05-14
From committee: Do pass as amended. (Ayes 5. Noes 1. Page 4262.) (May 14).
amendment-passage,committee-passage,committee-passage-favorable
2026-05-14
Read second time and amended. Ordered to second reading.
amendment-passage,reading-1,reading-2
2026-05-08
Set for hearing May 14.
2026-04-27
April 27 hearing: Placed on APPR. suspense file.
2026-04-17
Set for hearing April 27.
2026-04-16
From committee: Do pass and re-refer to Com. on APPR. (Ayes 7. Noes 1. Page 3901.) (April 15). Re-referred to Com. on APPR.
committee-passage,committee-passage-favorable,referral-committee
2026-04-07
From committee with author's amendments. Read second time and amended. Re-referred to Com. on HEALTH.
amendment-passage,committee-passage,reading-1,reading-2,referral-committee
2026-04-02
Set for hearing April 15.
2026-04-01
April 8 set for first hearing canceled at the request of author.
2026-03-23
Set for hearing April 8.
2026-02-18
Referred to Com. on HEALTH.
referral-committee
2026-02-12
From printer. May be acted upon on or after March 14.
2026-02-11
Introduced. Read first time. To Com. on RLS. for assignment. To print.
introduction,reading-1,referral-committee
Versions
- 02/11/26 - Introduced — 2026-02-11Compare
- 04/07/26 - Amended Senate — 2026-04-07Compare
- 05/14/26 - Amended Senate — 2026-05-14Compare
- 06/22/26 - Amended Assembly — 2026-06-22Compare
- 07/02/26 - Amended Assembly — 2026-07-02Compare
- 08/18/26 - Amended Assembly — 2026-08-18Compare
- 08/27/26 - Enrolled — 2026-08-27Compare
- SB1037Compare
- (document, no version)Compare
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Votes
Do pass, but first be re-referred to the Committee on [Appropriations]
2026-04-15 · pass · 7-1
Member-level votes (11)
- Caballero: yes
- Durazo: yes
- Padilla: yes
- Weber Pierson: yes
- Smallwood-Cuevas: yes
- Gonzalez: yes
- Rubio: yes
- Grove: no
- Pérez: other
- Menjivar: other
- Valladares: other
Placed on suspense file
2026-04-27 · pass · 7-0
Member-level votes (7)
- Wahab: yes
- Grayson: yes
- Dahle: yes
- Cabaldon: yes
- Seyarto: yes
- Cervantes: yes
- Richardson: yes
Do pass as amended
2026-05-14 · pass · 5-1
Member-level votes (7)
- Wahab: yes
- Cervantes: yes
- Cabaldon: yes
- Richardson: yes
- Grayson: yes
- Seyarto: no
- Dahle: other
3rd Reading SB1037 Weber Pierson
2026-05-27 · pass · 30-9
Member-level votes (40)
- Grayson: yes
- Hurtado: yes
- Limón: yes
- Wahab: yes
- Cortese: yes
- Blakespear: yes
- Cervantes: yes
- Durazo: yes
- Smallwood-Cuevas: yes
- Reyes: yes
- Cabaldon: yes
- Wiener: yes
- Padilla: yes
- Stern: yes
- Caballero: yes
- Umberg: yes
- Archuleta: yes
- Gonzalez: yes
- McGuire: yes
- Pérez: yes
- McNerney: yes
- Becker: yes
- Weber Pierson: yes
- Richardson: yes
- Arreguín: yes
- Ashby: yes
- Laird: yes
- Menjivar: yes
- Rubio: yes
- Allen: yes
- Ochoa Bogh: no
- Niello: no
- Valladares: no
- Strickland: no
- Choi: no
- Alvarado-Gil: no
- Grove: no
- Seyarto: no
- Jones: no
- Dahle: other
Do pass as amended and be re-referred to the Committee on [Appropriations]
2026-06-30 · pass · 12-4
Member-level votes (16)
- Schiavo: yes
- Sharp-Collins: yes
- Ahrens: yes
- Stefani: yes
- Mark González: yes
- Addis: yes
- Patel: yes
- Aguiar-Curry: yes
- Carrillo: yes
- Bonta: yes
- Caloza: yes
- Celeste Rodriguez: yes
- Sanchez: no
- Jeff Gonzalez: no
- Johnson: no
- Patterson: no
Related bills
No related bills recorded for this bill.
Official source
Attribution
Data from openstates_api_sync, retrieved 2026-09-28T10:57:27.315334Z
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