CA SB 418
vetoedHealth care coverage: prescription hormone therapy and nondiscrimination.
California · 2025-2026 Regular Session · upper
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Quick answers
Did CA SB 418 pass?
No. CA SB 418 passed the legislature but was vetoed. Latest recorded action (2026-03-02): Veto sustained.
What is CA SB 418 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 willful violation of the act's requirements a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law also provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services pursuant to a schedule of benefits. Existing law sets forth specified coverage requirements for health care service plan contracts and health insurance policies. Existing law generally authorizes a health care service plan or health insurer to use utilization controls to approve, modify, delay, or deny requests for health care services based on medical necessity. Existing law requires health care service plans and health insurers, as specified, within 6 months after the relevant department issues specified guidance, or no later than March 1, 2025, to require all of their staff who are in direct contact with enrollees or insureds in the delivery of care or enrollee or insured services to complete evidence-based cultural competency training for the purpose of providing trans-inclusive health care for individuals who identify as transgender, gender diverse, or intersex. This bill would require a health care service plan contract or health insurance policy issued, amended, renewed, or delivered on or after the bill's operative date that provides outpatient prescription drug benefits to cover up to a 12-month supply of a United States Food and Drug Administration (FDA) -approved prescription hormone therapy, and the necessary supplies for self-administration, that is prescribed by a network provider within their scope of practice and dispensed at one time, as specified. The bill would make the same prescription hormone therapy a covered benefit under the Medi-Cal program, as specified. The bill would prohibit a plan or an insurer from imposing utilization controls or other forms of medical management limiting the supply of this hormone therapy to an amount that is less than a 12-month supply, but would not prohibit a contract, a policy, or the Medi-Cal program from limiting refills that may be obtained in the last quarter of the plan, policy, or coverage year if a 12-month supply of the prescription hormone therapy has already been dispensed during that year. The bill would exclude a Medi-Cal managed care plan contracting with the State Department of Health Care Services from these requirements. The bill would repeal these provisions on January 1, 2035. This bill would prohibit a subscriber, enrollee, policyholder, or insured from being excluded from enrollment or participation in, being denied the benefits of, or being subjected to discrimination by, any health care service plan or health insurer licensed in this state, on the basis of race, color, national origin, age, disability, or sex. The bill would define discrimination on the basis of sex for those purposes to include, among other things, sex characteristics, including intersex traits, pregnancy, and gender identity. The bill would prohibit a health care service plan or health insurer from taking specified actions relating to providing access to health programs and activities, including, but not limited to, denying or limiting health care services to an individual based upon the individual's sex assigned at birth, gender identity, or gender otherwise recorded. The bill would prohibit a health care service plan or health insurer, in specified circumstances, from taking various actions, including, but not limited to, denying, canceling, limiting, or refusing to issue or renew health care service plan enrollment, health insurance coverage, or other health-related coverage, or denying or limiting coverage of a claim, or imposing additional cost sharing or other limitations or restrictions on coverage, on the basis of race, color, national origin, sex, age, or disability, as specified. Because a violation of the bill's requirements by a health care service plan would be a crime, the bill would impose a state-mandated local program. Existing law requires a pharmacist to dispense, at a patient's request, up to a 12-month supply of an FDA-approved, self-administered hormonal contraceptive pursuant to a valid prescription that specifies an initial quantity followed by periodic refills. This bill would additionally require a pharmacist to dispense, at a patient's request, up to a 12-month supply of an FDA-approved, prescription hormone therapy pursuant to a valid prescription that specifies an initial quantity followed by periodic refills, unless an exception is met. 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. This bill would declare that it is to take effect immediately as an urgency statute.
Who sponsors CA SB 418?
Menjivar is the primary sponsor of CA SB 418, joined by 2 cosponsors.
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 willful violation of the act's requirements a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law also provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services pursuant to a schedule of benefits. Existing law sets forth specified coverage requirements for health care service plan contracts and health insurance policies. Existing law generally authorizes a health care service plan or health insurer to use utilization controls to approve, modify, delay, or deny requests for health care services based on medical necessity. Existing law requires health care service plans and health insurers, as specified, within 6 months after the relevant department issues specified guidance, or no later than March 1, 2025, to require all of their staff who are in direct contact with enrollees or insureds in the delivery of care or enrollee or insured services to complete evidence-based cultural competency training for the purpose of providing trans-inclusive health care for individuals who identify as transgender, gender diverse, or intersex. This bill would require a health care service plan contract or health insurance policy issued, amended, renewed, or delivered on or after the bill's operative date that provides outpatient prescription drug benefits to cover up to a 12-month supply of a United States Food and Drug Administration (FDA) -approved prescription hormone therapy, and the necessary supplies for self-administration, that is prescribed by a network provider within their scope of practice and dispensed at one time, as specified. The bill would make the same prescription hormone therapy a covered benefit under the Medi-Cal program, as specified. The bill would prohibit a plan or an insurer from imposing utilization controls or other forms of medical management limiting the supply of this hormone therapy to an amount that is less than a 12-month supply, but would not prohibit a contract, a policy, or the Medi-Cal program from limiting refills that may be obtained in the last quarter of the plan, policy, or coverage year if a 12-month supply of the prescription hormone therapy has already been dispensed during that year. The bill would exclude a Medi-Cal managed care plan contracting with the State Department of Health Care Services from these requirements. The bill would repeal these provisions on January 1, 2035. This bill would prohibit a subscriber, enrollee, policyholder, or insured from being excluded from enrollment or participation in, being denied the benefits of, or being subjected to discrimination by, any health care service plan or health insurer licensed in this state, on the basis of race, color, national origin, age, disability, or sex. The bill would define discrimination on the basis of sex for those purposes to include, among other things, sex characteristics, including intersex traits, pregnancy, and gender identity. The bill would prohibit a health care service plan or health insurer from taking specified actions relating to providing access to health programs and activities, including, but not limited to, denying or limiting health care services to an individual based upon the individual's sex assigned at birth, gender identity, or gender otherwise recorded. The bill would prohibit a health care service plan or health insurer, in specified circumstances, from taking various actions, including, but not limited to, denying, canceling, limiting, or refusing to issue or renew health care service plan enrollment, health insurance coverage, or other health-related coverage, or denying or limiting coverage of a claim, or imposing additional cost sharing or other limitations or restrictions on coverage, on the basis of race, color, national origin, sex, age, or disability, as specified. Because a violation of the bill's requirements by a health care service plan would be a crime, the bill would impose a state-mandated local program. Existing law requires a pharmacist to dispense, at a patient's request, up to a 12-month supply of an FDA-approved, self-administered hormonal contraceptive pursuant to a valid prescription that specifies an initial quantity followed by periodic refills. This bill would additionally require a pharmacist to dispense, at a patient's request, up to a 12-month supply of an FDA-approved, prescription hormone therapy pursuant to a valid prescription that specifies an initial quantity followed by periodic refills, unless an exception is met. 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. This bill would declare that it is to take effect immediately as an urgency statute.
- Introduced
- 2025-02-18
- Latest action
- 2026-03-02 — Veto sustained.
- Bill type
- bill
- Last updated
- —
Subjects
Sponsors
- Menjivarauthor
- Cervantescoauthor
- Bontacoauthor
Committees
Not provided by source.
Action timeline
Newest first
2026-03-02
Veto sustained.
2026-03-02
Stricken from file.
2025-10-13
In Senate. Consideration of Governor's veto pending.
2025-10-13
Vetoed by the Governor.
executive-veto
2025-09-22
Enrolled and presented to the Governor at 2 p.m.
executive-receipt
2025-09-11
Assembly amendments concurred in. (Ayes 29. Noes 10. Page 2893.) Ordered to engrossing and enrolling.
amendment-passage,committee-passage,committee-passage-favorable
2025-09-11
Urgency clause adopted.
amendment-passage,passage
2025-09-10
In Senate. Concurrence in Assembly amendments pending.
2025-09-10
Read third time. Urgency clause adopted. Passed. (Ayes 60. Noes 18. Page 3174.) Ordered to the Senate.
amendment-passage,passage,reading-1,reading-3
2025-09-05
Ordered to third reading.
reading-1,reading-3
2025-09-05
Assembly Rule 69(b)(1) suspended.
2025-09-05
Read third time and amended.
amendment-passage,reading-1,reading-3
2025-09-02
Read second time. Ordered to third reading.
reading-1,reading-2,reading-3
2025-08-29
From committee: Do pass. (Ayes 11. Noes 4.) (August 29).
committee-passage,committee-passage-favorable
2025-08-20
August 20 set for first hearing. Placed on APPR. suspense file.
2025-07-09
Read second time and amended. Re-referred to Com. on APPR.
amendment-passage,reading-1,reading-2,referral-committee
2025-07-08
From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 12. Noes 5.) (July 8).
amendment-passage,committee-passage,committee-passage-favorable,referral-committee
2025-07-02
Coauthors revised.
2025-07-02
From committee: Do pass and re-refer to Com. on B. & P. (Ayes 12. Noes 2.) (July 1). Re-referred to Com. on B. & P.
committee-passage,committee-passage-favorable,referral-committee
2025-06-23
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
2025-06-05
Referred to Coms. on HEALTH and JUD.
referral-committee
2025-05-28
In Assembly. Read first time. Held at Desk.
reading-1
2025-05-28
Read third time. Passed. (Ayes 28. Noes 10. Page 1307.) Ordered to the Assembly.
passage,reading-1,reading-3
2025-05-06
Read second time. Ordered to third reading.
reading-1,reading-2,reading-3
2025-05-05
From committee: Be ordered to second reading pursuant to Senate Rule 28.8.
committee-passage,reading-1,reading-2
2025-04-29
Set for hearing May 5.
2025-04-24
Read second time and amended. Re-referred to Com. on APPR.
amendment-passage,reading-1,reading-2,referral-committee
2025-04-23
From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 11. Noes 1. Page 834.) (April 22).
amendment-passage,committee-passage,committee-passage-favorable,referral-committee
2025-04-10
From committee: Do pass and re-refer to Com. on JUD. (Ayes 9. Noes 0. Page 737.) (April 9). Re-referred to Com. on JUD.
committee-passage,committee-passage-favorable,referral-committee
2025-04-01
Set for hearing April 22 in JUD. pending receipt.
2025-03-28
Set for hearing April 9.
2025-03-27
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
2025-02-26
Referred to Coms. on HEALTH and JUD.
referral-committee
2025-02-19
From printer. May be acted upon on or after March 21.
2025-02-18
Introduced. Read first time. To Com. on RLS. for assignment. To print.
introduction,reading-1,referral-committee
Versions
- 02/18/25 - Introduced — 2025-02-18Compare
- 03/27/25 - Amended Senate — 2025-03-27Compare
- 04/24/25 - Amended Senate — 2025-04-24Compare
- 06/23/25 - Amended Assembly — 2025-06-23Compare
- 07/09/25 - Amended Assembly — 2025-07-09Compare
- 09/05/25 - Amended Assembly — 2025-09-05Compare
- 09/16/25 - Enrolled — 2025-09-16Compare
- SB418Compare
- (document, no version)Compare
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Votes
Do pass, but first be re-referred to the Committee on [Judiciary]
2025-04-09 · pass · 9-0
Member-level votes (11)
- Menjivar: yes
- Richardson: yes
- Rubio: yes
- Gonzalez: yes
- Limón: yes
- Weber Pierson: yes
- Wiener: yes
- Durazo: yes
- Padilla: yes
- Valladares: other
- Grove: other
Do pass as amended, but first amend, and re-refer to the Committee on [Appropriations]
2025-04-22 · pass · 11-1
Member-level votes (13)
- Allen: yes
- Wahab: yes
- Durazo: yes
- Umberg: yes
- Caballero: yes
- Laird: yes
- Arreguín: yes
- Stern: yes
- Weber Pierson: yes
- Ashby: yes
- Wiener: yes
- Valladares: no
- Niello: other
3rd Reading
2025-05-28 · pass · 28-10
Member-level votes (40)
- McNerney: yes
- Cabaldon: yes
- Allen: yes
- Padilla: yes
- Cervantes: yes
- Gonzalez: yes
- Smallwood-Cuevas: yes
- Laird: yes
- Becker: yes
- Rubio: yes
- Caballero: yes
- Arreguín: yes
- Wahab: yes
- Weber Pierson: yes
- Archuleta: yes
- McGuire: yes
- Richardson: yes
- Blakespear: yes
- Cortese: yes
- Hurtado: yes
- Durazo: yes
- Ashby: yes
- Grayson: yes
- Wiener: yes
- Stern: yes
- Pérez: yes
- Umberg: yes
- Menjivar: yes
- Alvarado-Gil: no
- Grove: no
- Ochoa Bogh: no
- Dahle: no
- Niello: no
- Strickland: no
- Choi: no
- Seyarto: no
- Valladares: no
- Jones: no
- Limón: other
- Reyes: other
Do pass and be re-referred to the Committee on [Business and Professions]
2025-07-01 · pass · 12-2
Member-level votes (16)
- Bonta: yes
- Caloza: yes
- Mark González: yes
- Schiavo: yes
- Aguiar-Curry: yes
- Celeste Rodriguez: yes
- Patel: yes
- Stefani: yes
- Krell: yes
- Addis: yes
- Carrillo: yes
- Sharp-Collins: yes
- Chen: no
- Sanchez: no
- Patterson: other
- Flora: other
Do pass as amended and be re-referred to the Committee on [Appropriations]
2025-07-08 · pass · 12-5
Member-level votes (18)
- Caloza: yes
- Pellerin: yes
- Jackson: yes
- Elhawary: yes
- Irwin: yes
- Lowenthal: yes
- Berman: yes
- Ahrens: yes
- Krell: yes
- Nguyen: yes
- Haney: yes
- Bains: yes
- Hadwick: no
- Chen: no
- Alanis: no
- Flora: no
- Macedo: no
- Bauer-Kahan: other
Do pass.
2025-08-29 · pass · 11-4
Member-level votes (15)
- Elhawary: yes
- Pellerin: yes
- Fong: yes
- Pacheco: yes
- Calderon: yes
- Arambula: yes
- Mark González: yes
- Wicks: yes
- Caloza: yes
- Ahrens: yes
- Solache: yes
- Sanchez: no
- Ta: no
- Tangipa: no
- Dixon: no
SB 418 Menjivar Third Reading Urgency By Bonta
2025-09-10 · pass · 60-18
Member-level votes (80)
- Ahrens: yes
- Mark González: yes
- Quirk-Silva: yes
- Gipson: yes
- Rogers: yes
- Addis: yes
- Ward: yes
- Haney: yes
- Hart: yes
- Fong: yes
- Elhawary: yes
- Calderon: yes
- Wilson: yes
- Carrillo: yes
- Bains: yes
- Ransom: yes
- Soria: yes
- Michelle Rodriguez: yes
- Berman: yes
- Valencia: yes
- Wicks: yes
- Celeste Rodriguez: yes
- Arambula: yes
- Connolly: yes
- Schultz: yes
- Bauer-Kahan: yes
- Bennett: yes
- Papan: yes
- Schiavo: yes
- Bonta: yes
- Ávila Farías: yes
- Aguiar-Curry: yes
- Pacheco: yes
- Boerner: yes
- Alvarez: yes
- Lee: yes
- Stefani: yes
- Caloza: yes
- Sharp-Collins: yes
- Nguyen: yes
- Ortega: yes
- Solache: yes
- Lowenthal: yes
- Blanca Rubio: yes
- Jackson: yes
- Bryan: yes
- Petrie-Norris: yes
- Harabedian: yes
- Gabriel: yes
- Zbur: yes
- McKinnor: yes
- Pellerin: yes
- Muratsuchi: yes
- Krell: yes
- Irwin: yes
- Ramos: yes
- Patel: yes
- Kalra: yes
- Rivas: yes
- Garcia: yes
- Johnson: no
- Dixon: no
- Hoover: no
- Hadwick: no
- Lackey: no
- Macedo: no
- Alanis: no
- Gallagher: no
- Jeff Gonzalez: no
- Sanchez: no
- Ta: no
- Chen: no
- Castillo: no
- Ellis: no
- Davies: no
- Flora: no
- Patterson: no
- DeMaio: no
- Tangipa: other
- Wallis: other
Unfinished Business SB418 Menjivar et al. Urgency Clause Concurrence
2025-09-11 · pass · 29-10
Member-level votes (40)
- Umberg: yes
- McGuire: yes
- Pérez: yes
- Cabaldon: yes
- Wiener: yes
- Reyes: yes
- McNerney: yes
- Cervantes: yes
- Caballero: yes
- Menjivar: yes
- Allen: yes
- Archuleta: yes
- Limón: yes
- Durazo: yes
- Richardson: yes
- Hurtado: yes
- Blakespear: yes
- Gonzalez: yes
- Ashby: yes
- Padilla: yes
- Laird: yes
- Stern: yes
- Grayson: yes
- Rubio: yes
- Cortese: yes
- Smallwood-Cuevas: yes
- Becker: yes
- Weber Pierson: yes
- Arreguín: yes
- Valladares: no
- Alvarado-Gil: no
- Ochoa Bogh: no
- Seyarto: no
- Jones: no
- Grove: no
- Strickland: no
- Niello: no
- Dahle: no
- Choi: no
- Wahab: other
Related bills
No related bills recorded for this bill.
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