Health care coverage: portable HEPA purifiers.

Plain English Breakdown

The bill was vetoed but the possibility of a legislative override remains uncertain.

Health Care Coverage: Portable HEPA Purifiers

AB-546 requires large group health insurance plans to cover one portable HEPA purifier for certain individuals affected by wildfires, if prescribed by a doctor.

What This Bill Does

• Requires large group health care service plan contracts and policies issued, amended, or renewed on or after January 1, 2026, to include coverage for one portable HEPA purifier.
• Limits the cost of the covered HEPA purifier to $500 or less, adjusted for inflation.
• Applies only if a person is pregnant, diagnosed with asthma, or COPD, and resides in or has been displaced from an area where a local or state emergency has been declared due to wildfires.
• Requires that the HEPA purifier be prescribed by a healthcare provider.

Who It Names or Affects

• People with large group health insurance plans who are pregnant or diagnosed with asthma or COPD and reside in wildfire-affected areas.
• Healthcare service providers and insurers offering large group plans.

Terms To Know

HEPA purifier

A device that removes tiny particles from the air, making it cleaner to breathe.

Large group health care plan

Health insurance provided by employers with 51 or more employees.

Limits and Unknowns

• The bill does not cover specialized health care service plans or policies.
• It only applies to areas where a local or state emergency has been declared due to wildfires.
• The governor vetoed this bill, but lawmakers could still override the veto.

Official Summary Text

AB 546, Caloza.
Health care coverage: portable HEPA purifiers.
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 sets forth specified coverage requirements for plan contracts and insurance policies, and limits the copayment, coinsurance, deductible, and other cost sharing that may be imposed for specified health care services.
This bill would require a large group health care service plan contract or large group health insurance policy, except a specialized health care service plan contract or health insurance policy, that is issued, amended, or renewed on or after January 1, 2026, to include coverage for one
portable high-efficiency particulate air (HEPA) purifier for an enrollee or insured who is pregnant or diagnosed with asthma or chronic obstructive pulmonary disease if the enrollee or insured is residing in or displaced from a county where a local or state emergency has been declared due to wildfires and the HEPA purifier is prescribed by the enrollee’s or insured’s health care provider. The bill would prohibit the cost of the HEPA purifier from exceeding $500, adjusted for inflation, as specified.
Because a willful violation of these provisions by a health care service plan would be a crime, this bill would impose a state-mandated local program.
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.

Current Bill Text

Download Bill PDF