Obesity Care Access Act.

Plain English Breakdown

The official source material does not provide specific details on which anti-obesity medications must be covered, leaving this detail uncertain.

Obesity Care Access Act

The Obesity Care Access Act requires health insurance plans to cover certain treatments for obesity, including intensive behavioral therapy and bariatric surgery.

What This Bill Does

• Requires individual or group health care service plan contracts and insurance policies that provide prescription drug coverage to include treatment options for obesity starting January 1, 2026.
• Includes intensive behavioral therapy as a covered treatment option for obesity.
• Covers bariatric surgery under the new requirements.
• Ensures at least one anti-obesity medication approved by the FDA is included in health insurance coverage.

Who It Names or Affects

• People with individual or group health care service plans and insurance policies that provide prescription drug benefits.
• Health care providers offering obesity treatments such as behavioral therapy and surgery.
• Insurance companies and managed health care organizations in California.

Terms To Know

Bariatric Surgery

Surgery that helps people lose weight by changing how the stomach or intestines work.

Intensive Behavioral Therapy

A type of therapy focused on helping people change their behaviors to manage obesity.

Limits and Unknowns

• The bill does not specify which anti-obesity medications must be covered.
• It is unclear how much the new coverage will cost or who will pay for it.

Official Summary Text

SB 535, as amended, Richardson.
Obesity
Treatment Parity
Care Access
Act.
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 disability and health insurers by the Department of Insurance.
Existing law sets forth specified coverage requirements for plan
contracts and insurance policies.
contracts.
This bill, the Obesity
Treatment Parity
Care Access
Act, would require an individual or group health care service plan contract or health insurance policy that provides coverage for outpatient prescription drug benefits and is issued, amended, or renewed on or after January 1, 2026, to include coverage for
intensive behavioral therapy for the treatment of obesity, bariatric surgery,
bariatric surgery
and at least one antiobesity medication approved by the United States Food and Drug Administration. 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.
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.

Current Bill Text

Download Bill PDF