SB 535 California Senate · 2025-2026 Regular Session

Obesity Care Access Act.

Summary

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 sets forth specified coverage requirements for plan contracts. This bill, the Obesity 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 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.

Issues: ✓ Healthcare

Bill status passed 3 of 5 stages cleared

Introduction

Feb 2025

Committee Review

Aug 2026

Senate Passage

May 2025

Assembly Passage

Governor

Introduced Feb 20, 2025 Last action Aug 13, 2026

Maddy AI version diff · 2 comparisons

What changed between versions

07/17/25 - Amended Assembly → SB535 · 2 edits

MINOR

This diff reflects a formatting and presentation update rather than a substantive policy change. The bill text was converted from the printed legislative format (with line numbers, page headers, and column layout) to the clean website version. The core requirements - coverage of bariatric surgery and at least one FDA-approved antiobesity medication under the Health and Safety Code, and coverage of intensive behavioral therapy, bariatric surgery, and at least one FDA-approved antiobesity medication under the Insurance Code - remain unchanged.

TECHNICAL

Section renumbering: the no-reimbursement provision was consolidated from a separate Section 5 into Section 4, eliminating an empty or redundant section number.

Formatting conversion from printed legislative document (with line numbers, page breaks, and column layout) to clean website text format. No policy language was altered.

02/20/25 - Introduced → 07/17/25 - Amended Assembly · 5 edits · Jul 17, 2025

MODERATE

The Assembly amended SB 535 in several ways: it renamed the bill to the 'Obesity Treatment Parity Care Access Act,' removed intensive behavioral therapy from the mandatory coverage list for health care service plans (while keeping it required for insurance policies), added a savings clause preserving existing prescription drug coverage rules, and narrowed the stated legislative purpose by removing explicit reference to eliminating the 'morbid obesity' threshold. The most significant policy change is that HMOs and other health care service plans will no longer be required to cover intensive behavioral therapy for obesity, creating an asymmetry with traditional insurance policies.

Scope change

The scope of mandatory coverage was narrowed for health care service plans by removing intensive behavioral therapy from the required benefit list, while insurance policies remain unchanged. A savings clause was added to clarify the bill does not reduce any existing prescription drug coverage obligations.

SCOPE

The bill was renamed from 'Obesity Treatment Parity Act' to 'Obesity Treatment Parity Care Access Act.'

The final legislative finding was narrowed. It previously stated the act would ensure treatment options are available 'without them having to reach a level of obesity considered morbid.' The amended version simply says it ensures 'the full range of treatment options are available to patients for patients with obesity,' removing the explicit commitment to eliminating the severe/morbid obesity threshold.

REQUIREMENT

Intensive behavioral therapy was removed from the list of mandatory obesity treatments that health care service plans (HMOs) must cover. Plans now only need to cover bariatric surgery and at least one FDA-approved antiobesity medication. Insurance policies regulated by the Department of Insurance still must cover all three.

A new subsection (f) was added to Section 1374.6 stating that the new law does not limit existing prescription drug coverage requirements, including those in Section 1300.67.24 of Title 28 of the California Code of Regulations.

DEFINITION

A new legislative finding was added noting that the federal Affordable Care Act already requires health plans to cover obesity screening and intensive behavioral interventions for individuals with a BMI of 30 or higher without cost sharing.

Floor votes · Senate May 28, 2025

How they voted

28–3

Passed · 9 other

Total votes 40

May 28, 2025

D Democratic30

28 Yea 2

93% Yea

R Republican10

3 Nay 7

30% Nay

Vote distribution

All Yea All Nay Mixed No data

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Amendments

Aug 13, 2026

Lower · Passed

August 13 hearing: Held in committee and under submission.

lower

Aug 29, 2025

Lower · Passed

August 29 hearing postponed by committee.

lower

Jul 17, 2025

Lower · Passed

Read second time and amended. Re-referred to Com. on APPR.

lower

Jul 16, 2025

Lower · Passed

From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 14. Noes 0.) (July 15).

lower

Jun 5, 2025

Committee

Referred to Com. on HEALTH.

lower

May 28, 2025

Upper · Passed

Read third time. Passed. (Ayes 28. Noes 3. Page 1302.) Ordered to the Assembly.

upper

May 23, 2025

Upper · Passed

From committee: Do pass. (Ayes 5. Noes 0. Page 1203.) (May 23).

upper

May 1, 2025

Upper · Passed

From committee: Do pass and re-refer to Com. on APPR. (Ayes 8. Noes 0. Page 965.) (April 30). Re-referred to Com. on APPR.

upper

Mar 5, 2025

Committee

Referred to Com. on HEALTH.

upper

Feb 20, 2025

Introduced

Introduced. Read first time. To Com. on RLS. for assignment. To print.

upper

1 primary · 0 co-sponsors