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CaliforniaSB 622025-2026 Regular SessionSenateWALLET

Health care coverage: essential health benefits.

Sponsored By: Caroline Menjivar (Democratic)

Signed by Governor

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Bill Overview

Analyzed Economic Effects

5 provisions identified: 4 benefits, 0 costs, 1 mixed.

2027: infertility, equipment, and hearing added

Beginning January 1, 2027, if federal HHS approves California’s new benchmark, plans must add key benefits. Coverage will include infertility treatments and related testing and storage, specified durable medical equipment like wheelchairs, CPAPs, and oxygen, and hearing care with an annual exam and one hearing aid per ear every three years.

Essential benefits for individual and small-group plans

The law requires individual and small-group plans issued, changed, or renewed on or after January 1, 2017 to cover essential health benefits. The same rules apply whether the plan is sold on the state Health Benefit Exchange or off it. For these benefits, your plan cannot set stricter treatment limits than the benchmark plan allows.

Habilitative care covered like rehab

Plans must cover habilitative services and devices on the same terms as rehabilitative care. Limits for habilitative and rehabilitative services cannot be combined. Habilitative care helps a person keep, learn, or improve daily living skills.

Stronger dental and vision for kids

Pediatric vision in covered plans must match the federal employee vision plan with the most enrollees in early 2014. Pediatric dental must match Medi‑Cal’s 2014 children’s dental package, including medically necessary braces. These benefits are on top of what the 2014 Kaiser benchmark already covered.

Rules and exceptions on required benefits

Plans cannot replace required benefits with other benefits unless federal and state rules allow it. A plan may use a different drug list only when federal law permits it and state drug coverage rules are met, which can change which medicines are covered. This section does not require coverage of changes from laws passed on or after December 31, 2011, and it does not obligate the state to fund benefits beyond federal essential health benefits. Some plan types are exempt: specialized plans, Medicare supplement plans, and grandfathered plans.

Sponsors & Cosponsors

Sponsor

  • Caroline Menjivar

    Democratic • Senate

Cosponsors

  • Mia Bonta

    Democratic • House

Roll Call Votes

All Roll Calls

Yes: 209 • No: 0

Senate vote • 9/8/2025

Item 167 — Senate SFLOOR

Yes: 39 • No: 0

House vote • 9/3/2025

Item 187 — Assembly AFLOOR

Yes: 76 • No: 0

legislature vote • 8/20/2025

Vote in CX25

Yes: 15 • No: 0

legislature vote • 7/15/2025

Vote in CX08

Yes: 16 • No: 0

Senate vote • 5/27/2025

Item 271 — Senate SFLOOR

Yes: 39 • No: 0

legislature vote • 5/23/2025

Vote in CS61

Yes: 6 • No: 0

legislature vote • 5/12/2025

Vote in CS61

Yes: 7 • No: 0

legislature vote • 4/30/2025

Vote in CS60

Yes: 11 • No: 0

Actions Timeline

  1. Chaptered by Secretary of State. Chapter 739, Statutes of 2025.

    10/13/2025Senate

  2. Approved by the Governor.

    10/13/2025legislature

  3. Enrolled and presented to the Governor at 3 p.m.

    9/16/2025legislature

  4. Assembly amendments concurred in. (Ayes 39. Noes 0. Page 2604.) Ordered to engrossing and enrolling.

    9/8/2025Senate

  5. In Senate. Concurrence in Assembly amendments pending.

    9/3/2025Senate

  6. Read third time. Passed. (Ayes 76. Noes 0. Page 2873.) Ordered to the Senate.

    9/3/2025House

  7. Read second time. Ordered to third reading.

    8/21/2025House

  8. From committee: Do pass. (Ayes 15. Noes 0.) (August 20).

    8/20/2025House

  9. From committee: Do pass and re-refer to Com. on APPR. (Ayes 16. Noes 0.) (July 15). Re-referred to Com. on APPR.

    7/16/2025House

  10. From committee with author's amendments. Read second time and amended. Re-referred to Com. on HEALTH.

    7/1/2025House

  11. Referred to Com. on HEALTH.

    6/5/2025House

  12. In Assembly. Read first time. Held at Desk.

    5/28/2025House

  13. Read third time. Passed. (Ayes 39. Noes 0. Page 1251.) Ordered to the Assembly.

    5/27/2025Senate

  14. Read second time. Ordered to third reading.

    5/23/2025Senate

  15. From committee: Do pass. (Ayes 6. Noes 0. Page 1190.) (May 23).

    5/23/2025Senate

  16. Set for hearing May 23.

    5/16/2025Senate

  17. May 12 hearing: Placed on APPR. suspense file.

    5/12/2025Senate

  18. Set for hearing May 12.

    5/2/2025Senate

  19. From committee: Do pass and re-refer to Com. on APPR. (Ayes 11. Noes 0. Page 965.) (April 30). Re-referred to Com. on APPR.

    5/1/2025Senate

  20. From committee with author's amendments. Read second time and amended. Re-referred to Com. on HEALTH.

    4/23/2025Senate

  21. Set for hearing April 30.

    4/11/2025Senate

  22. Referred to Com. on HEALTH.

    1/29/2025Senate

  23. From printer. May be acted upon on or after February 9.

    1/10/2025Senate

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

    1/9/2025Senate

Bill Text

  • Chaptered

    10/13/2025

    HTML

  • Enrolled

    9/10/2025

    HTML

  • Amended Assembly

    7/1/2025

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  • Amended Senate

    4/23/2025

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  • Introduced

    1/9/2025

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