SB 62: Health care coverage: essential health benefits.

Official summary

Legislative Counsel’s Digest (official, as of the latest version). Written by nonpartisan legislative staff; reproduced verbatim.

Existing law, the Knox-Keene Health Care Service Plan Act of 1975, requires the Department of Managed Health Care to license and regulate health care service plans and makes a willful violation of the act a crime. Existing law requires an individual or small group health care service plan contract issued, amended, or renewed on or after January 1, 2017, to include, at a minimum, coverage for essential health benefits pursuant to the federal Patient Protection and Affordable Care Act. Existing law requires a health care service plan contract to cover the same health benefits that the benchmark plan, the Kaiser Foundation Health Plan Small Group HMO 30 plan, offered during the first quarter of 2014, as specified.

This bill would express the intent of the Legislature to review California’s essential health benefits benchmark plan and establish a new benchmark plan for the 2027 plan year for health care service plans. The bill would require, commencing January 1, 2027, if the United States Department of Health and Human Services approves a new essential health benefits benchmark plan for the state, as specified, the benchmark plan for health care service plans to include certain additional benefits, including coverage for specified fertility services and specified durable medical equipment. Because a violation of the bill 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.

Sponsors

Sponsors by party (alphabetical): Democratic 2

“Support” is shown only as formal sponsorship recorded by the legislature. Roll-call votes are available on the official bill page.

Recent official actions

1. October 13, 2025Chaptered by Secretary of State. Chapter 739, Statutes of 2025.
2. October 13, 2025Approved by the Governor.
3. September 16, 2025Enrolled and presented to the Governor at 3 p.m.
4. September 8, 2025Assembly amendments concurred in. (Ayes 39. Noes 0. Page 2604.) Ordered to engrossing and enrolling.
5. September 3, 2025In Senate. Concurrence in Assembly amendments pending.
6. September 3, 2025Read third time. Passed. (Ayes 76. Noes 0. Page 2873.) Ordered to the Senate.
7. August 21, 2025Read second time. Ordered to third reading.
8. August 20, 2025From committee: Do pass. (Ayes 15. Noes 0.) (August 20).
9. July 16, 2025From committee: Do pass and re-refer to Com. on APPR. (Ayes 16. Noes 0.) (July 15). Re-referred to Com. on APPR.
10. July 1, 2025From committee with author's amendments. Read second time and amended. Re-referred to Com. on HEALTH.
11. June 5, 2025Referred to Com. on HEALTH.
12. May 28, 2025In Assembly. Read first time. Held at Desk.