California 20252026 Regular Session Status: To Executive 2 D cosponsors

SB 40 — Health care coverage: insulin.

Last action — Chaptered by Secretary of State. Chapter 737, Statutes of 2025.

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  1. ✓
    Introduced
  2. ✓
    In Committee
  3. ✓
    Passed Senate
  4. ✓
    Passed Assembly
  5. 5
    To Executive
  6. 6
    Enacted

This bill has been sent to the executive. Introduced December 03, 2024. It awaits signature.

Next likely step: the executive signs it into law or issues a veto.

Prognosis

Likely to advance 70% · moderate confidence

Where this bill stands today.

Odds of enactment

Moderate

How often bills like it became law.

  • To Executive

    Current position in the legislative process.

  • 4 sponsors

    1 primary, 3 co-sponsors signed on.

  • Single-party support

    Sponsorship is currently within one party (2 D).

  • Cleared a recorded vote

    Passed 8 recorded votes so far.

Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.

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 provides for the regulation of health insurers by the Department of Insurance. Existing law requires a health care service plan contract or disability insurance policy issued, amended, delivered, or renewed on or after January 1, 2000, that covers prescription benefits to include coverage for insulin if it is determined to be medically necessary. This bill would prohibit a large group health care service plan contract or health insurance policy issued, amended, delivered, or renewed on or after January 1, 2026, or an individual or small group health care service plan contract or health insurance policy on or after January 1, 2027, from imposing a copayment, coinsurance, deductible, or other cost sharing of more than $35 for a 30-day supply of an insulin prescription drug, except as specified. On and after January 1, 2026, the bill would prohibit a health care service plan or health insurer from imposing step therapy as a prerequisite to authorizing coverage of insulin, and, for a large group health care service plan contract or health insurance policy, would require at least one insulin for a given drug type in all forms and concentrations to be on the prescription drug formulary. The bill would limit the $35 cap for an individual or small group health care service plan contract or health insurance policy to only Tier 1 and Tier 2 insulin if the drug formulary is grouped into tiers, except as provided. 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.

Bill Text

Action History

  1. Chaptered by Secretary of State. Chapter 737, Statutes of 2025.

  2. Approved by the Governor.

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

  4. Assembly amendments concurred in. (Ayes 40. Noes 0. Page 2709.) Ordered to engrossing and enrolling.

  5. In Senate. Concurrence in Assembly amendments pending.

  6. Read third time. Passed. (Ayes 79. Noes 0. Page 2865.) Ordered to the Senate.

  7. Ordered to third reading.

  8. Read third time and amended.

  9. Read second time. Ordered to third reading.

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

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

  12. From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 16. Noes 0.) (July 15).

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

  14. June 24 hearing postponed by committee.

  15. Referred to Com. on HEALTH.

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

  17. Read third time. Passed. (Ayes 37. Noes 0. Page 1280.) Ordered to the Assembly.

  18. Read second time. Ordered to third reading.

  19. From committee: Do pass as amended. (Ayes 6. Noes 0. Page 1189.) (May 23).

  20. Read second time and amended. Ordered to second reading.

  21. Set for hearing May 23.

  22. April 21 hearing: Placed on APPR. suspense file.

  23. Set for hearing April 21.

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

  25. From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 11. Noes 0. Page 635.) (April 2).

  26. Set for hearing April 2.

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

  28. Referred to Com. on HEALTH.

  29. Read first time.

  30. From printer. May be acted upon on or after January 3.

  31. Introduced. To Com. on RLS. for assignment. To print.

Sponsors

Sponsorship breakdown

Export CSV (upgrade) →

1 sponsors · 3 co-sponsors · 118 not signed on

Sponsors (1)

Co-sponsors (3)

Not signed on (118)

118 members have not signed on to this bill.

Show all 118 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Votes

Passed 40 Yea · 0 Nay
Party YeaNayPresentNot Voting
Democratic 30000
Republican 10000
Total 40000
% of votes cast 100%0%0%0%
How each member voted (40)
Member Party Vote
Allen, Benjamin Democratic Yea
Archuleta, Bob Democratic Yea
Arreguín, Jesse Democratic Yea
Ashby, Angelique V. Democratic Yea
Becker, Josh Democratic Yea
Blakespear, Catherine S. Democratic Yea
Cabaldon, Christopher Democratic Yea
Caballero, Anna M. Democratic Yea
Cervantes, Sabrina Democratic Yea
Cortese, Dave Democratic Yea
Durazo, Maria Elena Democratic Yea
Gonzalez, Lena A. Democratic Yea
Grayson, Timothy S. Democratic Yea
Hurtado, Melissa Democratic Yea
Laird, John Democratic Yea
Limón, Monique Democratic Yea
McGuire, Mike Democratic Yea
McNerney, Jerry Democratic Yea
Menjivar, Caroline Democratic Yea
Padilla, Stephen C. Democratic Yea
Pérez, Sasha Renée Democratic Yea
Reyes, Eloise Gómez Democratic Yea
Richardson, Laura Democratic Yea
Rubio, Susan Democratic Yea
Smallwood-Cuevas, Lola Democratic Yea
Stern, Henry I. Democratic Yea
Umberg, Thomas J. Democratic Yea
Wahab, Aisha Democratic Yea
Weber Pierson, M.D., Akilah Democratic Yea
Wiener, Scott D. Democratic Yea
Alvarado-Gil, Marie Republican Yea
Choi, Steven S. Republican Yea
Dahle, Megan Republican Yea
Grove, Shannon Republican Yea
Jones, Brian W. Republican Yea
Niello, Roger W. Republican Yea
Ochoa Bogh, Rosilicie Republican Yea
Seyarto, Kelly Republican Yea
Strickland, Tony Republican Yea
Valladares, Suzette Martinez Republican Yea

Official roll call →

Passed 79 Yea · 0 Nay
Party YeaNayPresentNot Voting
Democratic 59000
Republican 19000
Unaffiliated 1000
Total 79000
% of votes cast 100%0%0%0%
How each member voted (79)
Member Party Vote
Ávila Farías — Yea
Addis, Dawn Democratic Yea
Aguiar-Curry, Cecilia M. Democratic Yea
Ahrens, Patrick Democratic Yea
Alvarez, David Democratic Yea
Arambula, Joaquin Democratic Yea
Bains, Jasmeet Democratic Yea
Bauer-Kahan, Rebecca Democratic Yea
Bennett, Steve Democratic Yea
Berman, Marc Democratic Yea
Boerner, Tasha Democratic Yea
Bonta, Mia Democratic Yea
Bryan, Isaac G. Democratic Yea
Calderon, Lisa Democratic Yea
Caloza, Jessica Democratic Yea
Carrillo, Juan Democratic Yea
Connolly, Damon Democratic Yea
Elhawary, Sade Democratic Yea
Fong, Mike Democratic Yea
Gabriel, Jesse Democratic Yea
Garcia, Robert Democratic Yea
Gipson, Mike A. Democratic Yea
González, Mark Democratic Yea
Haney, Matt Democratic Yea
Harabedian, John Democratic Yea
Hart, Gregg Democratic Yea
Irwin, Jacqui Democratic Yea
Jackson, Corey A. Democratic Yea
Kalra, Ash Democratic Yea
Krell, Maggy Democratic Yea
Lee, Alex Democratic Yea
Lowenthal, Josh Democratic Yea
McKinnor, Tina Democratic Yea
Muratsuchi, Al Democratic Yea
Nguyen, Stephanie Democratic Yea
Ortega, Liz Democratic Yea
Pacheco, Blanca Democratic Yea
Papan, Diane Democratic Yea
Patel, Darshana R. Democratic Yea
Pellerin, Gail Democratic Yea
Petrie-Norris, Cottie Democratic Yea
Quirk-Silva, Sharon Democratic Yea
Ramos, James C. Democratic Yea
Ransom, Rhodesia Democratic Yea
Rivas, Robert Democratic Yea
Rodriguez, Celeste Democratic Yea
Rodriguez, Michelle Democratic Yea
Rogers, Chris Democratic Yea
Rubio, Blanca E. Democratic Yea
Schiavo, Pilar Democratic Yea
Schultz, Nick Democratic Yea
Sharp-Collins, LaShae Democratic Yea
Solache, Jr., José Luis Democratic Yea
Soria, Esmeralda Democratic Yea
Stefani, Catherine Democratic Yea
Valencia, Avelino Democratic Yea
Ward, Christopher M. Democratic Yea
Wicks, Buffy Democratic Yea
Wilson, Lori D. Democratic Yea
Zbur, Rick Chavez Democratic Yea
Alanis, Juan Republican Yea
Castillo, Leticia Republican Yea
Chen, Phillip Republican Yea
Davies, Laurie Republican Yea
DeMaio, Carl Republican Yea
Dixon, Diane Republican Yea
Ellis, Stan Republican Yea
Flora, Heath Republican Yea
Gallagher, James Republican Yea
Gonzalez, Jeff Republican Yea
Hadwick, Heather Republican Yea
Hoover, Josh Republican Yea
Lackey, Tom Republican Yea
Macedo, Alexandra Republican Yea
Patterson, Joe Republican Yea
Sanchez, Kate Republican Yea
Ta, Tri Republican Yea
Tangipa, David J. Republican Yea
Wallis, Greg Republican Yea

Official roll call →

Do pass.

Passed 15 Yea · 0 Nay
Party YeaNayPresentNot Voting
Democratic 11000
Republican 4000
Total 15000
% of votes cast 100%0%0%0%
How each member voted (15)
Member Party Vote
Arambula, Joaquin Democratic Yea
Calderon, Lisa Democratic Yea
Caloza, Jessica Democratic Yea
Elhawary, Sade Democratic Yea
Fong, Mike Democratic Yea
González, Mark Democratic Yea
Hart, Gregg Democratic Yea
Pacheco, Blanca Democratic Yea
Pellerin, Gail Democratic Yea
Solache, Jr., José Luis Democratic Yea
Wicks, Buffy Democratic Yea
Dixon, Diane Republican Yea
Gonzalez, Jeff Republican Yea
Ta, Tri Republican Yea
Tangipa, David J. Republican Yea

Official roll call →

Passed 16 Yea · 0 Nay
Party YeaNayPresentNot Voting
Democratic 12000
Republican 4000
Total 16000
% of votes cast 100%0%0%0%
How each member voted (16)
Member Party Vote
Addis, Dawn Democratic Yea
Aguiar-Curry, Cecilia M. Democratic Yea
Bonta, Mia Democratic Yea
Caloza, Jessica Democratic Yea
Carrillo, Juan Democratic Yea
González, Mark Democratic Yea
Krell, Maggy Democratic Yea
Patel, Darshana R. Democratic Yea
Rodriguez, Celeste Democratic Yea
Schiavo, Pilar Democratic Yea
Sharp-Collins, LaShae Democratic Yea
Stefani, Catherine Democratic Yea
Chen, Phillip Republican Yea
Flora, Heath Republican Yea
Patterson, Joe Republican Yea
Sanchez, Kate Republican Yea

Official roll call →

Passed 37 Yea · 0 Nay · 3 Other
Party YeaNayPresentNot Voting
Democratic 27003
Republican 10000
Total 37003
% of votes cast 93%0%0%8%
How each member voted (40)
Member Party Vote
Allen, Benjamin Democratic Yea
Archuleta, Bob Democratic Yea
Arreguín, Jesse Democratic Yea
Ashby, Angelique V. Democratic Yea
Becker, Josh Democratic Yea
Blakespear, Catherine S. Democratic Yea
Cabaldon, Christopher Democratic Yea
Caballero, Anna M. Democratic Yea
Cervantes, Sabrina Democratic Not Voting
Cortese, Dave Democratic Yea
Durazo, Maria Elena Democratic Yea
Gonzalez, Lena A. Democratic Yea
Grayson, Timothy S. Democratic Yea
Hurtado, Melissa Democratic Yea
Laird, John Democratic Yea
Limón, Monique Democratic Not Voting
McGuire, Mike Democratic Yea
McNerney, Jerry Democratic Yea
Menjivar, Caroline Democratic Yea
Padilla, Stephen C. Democratic Yea
Pérez, Sasha Renée Democratic Yea
Reyes, Eloise Gómez Democratic Not Voting
Richardson, Laura Democratic Yea
Rubio, Susan Democratic Yea
Smallwood-Cuevas, Lola Democratic Yea
Stern, Henry I. Democratic Yea
Umberg, Thomas J. Democratic Yea
Wahab, Aisha Democratic Yea
Weber Pierson, M.D., Akilah Democratic Yea
Wiener, Scott D. Democratic Yea
Alvarado-Gil, Marie Republican Yea
Choi, Steven S. Republican Yea
Dahle, Megan Republican Yea
Grove, Shannon Republican Yea
Jones, Brian W. Republican Yea
Niello, Roger W. Republican Yea
Ochoa Bogh, Rosilicie Republican Yea
Seyarto, Kelly Republican Yea
Strickland, Tony Republican Yea
Valladares, Suzette Martinez Republican Yea

Official roll call →

Passed 11 Yea · 0 Nay
Party YeaNayPresentNot Voting
Democratic 9000
Republican 2000
Total 11000
% of votes cast 100%0%0%0%
How each member voted (11)
Member Party Vote
Durazo, Maria Elena Democratic Yea
Gonzalez, Lena A. Democratic Yea
Limón, Monique Democratic Yea
Menjivar, Caroline Democratic Yea
Padilla, Stephen C. Democratic Yea
Richardson, Laura Democratic Yea
Rubio, Susan Democratic Yea
Weber Pierson, M.D., Akilah Democratic Yea
Wiener, Scott D. Democratic Yea
Grove, Shannon Republican Yea
Valladares, Suzette Martinez Republican Yea

Official roll call →

Subjects

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Frequently asked questions

What does SB 40 do?
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 requires a health care service plan contract or disability insurance policy issued, amended, delivered, or renewed on or after January 1, 2000, that covers prescription benefits to include coverage for insulin if it is determined to be medically necessary. This bill would prohibit a large group health care service plan contract or health insurance policy issued, amended, delivered, or renewed on or after January 1, 2026, or an individual or small group health care service plan contract or health insurance policy on or after January 1, 2027, from imposing a copayment, coinsurance, deductible, or other cost sharing of more than $35 for a 30-day supply of an insulin prescription drug, except as specified. On and after January 1, 2026, the bill would prohibit a health care service plan or health insurer from imposing step therapy as a prerequisite to authorizing coverage of insulin, and, for a large group health care service plan contract or health insurance policy, would require at least one insulin for a given drug type in all forms and concentrations to be on the prescription drug formulary. The bill would limit the $35 cap for an individual or small group health care service plan contract or health insurance policy to only Tier 1 and Tier 2 insulin if the drug formulary is grouped into tiers, except as provided. 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.
Who sponsors SB 40?
SB 40 is sponsored by Arambula, Bains, Rubio, Susan (Democratic), and Wiener, Scott D. (Democratic).
What is the current status of SB 40?
This bill has been sent to the executive. Introduced December 03, 2024. It awaits signature.
Where can I track SB 40?
Track SB 40 free on One Click Politics — get push/email alerts when it moves.

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