SB 418 — Health care coverage: prescription hormone therapy and nondiscrimination.
Last action — Veto sustained.
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✓Introduced
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✓In Committee
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✓Passed Senate
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✓Passed Assembly
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5To Executive
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6Enacted
This bill has been sent to the executive. Introduced February 18, 2025. It awaits signature.
Vetoed by Governor Gavin Newsom (Democratic) on March 02, 2026.
Next likely step: the executive signs it into law or issues a veto.
Prognosis
Where this bill stands today.
Odds of enactment
LowHow often bills like it became law.
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To Executive
Current position in the legislative process.
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1 sponsor
1 primary, 0 co-sponsors signed on.
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Single-party support
Sponsorship is currently within one party (1 D).
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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 also provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services pursuant to a schedule of benefits. Existing law sets forth specified coverage requirements for health care service plan contracts and health insurance policies. Existing law generally authorizes a health care service plan or health insurer to use utilization controls to approve, modify, delay, or deny requests for health care services based on medical necessity. Existing law requires health care service plans and health insurers, as specified, within 6 months after the relevant department issues specified guidance, or no later than March 1, 2025, to require all of their staff who are in direct contact with enrollees or insureds in the delivery of care or enrollee or insured services to complete evidence-based cultural competency training for the purpose of providing trans-inclusive health care for individuals who identify as transgender, gender diverse, or intersex. This bill would require a health care service plan contract or health insurance policy issued, amended, renewed, or delivered on or after the bill's operative date that provides outpatient prescription drug benefits to cover up to a 12-month supply of a United States Food and Drug Administration (FDA) -approved prescription hormone therapy, and the necessary supplies for self-administration, that is prescribed by a network provider within their scope of practice and dispensed at one time, as specified. The bill would make the same prescription hormone therapy a covered benefit under the Medi-Cal program, as specified. The bill would prohibit a plan or an insurer from imposing utilization controls or other forms of medical management limiting the supply of this hormone therapy to an amount that is less than a 12-month supply, but would not prohibit a contract, a policy, or the Medi-Cal program from limiting refills that may be obtained in the last quarter of the plan, policy, or coverage year if a 12-month supply of the prescription hormone therapy has already been dispensed during that year. The bill would exclude a Medi-Cal managed care plan contracting with the State Department of Health Care Services from these requirements. The bill would repeal these provisions on January 1, 2035. This bill would prohibit a subscriber, enrollee, policyholder, or insured from being excluded from enrollment or participation in, being denied the benefits of, or being subjected to discrimination by, any health care service plan or health insurer licensed in this state, on the basis of race, color, national origin, age, disability, or sex. The bill would define discrimination on the basis of sex for those purposes to include, among other things, sex characteristics, including intersex traits, pregnancy, and gender identity. The bill would prohibit a health care service plan or health insurer from taking specified actions relating to providing access to health programs and activities, including, but not limited to, denying or limiting health care services to an individual based upon the individual's sex assigned at birth, gender identity, or gender otherwise recorded. The bill would prohibit a health care service plan or health insurer, in specified circumstances, from taking various actions, including, but not limited to, denying, canceling, limiting, or refusing to issue or renew health care service plan enrollment, health insurance coverage, or other health-related coverage, or denying or limiting coverage of a claim, or imposing additional cost sharing or other limitations or restrictions on coverage, on the basis of race, color, national origin, sex, age, or disability, as specified. Because a violation of the bill's requirements by a health care service plan would be a crime, the bill would impose a state-mandated local program. Existing law requires a pharmacist to dispense, at a patient's request, up to a 12-month supply of an FDA-approved, self-administered hormonal contraceptive pursuant to a valid prescription that specifies an initial quantity followed by periodic refills. This bill would additionally require a pharmacist to dispense, at a patient's request, up to a 12-month supply of an FDA-approved, prescription hormone therapy pursuant to a valid prescription that specifies an initial quantity followed by periodic refills, unless an exception is met. 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. This bill would declare that it is to take effect immediately as an urgency statute.
Bill Text
- Enrolled 09/16/25 - Enrolled Current pdf September 16, 2025
- Amended 09/05/25 - Amended Assembly pdf September 05, 2025
- Amended 07/09/25 - Amended Assembly pdf July 09, 2025
- Amended 06/23/25 - Amended Assembly pdf June 23, 2025
- Amended 04/24/25 - Amended Senate pdf April 24, 2025
- Amended 03/27/25 - Amended Senate pdf March 27, 2025
- Introduced 02/18/25 - Introduced pdf February 18, 2025
- SB418 View text html
Action History
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Stricken from file.
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Veto sustained.
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In Senate. Consideration of Governor's veto pending.
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Vetoed by the Governor.
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Enrolled and presented to the Governor at 2 p.m.
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Assembly amendments concurred in. (Ayes 29. Noes 10. Page 2893.) Ordered to engrossing and enrolling.
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Urgency clause adopted.
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In Senate. Concurrence in Assembly amendments pending.
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Read third time. Urgency clause adopted. Passed. (Ayes 60. Noes 18. Page 3174.) Ordered to the Senate.
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Ordered to third reading.
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Read third time and amended.
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Assembly Rule 69(b)(1) suspended.
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Read second time. Ordered to third reading.
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From committee: Do pass. (Ayes 11. Noes 4.) (August 29).
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August 20 set for first hearing. Placed on APPR. suspense file.
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Read second time and amended. Re-referred to Com. on APPR.
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From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 12. Noes 5.) (July 8).
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From committee: Do pass and re-refer to Com. on B. & P. (Ayes 12. Noes 2.) (July 1). Re-referred to Com. on B. & P.
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Coauthors revised.
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From committee with author's amendments. Read second time and amended. Re-referred to Com. on HEALTH.
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Referred to Coms. on HEALTH and JUD.
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In Assembly. Read first time. Held at Desk.
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Read third time. Passed. (Ayes 28. Noes 10. Page 1307.) Ordered to the Assembly.
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Read second time. Ordered to third reading.
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From committee: Be ordered to second reading pursuant to Senate Rule 28.8.
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Set for hearing May 5.
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Read second time and amended. Re-referred to Com. on APPR.
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From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 11. Noes 1. Page 834.) (April 22).
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From committee: Do pass and re-refer to Com. on JUD. (Ayes 9. Noes 0. Page 737.) (April 9). Re-referred to Com. on JUD.
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Set for hearing April 22 in JUD. pending receipt.
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Set for hearing April 9.
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From committee with author's amendments. Read second time and amended. Re-referred to Com. on HEALTH.
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Referred to Coms. on HEALTH and JUD.
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From printer. May be acted upon on or after March 21.
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Introduced. Read first time. To Com. on RLS. for assignment. To print.
Sponsors
- Caroline Menjivar · Primary
Sponsorship breakdown
Export CSV (upgrade) →1 sponsors · 0 co-sponsors · 121 not signed on · 29 voted No
Sponsors (1)
- Menjivar, Caroline Democratic
Co-sponsors (0)
None.
Not signed on (121)
121 members have not signed on to this bill.
Show all 121 →"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.
Votes
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Democratic | 29 | 0 | 0 | 1 |
| Republican | 0 | 10 | 0 | 0 |
| Total | 29 | 10 | 0 | 1 |
| % of votes cast | 73% | 25% | 0% | 3% |
How each member voted (40)
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Democratic | 59 | 0 | 0 | 0 |
| Unaffiliated | 1 | 0 | 0 | 0 |
| Republican | 0 | 18 | 0 | 2 |
| Total | 60 | 18 | 0 | 2 |
| % of votes cast | 75% | 23% | 0% | 3% |
How each member voted (80)
| 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 | Nay |
| Castillo, Leticia | Republican | Nay |
| Chen, Phillip | Republican | Nay |
| Davies, Laurie | Republican | Nay |
| DeMaio, Carl | Republican | Nay |
| Dixon, Diane | Republican | Nay |
| Ellis, Stan | Republican | Nay |
| Flora, Heath | Republican | Nay |
| Gallagher, James | Republican | Nay |
| Gonzalez, Jeff | Republican | Nay |
| Hadwick, Heather | Republican | Nay |
| Hoover, Josh | Republican | Nay |
| Johnson, Natasha | Republican | Nay |
| Lackey, Tom | Republican | Nay |
| Macedo, Alexandra | Republican | Nay |
| Patterson, Joe | Republican | Nay |
| Sanchez, Kate | Republican | Nay |
| Ta, Tri | Republican | Nay |
| Tangipa, David J. | Republican | Not Voting |
| Wallis, Greg | Republican | Not Voting |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Democratic | 11 | 0 | 0 | 0 |
| Republican | 0 | 4 | 0 | 0 |
| Total | 11 | 4 | 0 | 0 |
| % of votes cast | 73% | 27% | 0% | 0% |
How each member voted (15)
| Member | Party | Vote |
|---|---|---|
| Ahrens, Patrick | Democratic | Yea |
| Arambula, Joaquin | Democratic | Yea |
| Calderon, Lisa | Democratic | Yea |
| Caloza, Jessica | Democratic | Yea |
| Elhawary, Sade | Democratic | Yea |
| Fong, Mike | Democratic | Yea |
| González, Mark | Democratic | Yea |
| Pacheco, Blanca | Democratic | Yea |
| Pellerin, Gail | Democratic | Yea |
| Solache, Jr., José Luis | Democratic | Yea |
| Wicks, Buffy | Democratic | Yea |
| Dixon, Diane | Republican | Nay |
| Sanchez, Kate | Republican | Nay |
| Ta, Tri | Republican | Nay |
| Tangipa, David J. | Republican | Nay |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Democratic | 12 | 0 | 0 | 1 |
| Republican | 0 | 5 | 0 | 0 |
| Total | 12 | 5 | 0 | 1 |
| % of votes cast | 67% | 28% | 0% | 6% |
How each member voted (18)
| Member | Party | Vote |
|---|---|---|
| Ahrens, Patrick | Democratic | Yea |
| Bains, Jasmeet | Democratic | Yea |
| Bauer-Kahan, Rebecca | Democratic | Not Voting |
| Berman, Marc | Democratic | Yea |
| Caloza, Jessica | Democratic | Yea |
| Elhawary, Sade | Democratic | Yea |
| Haney, Matt | Democratic | Yea |
| Irwin, Jacqui | Democratic | Yea |
| Jackson, Corey A. | Democratic | Yea |
| Krell, Maggy | Democratic | Yea |
| Lowenthal, Josh | Democratic | Yea |
| Nguyen, Stephanie | Democratic | Yea |
| Pellerin, Gail | Democratic | Yea |
| Alanis, Juan | Republican | Nay |
| Chen, Phillip | Republican | Nay |
| Flora, Heath | Republican | Nay |
| Hadwick, Heather | Republican | Nay |
| Macedo, Alexandra | Republican | Nay |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Democratic | 12 | 0 | 0 | 0 |
| Republican | 0 | 2 | 0 | 2 |
| Total | 12 | 2 | 0 | 2 |
| % of votes cast | 75% | 13% | 0% | 13% |
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 | Nay |
| Flora, Heath | Republican | Not Voting |
| Patterson, Joe | Republican | Not Voting |
| Sanchez, Kate | Republican | Nay |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Democratic | 28 | 0 | 0 | 2 |
| Republican | 0 | 10 | 0 | 0 |
| Total | 28 | 10 | 0 | 2 |
| % of votes cast | 70% | 25% | 0% | 5% |
How each member voted (40)
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Democratic | 11 | 0 | 0 | 0 |
| Republican | 0 | 1 | 0 | 1 |
| Total | 11 | 1 | 0 | 1 |
| % of votes cast | 85% | 8% | 0% | 8% |
How each member voted (13)
| Member | Party | Vote |
|---|---|---|
| Allen, Benjamin | Democratic | Yea |
| Arreguín, Jesse | Democratic | Yea |
| Ashby, Angelique V. | Democratic | Yea |
| Caballero, Anna M. | Democratic | Yea |
| Durazo, Maria Elena | Democratic | Yea |
| Laird, John | 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 |
| Niello, Roger W. | Republican | Not Voting |
| Valladares, Suzette Martinez | Republican | Nay |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Democratic | 9 | 0 | 0 | 0 |
| Republican | 0 | 0 | 0 | 2 |
| Total | 9 | 0 | 0 | 2 |
| % of votes cast | 82% | 0% | 0% | 18% |
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 | Not Voting |
| Valladares, Suzette Martinez | Republican | Not Voting |
Subjects
Frequently asked questions
- What does SB 418 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 also provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services pursuant to a schedule of benefits. Existing law sets forth specified coverage requirements for health care service plan contracts and health insurance policies. Existing law generally authorizes a health care service plan or health insurer to use utilization controls to approve, modify, delay, or deny requests for health care services based on medical necessity. Existing law requires health care service plans and health insurers, as specified, within 6 months after the relevant department issues specified guidance, or no later than March 1, 2025, to require all of their staff who are in direct contact with enrollees or insureds in the delivery of care or enrollee or insured services to complete evidence-based cultural competency training for the purpose of providing trans-inclusive health care for individuals who identify as transgender, gender diverse, or intersex. This bill would require a health care service plan contract or health insurance policy issued, amended, renewed, or delivered on or after the bill's operative date that provides outpatient prescription drug benefits to cover up to a 12-month supply of a United States Food and Drug Administration (FDA) -approved prescription hormone therapy, and the necessary supplies for self-administration, that is prescribed by a network provider within their scope of practice and dispensed at one time, as specified. The bill would make the same prescription hormone therapy a covered benefit under the Medi-Cal program, as specified. The bill would prohibit a plan or an insurer from imposing utilization controls or other forms of medical management limiting the supply of this hormone therapy to an amount that is less than a 12-month supply, but would not prohibit a contract, a policy, or the Medi-Cal program from limiting refills that may be obtained in the last quarter of the plan, policy, or coverage year if a 12-month supply of the prescription hormone therapy has already been dispensed during that year. The bill would exclude a Medi-Cal managed care plan contracting with the State Department of Health Care Services from these requirements. The bill would repeal these provisions on January 1, 2035. This bill would prohibit a subscriber, enrollee, policyholder, or insured from being excluded from enrollment or participation in, being denied the benefits of, or being subjected to discrimination by, any health care service plan or health insurer licensed in this state, on the basis of race, color, national origin, age, disability, or sex. The bill would define discrimination on the basis of sex for those purposes to include, among other things, sex characteristics, including intersex traits, pregnancy, and gender identity. The bill would prohibit a health care service plan or health insurer from taking specified actions relating to providing access to health programs and activities, including, but not limited to, denying or limiting health care services to an individual based upon the individual's sex assigned at birth, gender identity, or gender otherwise recorded. The bill would prohibit a health care service plan or health insurer, in specified circumstances, from taking various actions, including, but not limited to, denying, canceling, limiting, or refusing to issue or renew health care service plan enrollment, health insurance coverage, or other health-related coverage, or denying or limiting coverage of a claim, or imposing additional cost sharing or other limitations or restrictions on coverage, on the basis of race, color, national origin, sex, age, or disability, as specified. Because a violation of the bill's requirements by a health care service plan would be a crime, the bill would impose a state-mandated local program. Existing law requires a pharmacist to dispense, at a patient's request, up to a 12-month supply of an FDA-approved, self-administered hormonal contraceptive pursuant to a valid prescription that specifies an initial quantity followed by periodic refills. This bill would additionally require a pharmacist to dispense, at a patient's request, up to a 12-month supply of an FDA-approved, prescription hormone therapy pursuant to a valid prescription that specifies an initial quantity followed by periodic refills, unless an exception is met. 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. This bill would declare that it is to take effect immediately as an urgency statute.
- Who sponsors SB 418?
- SB 418 is sponsored by Menjivar, Caroline (Democratic).
- What is the current status of SB 418?
- This bill has been sent to the executive. Introduced February 18, 2025. It awaits signature.
- Where can I track SB 418?
- Track SB 418 free on One Click Politics — get push/email alerts when it moves.
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