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<ns0:Id>20250SB__108998AMD</ns0:Id>
<ns0:VersionNum>98</ns0:VersionNum>
<ns0:History>
<ns0:Action>
<ns0:ActionText>INTRODUCED</ns0:ActionText>
<ns0:ActionDate>2026-02-13</ns0:ActionDate>
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<ns0:Action>
<ns0:ActionText>AMENDED_SENATE</ns0:ActionText>
<ns0:ActionDate>2026-03-24</ns0:ActionDate>
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<ns0:SessionYear>2025</ns0:SessionYear>
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<ns0:AuthorText authorType="LEAD_AUTHOR">Introduced by Senator Richardson</ns0:AuthorText>
<ns0:Authors>
<ns0:Legislator>
<ns0:Contribution>LEAD_AUTHOR</ns0:Contribution>
<ns0:House>SENATE</ns0:House>
<ns0:Name>Richardson</ns0:Name>
</ns0:Legislator>
</ns0:Authors>
<ns0:Title> An act to add and repeal Section 22853.5 of the Government Code, and to amend Section 127693 of the Health and Safety Code, relating to health. </ns0:Title>
<ns0:RelatingClause>health</ns0:RelatingClause>
<ns0:GeneralSubject>
<ns0:Subject>Preventive Treatment Health Care Act. </ns0:Subject>
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<html:p>
(1)
<html:span class="EnSpace"/>
Existing law requires the California Health and Human Services Agency (CHHSA) to enter into partnerships resulting in the production of generic prescription drugs, including at least one form of insulin made available at production and dispensing costs, if one does not already exist in the market. Existing law requires the insulin production partnership to consider guaranteeing priority access to insulin supply for the state.
</html:p>
<html:p>This bill, the Preventive Treatment Health Care Act, would require the above-described partnerships to also include the
acquisition of brand name prescription drugs and the acquisition or production of pens, vial injections, pills, and patches of glucagon-like peptide-1 (GLP-1) semaglutide, GLP-1 receptor agonist (GLP-1RA), glucose-dependent insulinotropic polypeptide plus GLP-1 (GIP+GLP-1) tirzepatide, and future chronic weight disease products made available at production and dispensing costs and to consider guaranteeing priority access to GLP-1
semaglutide, GLP-1RA, GIP+GLP-1 tirzepatide, and future chronic weight disease products supply for the state.</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
Existing law authorizes the Board of Administration of the Public Employees’ Retirement System to contract with carriers to provide health benefit plans and contracts for employees and annuitants. Existing law sets forth specified coverage requirements for these health benefit plans and contracts.
</html:p>
<html:p>Commencing January 1, 2027, until January 1, 2032, this bill would require a health benefit plan or contract offered to public employees and annuitants to offer optional coverage for weight loss management, including nutritional information and GLP-1 semaglutide, GLP-1RA, GIP+GLP-1 tirzepatide, and future chronic weight disease products as part of one of its health plan options. The bill would specify cost and usage requirements for these covered chronic weight disease management items. The bill would require CHHSA to make chronic weight disease management medications available to state and local government
employers, and to determine if chronic weight disease management medications should be made available to all Californians, at the costs for which they are available under a Public Employees’ Retirement System health benefit plan or contract.</html:p>
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<ns0:Preamble>The people of the State of California do enact as follows:</ns0:Preamble>
<ns0:BillSection id="id_3BB7CA90-9470-44F0-8490-C8B606443497">
<ns0:Num>SECTION 1.</ns0:Num>
<ns0:Content>
<html:p>This act shall be known, and may be cited, as the Preventive Treatment Health Care Act.</html:p>
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<ns0:Num>SEC. 2.</ns0:Num>
<ns0:Content>
<html:p>The Legislature finds and declares all of the following:</html:p>
<html:p>
(a)
<html:span class="EnSpace"/>
There are approximately 30,000,000 adults 18 years of age and older living in California.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
(1)
<html:span class="EnSpace"/>
According to the University of California, Los Angeles, California Health Interview Survey, nearly 61 percent of, or more than 24,500,000, California adults 18 to 64 years of age, inclusive, are suffering from chronic weight disease, thereby falling into the combined overweight or obese category.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
The body mass index (BMI) is a formula that screens for excess weight relative to height.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
The federal Centers for Disease Control and Prevention classifies weight into six categories. The BMI formula used is categorized as follows:
</html:p>
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<html:tbody>
<html:tr>
<html:td width="208">Underweight</html:td>
<html:td width="208">BMI below 18.5</html:td>
</html:tr>
<html:tr>
<html:td width="208">Healthy weight</html:td>
<html:td width="208">BMI 18.5 to 24.9</html:td>
</html:tr>
<html:tr>
<html:td width="208">Overweight</html:td>
<html:td width="208">BMI 25.0 to 29.9</html:td>
</html:tr>
<html:tr>
<html:td width="208">Class 1 Obesity</html:td>
<html:td width="208">BMI 30.0-34.9</html:td>
</html:tr>
<html:tr>
<html:td width="208">Class 2 Obesity</html:td>
<html:td width="208">BMI 35.0 to 39.9</html:td>
</html:tr>
<html:tr>
<html:td width="208">Class 3 Obesity</html:td>
<html:td width="208">BMI 40.0 and above</html:td>
</html:tr>
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<html:p>
(4)
<html:span class="EnSpace"/>
Further, BMI is measured to determine risk for weight-related disease often associated with a waist size of 35 inches or more in women and 40 inches or more in men.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
Californians with a greater determination of overweight beyond a BMI higher than 30.0 are clinically described as obese, which has increased from 19.3 percent in 2001 to over 29 percent in 2023. Even more alarming, without prevention, obesity could reach 41 percent by 2030 in California adults.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
Serious chronic weight disease with a BMI formula rating over 30 is recognized as such by major medical organizations, including the American Medical
Association since 2013, the American Association of Clinical Endocrinology, the American College of Cardiology, the Endocrine Society, the American Society for Reproductive Medicine, the Society for Cardiovascular Angiography and Interventions, the American Urological Association, and the American College of Surgeons.
</html:p>
<html:p>
(e)
<html:span class="EnSpace"/>
(1)
<html:span class="EnSpace"/>
Chronic weight disease extends beyond the need to lose pounds but can also contribute to possible cancers and other comorbidities. From 2005 to 2014, several cancers that may be associated with chronic weight disease have increased in the United States, while cancers associated with other health factors decreased.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
Chronic weight disease reduces a patient’s overall cancer-specific survival rate, as well as increases the risk of cancer recurrence.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
The 13 types of cancer related to chronic weight disease are:
</html:p>
<html:p>
(A)
<html:span class="EnSpace"/>
Adenocarcinoma of the esophagus.
</html:p>
<html:p>
(B)
<html:span class="EnSpace"/>
Postmenopausal breast.
</html:p>
<html:p>
(C)
<html:span class="EnSpace"/>
Colon and rectal, or colorectal.
</html:p>
<html:p>
(D)
<html:span class="EnSpace"/>
Endometrial of the uterus.
</html:p>
<html:p>
(E)
<html:span class="EnSpace"/>
Gallbladder.
</html:p>
<html:p>
(F)
<html:span class="EnSpace"/>
Gastric cardia, or upper stomach.
</html:p>
<html:p>
(G)
<html:span class="EnSpace"/>
Renal cell carcinoma of the kidney.
</html:p>
<html:p>
(H)
<html:span class="EnSpace"/>
Liver.
</html:p>
<html:p>
(I)
<html:span class="EnSpace"/>
Ovarian.
</html:p>
<html:p>
(J)
<html:span class="EnSpace"/>
Pancreatic.
</html:p>
<html:p>
(K)
<html:span class="EnSpace"/>
Thyroid.
</html:p>
<html:p>
(L)
<html:span class="EnSpace"/>
Meningioma, a type of brain cancer.
</html:p>
<html:p>
(M)
<html:span class="EnSpace"/>
Multiple myeloma, a blood cancer.
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
Chronic weight disease is associated with an increased risk of more than 200 comorbid conditions. Some of those conditions are:
</html:p>
<html:p>
(A)
<html:span class="EnSpace"/>
Type 2 diabetes.
</html:p>
<html:p>
(B)
<html:span class="EnSpace"/>
High blood pressure.
</html:p>
<html:p>
(C)
<html:span class="EnSpace"/>
Heart disease.
</html:p>
<html:p>
(D)
<html:span class="EnSpace"/>
Stroke.
</html:p>
<html:p>
(E)
<html:span class="EnSpace"/>
Metabolic syndrome.
</html:p>
<html:p>
(F)
<html:span class="EnSpace"/>
Fatty liver
diseases.
</html:p>
<html:p>
(G)
<html:span class="EnSpace"/>
Other types of cancers.
</html:p>
<html:p>
(H)
<html:span class="EnSpace"/>
Breathing problems.
</html:p>
<html:p>
(I)
<html:span class="EnSpace"/>
Osteoarthritis.
</html:p>
<html:p>
(J)
<html:span class="EnSpace"/>
Gout.
</html:p>
<html:p>
(K)
<html:span class="EnSpace"/>
Diseases of the gallbladder and pancreas.
</html:p>
<html:p>
(L)
<html:span class="EnSpace"/>
Kidney disease.
</html:p>
<html:p>
(M)
<html:span class="EnSpace"/>
Pregnancy problems.
</html:p>
<html:p>
(N)
<html:span class="EnSpace"/>
Fertility problems.
</html:p>
<html:p>
(O)
<html:span class="EnSpace"/>
Sexual function problems.
</html:p>
<html:p>
(P)
<html:span class="EnSpace"/>
Mental health problems.
</html:p>
<html:p>
(f)
<html:span class="EnSpace"/>
(1)
<html:span class="EnSpace"/>
In addition to
individual health impacts of chronic weight disease, employee productivity and contributions to California’s economy are impacted by the prevention and management of chronic weight disease.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
Chronic weight disease can be related to reduced labor participation and earnings and increased early mortality, absenteeism, disability, and health care costs exceeding $1 billion and a 2.6-percent reduction in the California gross domestic product.
</html:p>
<html:p>
(g)
<html:span class="EnSpace"/>
Barriers to the reduction, maintenance, or elimination of chronic weight disease are essentially access and cost.
</html:p>
<html:p>
(h)
<html:span class="EnSpace"/>
This act is intended to increase access to the California workforce, starting with state and local employees, to identify, counsel, and treat chronic weight disease, and ensure treatments available through the California Affordable Drug Manufacturing Act of
2020, including pens, vial injections, pills, and patches of glucagon-like peptide-1 (GLP-1) semaglutide, GLP-1 receptor agonist (GLP-1RA), glucose-dependent insulinotropic polypeptide plus GLP-1 (GIP+GLP-1) tirzepatide, and future chronic weight disease products are available at the former Medi-Cal 2025 price, most favored nation price, or a better price.
</html:p>
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<ns0:Num>SEC. 3.</ns0:Num>
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Section 22853.5 is added to the
<ns0:DocName>Government Code</ns0:DocName>
, to read:
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<ns0:Num>22853.5.</ns0:Num>
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<ns0:Content>
<html:p>
(a)
<html:span class="EnSpace"/>
Commencing January 1, 2027, a health benefit plan or contract that contracts with the board pursuant to this chapter shall offer optional coverage for chronic weight disease management, including nutritional information and pens, vial injections, pills, and patches of glucagon-like peptide-1 (GLP-1) semaglutide, GLP-1 receptor agonist (GLP-1RA), glucose-dependent insulinotropic polypeptide plus GLP-1 (GIP+GLP-1) tirzepatide, and future chronic weight disease products, as part of one of its health plan options.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
Chronic weight disease management covered pursuant to subdivision (a) shall be offered at the cost previously provided to Medi-Cal beneficiaries in the year 2025 or the most favored nation pricing, as set forth in federal
Executive Order No. 14297 on May 12, 2025, or better pricing.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
Chronic weight disease management covered pursuant to subdivision (a) shall follow United States Food and Drug Administration label indications for usage.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
The California Health and Human Services Agency shall make chronic weight disease management medications described in subdivision (a) available to state and local government employers, and shall determine if chronic weight disease management medications described in subdivision (a) shall be made available to all Californians, including enrollees and insureds of licensed health care service plan contracts and health insurance policies, at the cost described in subdivision (b).
</html:p>
<html:p>
(e)
<html:span class="EnSpace"/>
This section shall remain in effect only until January 1, 2032, and as of that date is repealed.
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<ns0:Num>SEC. 4.</ns0:Num>
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Section 127693 of the
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is amended to read:
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<ns0:Num>127693.</ns0:Num>
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<html:p>
(a)
<html:span class="EnSpace"/>
CHHSA shall enter into partnerships resulting in the acquisition of brand name prescription drugs or production, procurement, or distribution of generic prescription drugs, with the intent that these drugs be made widely available to public and private purchasers, providers and suppliers as defined in subdivision (b) of Section 1367.50, and pharmacies as defined in Section 4037 of the Business and Professions Code, as appropriate. The generic prescription drugs shall be produced or distributed by a drug company or generic drug manufacturer that is registered with the United States Food and Drug Administration.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
(1)
<html:span class="EnSpace"/>
CHHSA shall only enter into partnerships pursuant to subdivision (a) to acquire brand name prescription drugs or to produce a generic prescription drug at a price that results in savings, targets failures in the market for generic drugs, or improves patient access to affordable medications.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
For top drugs identified pursuant to the criteria listed in paragraph (5), CHHSA shall determine if viable pathways exist for partnerships to manufacture, procure, or distribute generic prescription drugs by examining the relevant legal, market, policy, and regulatory factors.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
CHHSA shall consider the following, if applicable, when setting the price of
an acquired brand name prescription drug or a generic prescription drug:
</html:p>
<html:p>
(A)
<html:span class="EnSpace"/>
United States Food and Drug Administration user fees.
</html:p>
<html:p>
(B)
<html:span class="EnSpace"/>
Abbreviated new drug application acquisition costs amortized over a five-year period.
</html:p>
<html:p>
(C)
<html:span class="EnSpace"/>
Mandatory rebates.
</html:p>
<html:p>
(D)
<html:span class="EnSpace"/>
Total contracting and production costs for the drug, including a reasonable amount for administrative, operating, and rate-of-return expenses of the drug company or generic drug manufacturer.
</html:p>
<html:p>
(E)
<html:span class="EnSpace"/>
Research and development costs attributed to the drug over a five-year period.
</html:p>
<html:p>
(F)
<html:span class="EnSpace"/>
Other initial start-up costs amortized over a five-year period.
</html:p>
<html:p>
(G)
<html:span class="EnSpace"/>
The cost previously provided to Medi-Cal beneficiaries in the year 2025 or a lower cost.
</html:p>
<html:p>
(H)
<html:span class="EnSpace"/>
The cost previously provided as the most favored nation pricing as set forth in federal Executive Order No. 14297 on May 12, 2025.
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
Each drug shall be made available to providers, patients, and purchasers, as appropriate, at a transparent price and without rebates, other than federally required rebates.
</html:p>
<html:p>
(5)
<html:span class="EnSpace"/>
CHHSA shall prioritize the selection of
brand name and generic prescription drugs that have the greatest impact on lowering drug costs to patients, increasing competition and addressing shortages in the prescription drug market, improving public health, or reducing the cost of prescription drugs to public and private purchasers.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
(1)
<html:span class="EnSpace"/>
In identifying brand name prescription drugs to be acquired or generic prescription drugs to be produced, CHHSA shall consider the report produced by the Department of Managed Health Care pursuant to subdivision (b) of Section 1367.243, the report produced by the Department of Insurance pursuant to subdivision (b) of Section 10123.205 of the Insurance Code, and pharmacy spending data from Medi-Cal and
other entities for which the state pays the cost of brand name or generic prescription drugs.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
The partnerships entered into pursuant to subdivision (a) shall include the production of at least one form of insulin and the acquisition or production of pens, vial injections, pills, and patches of glucagon-like peptide-1 (GLP-1) semaglutide, GLP-1 receptor agonist (GLP-1RA), glucose-dependent insulinotropic polypeptide plus GLP-1 (GIP+GLP-1) tirzepatide, and future chronic weight disease products
made available at production and dispensing costs, if one does not already exist in the market. Dispensing costs may include related expenses such as transportation, distribution, and market operations. Any partnership shall also consider:
</html:p>
<html:p>
(A)
<html:span class="EnSpace"/>
Guaranteeing priority access to insulin supply and supply of pens, vial injections, pills, and patches of GLP-1 semaglutide, GLP-1RA, GIP+GLP-1 tirzepatide, and future chronic weight disease products for the state.
</html:p>
<html:p>
(B)
<html:span class="EnSpace"/>
Guaranteeing the manufacture of at least four high-priority drugs for California, as identified pursuant to paragraph (5) of subdivision (b).
</html:p>
<html:p>
(C)
<html:span class="EnSpace"/>
Creating a state
brand identifying biosimilar
insulin, pens, vial injections, pills, and patches of GLP-1 semaglutide, GLP-1RA, GIP+GLP-1 tirzepatide, and future chronic weight disease products, and generic prescription drugs sold in California under this section.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
CHHSA shall prioritize drugs for chronic and high-cost conditions, and shall consider prioritizing those that can be delivered through mail order.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
CHHSA shall consult with all of the following public and private purchasers, as appropriate, to develop a list of generic prescription drugs to be
acquired, manufactured, or distributed through partnerships:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
The Public Employees’ Retirement System, the State Department of Health Care Services, the California Health Benefit Exchange (Covered California), the State Department of Public Health, the Department of General Services, and the Department of Corrections and Rehabilitation, or the entities acting on behalf of each of those state purchasers.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
Licensed health care service plans.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
Health insurers holding a valid outstanding certificate of authority from the Insurance Commissioner.
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
Hospitals.
</html:p>
<html:p>
(e)
<html:span class="EnSpace"/>
Before effectuating a partnership pursuant to this section, CHHSA shall consider the volume of each brand name prescription drug or generic prescription drug over a multiyear period to support a market for a lower cost
generic prescription drug, if volume is an important factor in driving down the cost of the drug. For partnerships involving procurement, CHHSA shall determine minimum thresholds for procurement of an entity’s expected volume of a targeted drug from the company or manufacturer over a defined target period. In making advance commitments, CHHSA may consult with the Statewide Pharmaceutical Program and the California Pharmaceutical Collaborative.
</html:p>
<html:p>
(f)
<html:span class="EnSpace"/>
The listed entities in paragraphs (2) to (4), inclusive, of subdivision (d) shall not be required to purchase prescription drugs from CHHSA or entities that contract or partner with CHHSA pursuant to this chapter.
</html:p>
<html:p>
(g)
<html:span class="EnSpace"/>
CHHSA shall not be required to consult with every entity listed in paragraphs (2) to (4), inclusive,
of subdivision (d), so long as purchaser engagement includes a reasonable representation from these groups.
</html:p>
<html:p>
(h)
<html:span class="EnSpace"/>
Any partnership entered into pursuant to this section may include representation and involvement with the governance of the contractor entity.
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