SB 1089: Preventive Care Act.

(1)Existing law requires the California Health and Human Services Agency 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.

This bill, the Preventive Care Act, would require the above-described partnerships to also include the production of at least one glucagon-like peptide-1 (GLP-1) or GLP-1 receptor agonist (GLP-1RA) made available at production and dispensing costs and to consider guaranteeing priority access to GLP-1 or GLP-1RA supply for the state.

(2)Existing law requires the State Department of Health Care Services to negotiate drug discount agreements with drug manufacturers and to encourage manufacturers to maintain private discount drug programs.

This bill would authorize an employer with 100 or more employees to negotiate directly with a drug manufacturer to provide a discount for a GLP-1 or GLP-1RA.

(3)Existing law sets forth the obligations of an employer in the employment relationship with an employee.

This bill would require an employer with 100 or more to offer its employees access to exercise programs, gym memberships, or both, nutrition programs, and coverage for a GLP-1 or GLP-1RA.

(4)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 a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law sets forth specified coverage requirements for plan contracts and insurance policies.

This bill would require a large group health care service plan contract or health insurance policy issued, amended, or renewed on or after January 1, 2027, to cover weight loss as a medical condition. The bill would require a health care service plan contract that provides coverage for outpatient prescription drug benefits and is issued, amended, or renewed on or after January 1, 2027, to include coverage for at least one antiobesity medication approved by the United States Food and Drug Administration. 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.

(5)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.