AB 1970CALIFORNIASession 20252026

High Impact

California bans step therapy for mental health and substance use disorder medications

Original title: Health care coverage: mental health or substance use disorders.

August 13, 2026

Healthcare Mental Health Substance Use Insurance Regulation Prescription Drugs Healthcarecoverage mentalhealthorsubstanceusedisorders

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The Frame

What this does

This measure removes a common administrative barrier for patients seeking immediate access to specific treatments for mental health and addiction, potentially reducing the time between diagnosis and receiving a prescribed medication.

Who is mentioned in the record

Potentially affected actors named in the source documents. Mention is not a position.

Patients with serious mental illness or substance use disorders

These individuals will no longer be subject to step therapy requirements for their prescribed medications starting in 2027.

Health care service plans

These entities must update their coverage policies to remove step therapy for specified mental health and substance use disorder drugs.

Health insurers

These entities must comply with the new prohibition on step therapy for specified mental health and substance use disorder drugs.

What changed

Last recorded activity August 13, 2026.

What's next

Introduced.

Summary

Starting January 1, 2027, health insurance plans in California are prohibited from requiring patients to try other medications first—a practice known as ''—before covering drugs prescribed for serious mental illness or substance use disorders. This change applies to all new, amended, or renewed health care service plan contracts and insurance policies.

Key Facts

You don't have to trust us. Each fact below is taken straight from the official document - click any one to see the exact passage, highlighted in the original.

Why It Matters

Frequently Asked Questions

What is step therapy?

is a medical management practice where an insurance plan requires a patient to try one or more alternative, often lower-cost, medications before the plan will cover the specific drug prescribed by the patient's doctor.

Does this apply to all prescription drugs?

No, this prohibition specifically applies only to prescription drugs used for the treatment of serious mental illness or substance use disorders.

Are there any exceptions to this ban?

Yes, the ban does not apply if the drug's FDA-labeled indications and usage specifically state that a prior medication must be taken before using that drug.

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Related Legislation

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