WeVote
Log In

Bill

Bill

SB 40

RELATING TO STATE FINANCES.

2025 Regular Session Introduced by Stanley Chang and 6 co-sponsors

SB 40 caps insulin costs at $35 per month for Californians with diabetes, ensuring affordability and access for 4 million residents, improving health outcomes.

Reported from HSG (Stand. Com. Rep. No. 1350) as amended in HD 1, recommending passage on Second Reading and referral to FIN.
#bondvolumecaprecyclingprogram #hhfdc #lineofcredit #revenuebonds
0
WeVote Research Nonpartisan
Bill Summary · SB 40

Summary of SB 40: Health Care Coverage for Insulin

Bill Number: SB 40
Introduced: December 3, 2024
Status: Chaptered by Secretary of State. Chapter 737, Statutes of 2025.
Vote: Majority
Appropriation: No
Fiscal Committee: Yes
Local Program: Yes

Purpose and Intent

SB 40 aims to address the rising costs of insulin for Californians diagnosed with diabetes. The bill seeks to ensure that individuals have affordable access to insulin, a critical medication for managing diabetes, by limiting out-of-pocket costs associated with insulin prescriptions.

Key Provisions

  1. Cost Sharing Limits:

    • Effective January 1, 2026, large group health care service plans and health insurance policies cannot impose a copayment, coinsurance, deductible, or any other cost-sharing mechanism exceeding $35 for a 30-day supply of insulin.
    • For individual and small group plans, this limit applies starting January 1, 2027.

  2. Step Therapy Restrictions:

    • Beginning January 1, 2026, health care service plans and insurers are prohibited from requiring step therapy (a practice where patients must try and fail on cheaper medications before being approved for more expensive ones) as a condition for insulin coverage.

  3. Formulary Requirements:

    • Large group plans must include at least one insulin option for each drug type in all forms and concentrations on their prescription drug formulary.
    • For individual and small group plans, the $35 cap applies only to Tier 1 and Tier 2 insulin if the formulary is tiered.

  4. High Deductible Health Plans:

    • High deductible health plans must also adhere to the $35 limit for insulin prescriptions, unless it conflicts with federal regulations.

  5. State Production of Insulin:

    • If the state can produce or label an insulin drug, the same cost-sharing limits will apply.

Impact

  • Affected Population: The bill primarily benefits the approximately 4 million Californians living with diabetes, including 263,000 newly diagnosed with type 1 diabetes each year.
  • Financial Relief: By capping insulin costs, the bill aims to alleviate the financial burden on individuals who rely on insulin, addressing the issue of insulin underuse due to high costs.
  • Health Outcomes: The legislation is expected to improve health outcomes by ensuring better access to necessary medications, potentially reducing emergency room visits and hospitalizations related to diabetes complications.

Procedural Aspects

  • The bill was approved by the Governor on October 13, 2025, and officially chaptered the same day.
  • It underwent several amendments and committee reviews throughout 2025 before reaching its final form.

Conclusion

SB 40 represents a significant step towards making insulin more affordable and accessible for Californians with diabetes, addressing a critical public health issue and aiming to improve the quality of life for those affected by this chronic condition.

Compiled from official sources — confirm details with the bill’s official record.

Sign in to ask a question.