California mandates HEPA filter coverage for pregnant individuals and those with respiratory issues

California Assembly Bill 546 is set to revolutionize health coverage for vulnerable populations by mandating insurance plans to cover portable high-efficiency particulate air (HEPA) purifiers for pregnant individuals and those diagnosed with asthma or chronic obstructive pulmonary disease (COPD). Introduced on February 11, 2025, the bill aims to enhance air quality for these groups, who are particularly susceptible to airborne pollutants.

The bill stipulates that starting January 1, 2026, health care service plans and insurance policies must include coverage for HEPA purifiers without imposing deductibles, coinsurance, or copayment requirements. This provision is especially significant for those enrolled in high deductible health plans, ensuring that cost-sharing does not hinder access to essential air purification technology.

Key provisions also clarify that the bill applies to members of the Public Employees’ Retirement System (CalPERS) and the State Teachers’ Retirement System (CalSTRS), while excluding Medicare supplement policies, specialized health care plans, and self-insured employer plans governed by ERISA.

The introduction of AB 546 has sparked discussions among lawmakers and health advocates, with supporters emphasizing the importance of clean air for pregnant individuals and those with respiratory conditions. Critics, however, raise concerns about the potential financial impact on insurance providers and the feasibility of implementation.

Experts suggest that the bill could have far-reaching implications for public health, potentially reducing hospital visits and improving quality of life for affected individuals. As the bill progresses through the legislative process, its fate will hinge on balancing health benefits against economic considerations in California's complex insurance landscape.

With the growing awareness of air quality's impact on health, AB 546 stands as a pivotal step toward ensuring that essential health resources are accessible to those who need them most. The anticipated outcomes could set a precedent for similar legislation in other states, highlighting California's role as a leader in health care reform.