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Bill would ban copay accumulators that keep patient assistance from counting toward deductibles

Senate Committee on Health, California State Senate · April 22, 2026
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Summary

SB 11 99 would prevent insurers or pharmacy benefit managers from excluding manufacturer or third-party copay assistance from a patient's deductible or maximum out-of-pocket calculation; patient advocates described cases of large unexpected bills and lost coverage protections.

Sen. Weber Pearson presented SB 11 99 to prohibit copay accumulators and ensure that payments made by, or on behalf of, patients toward prescription cost sharing count toward the enrollee’s deductible and maximum out-of-pocket (MOOP). The Department of Insurance and numerous patient-advocacy organizations supported the bill,…

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