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Bill would require commercial plans to cover FDA-approved Alzheimer's treatments quickly; insurers raise step-therapy concerns
Summary
SB 950 directs commercial health plans to provide timely coverage of medically necessary, FDA-approved treatments for early-onset Alzheimer's and designates Alzheimer's as an exigent circumstance; sponsors cited limited eligibility windows while insurers urged caution on step-therapy and costs.
Senator Weber Pearson told the committee SB 950 clarifies that Californians with early-onset Alzheimer's disease should be able to access medically necessary, FDA-approved therapies through commercial plans without inappropriate rerouting or delay. "Timely and easy access is important," she said, noting that delays can mean patients lose eligibility windows for disease-modifying therapies.
The Alzheimer's Association and advocates urged support; volunteer advocate Andrew Cope described waiting a year for diagnosis and the value of new therapies that can reduce plaque progression. Health-plan representatives (California Association of Health Plans; Association of California Life and Health Insurance Companies) signaled respectful opposition, citing concerns about limiting step therapy, high prices for anti-amyloid drugs (testimony cited list prices in the tens of thousands) and the potential for challenges to plan formulary management. The committee moved SB 950, as amended, to the Appropriations Committee with roll-call recorded in the transcript.
