Health care coverage cost sharing.

Assembly Member Bonta's proposal to eliminate cost-sharing requirements for Californians under 21 would reshape how health plans and insurers structure coverage for young patients, marking a significant shift in healthcare financing for this age group.

The legislation prohibits health plans and insurers from imposing deductibles, copayments, coinsurance, or other cost-sharing requirements on in-network services for enrollees and beneficiaries under age 21, starting January 1, 2026. In-network services include care from contracted providers, emergency services, and certain out-of-network care when in-network providers are unavailable within required timeframes. The bill also bars providers from billing these patients directly for covered in-network services.

For high-deductible health plans paired with health savings accounts, the bill creates a modified framework: preventive care remains exempt from cost-sharing for those under 21, while other in-network services become free of additional charges once the plan's deductible is met. This maintains these plans' compliance with federal HSA requirements while extending protections to young patients.

The measure includes enforcement provisions that classify willful violations by health plans as crimes under state law. While this creates a state-mandated local program, the bill specifies that no reimbursement to local agencies is required since the mandate stems from defining new criminal conduct.