Health care coverage: nondiscrimination.

Senator Menjivar's health care nondiscrimination legislation prohibits California health plans and insurers from discriminating against enrollees based on race, color, national origin, age, disability, or sex, with specific protections for sex characteristics, pregnancy, sexual orientation, and gender identity.

The bill bars health plans and insurers from denying or limiting health services based on an individual's sex assigned at birth or gender identity. Plans cannot implement categorical exclusions for gender-affirming care or adopt policies that prevent individuals from accessing care consistent with their gender identity. The legislation also prohibits discriminatory marketing practices and benefit designs that could restrict coverage based on protected characteristics.

While health plans retain the ability to deny coverage for services based on clinical appropriateness or medical necessity, these determinations must stem from legitimate, nondiscriminatory reasons rather than bias. The bill requires plans to include nondiscrimination notices in coverage documents and establish clear procedures for filing discrimination-related grievances. Violations of these requirements by health plans would constitute a criminal offense under California law.