Text of CA AB 2551 (2026)

CALIFORNIA LEGISLATURE— 2025–2026 REGULAR SESSION Assembly Bill No. 2551 Introduced by Assembly Member Elhawary February 20, 2026 An act relating to health care coverage. LEGISLATIVE COUNSEL'S DIGEST AB 2551, as introduced, Elhawary. Behavioral health care coverage. Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law requires a health care service plan contract or health insurance policy issued, amended, or renewed on or after January 1, 2021, to provide coverage for medically necessary treatment of mental health and substance use disorders, as defined, under the same terms and conditions applied to other medical conditions. This bill would express the intent of the Legislature to enact legislation to require health care service plans and health insurers to survey and publicly report the percentage of enrollees or insureds going in network or out of network for behavioral health care, among other things. The bill would also make related findings and declarations. Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: NO Local Program: NO Bill Text The people of the State of California do enact as follows: SECTION 1. The Legislature finds and declares all of the following: (a) Access to behavioral health care is at a crisis point in California and the nation. Despite billions of dollars in state investment in the public mental health safety net and updated laws requiring health care service plans and health insurers to provide necessary care, too many Californians report struggling to access effective behavioral health services. (b) Communities of color face particular challenges with access to care and report some of the lowest rates of utilization of mental health services. (c) For Californians who speak a language other than English, finding behavioral health care that meets their needs is particularly daunting. (d) LGBTQIA+ individuals within Black, Indigenous, and People of Color (BIPOC) communities, in particular, face distinct challenges that compound the barriers to equitable mental health care. Navigating the health system to find and access a culturally affirming provider can feel like an impossibility, forcing many to seek care outside of their plan or policy or to forgo care entirely because they cannot afford to pay out of pocket. (e) Since passage of the federal Patient Protection and Affordable Care Act, health care service plans and health insurers have been required to provide medically necessary mental health services for their enrollees and insureds. Additionally, in 2020, the Legislature took action to ensure strong enforcement of the Paul Wellstone and Pete Domenici Mental Health Parity Addiction Equity Act of 2008, which requires health care service plan contracts and health insurance policies to provide mental health and substance use disorder coverage that is no more restrictive or costly than coverage for physical health for medical or surgical conditions. (f) California consumers are increasingly forced to go out of network to access behavioral health care. Nationally, consumers pay $15 billion in out-of-pocket expenses for treatment for mental health disorders. (g) Individuals seeking mental health services are six times more likely to have to go out of network for care compared to other services, and in one-third of these cases, they bear the full cost themselves. (h) Behavioral health out-of-pocket spending rose at double the rate by 2022 of other medical costs for children, causing major family financial strain. (i) Despite legislation, Department of Managed Health Care behavioral health investigations have found contracted providers are increasingly dissatisfied with network access. Low reimbursement rates, onerous health care service plan processes for authorizing payment, and burdensome contracting terms are the dominant reasons for the shortage of in-network mental health providers. Though the number of therapists who accept health care coverage isn’t tracked by a single organization, one estimate suggests 42 percent of therapists in California don’t accept health care coverage at all. (j) Without the financial help of health care coverage, clients pay an average of $130 out of pocket per session or higher in major cities. SEC. 2. It is the intent of the Legislature to enact legislation to do all of the following: (a) Require health care service plans and health insurers to survey and publicly report the percentage of enrollees or insureds going in network or out of network for behavioral health care and why, including lack of access to culturally and linguistically responsive care. (b) Require health care service plans and health insurers to conduct a cultural competency and health equity assessment of their enrollees or insureds, including identifying disparities among the enrollee or insured population by age, race, culture, ethnicity, sexual orientation, gender identity, income level, and geographic location, amongst other categories. As part of that assessment, plans and insurers would develop and implement comprehensive and effective training and programs for staff and participating providers and an evaluation and demonstration of how the assessment is being used to improve health outcomes, and reduce or eliminate disparities by understanding the challenges faced by enrollees or insureds. (c) Add a question on licensing renewal forms stating whether or not providers of the healing arts are currently contracting with a plan or insurer and the type of plan or insurer so California regulators can more readily monitor trends in provider contracting by region, language spoken, and provider type, amongst other categories.