# CA Bulletin 2025-14: Chaptered Assembly Bill 144 and Coverage of Preventive Care Services

> California · Agency guidance · In force

URL: https://www.frixlaw.com/law-library/statutes/CA_INS_B_2025-14

## Section

- **Citation:** CA Bulletin 2025-14
- **Heading:** Chaptered Assembly Bill 144 and Coverage of Preventive Care Services
- **Jurisdiction:** California
- **Kind:** Agency guidance
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** California Department of Insurance Bulletins / Chaptered Assembly Bill 144 and Coverage of Preventive Care Services

## Text

RICARDO LARA
CALIFORNIA INSURANCE COMMISSIONER
BULLETIN 2025-14
TO:
All Health Insurers1
FROM:
Insurance Commissioner Ricardo Lara
DATE:
September 30, 2025
RE:
Chaptered Assembly Bill 144 and Coverage of Preventive Care Services
On September 17, 2025, Governor Gavin Newsom signed Assembly Bill (AB) 144
(Assembly Committee on Budget, Stats. 2025, Ch. 105). In part, AB 144 ensures
California consumers have continued access to necessary preventive care services.
AB 144 directs health insurers to cover preventive care items and services, including
immunizations, if such care was recommended by existing federal bodies2 as of
January 1, 2025, or is recommended by the California Department of Public Health
(CDPH). AB 144 is an urgency measure that went into effect immediately.
This Bulletin outlines the obligations of health insurers to cover preventive care items
and services prior to enactment of AB 144 and summarizes AB 144’s new requirements
regarding coverage of preventive care items and services. The Bulletin also highlights
recent recommendations by CDPH regarding immunizations to protect against
coronavirus disease 2019 (COVID-19), respiratory syncytial virus (RSV), and influenza.
I. Background
California Insurance Code (CIC) sections 10110.7, 10110.75, 10112.2, 10123.5, and
10123.55 each include requirements related to coverage of preventive care. State law
requirements prior to the adoption of AB 144 are detailed in this section.
A. Previous CIC section 10112.2 (immunizations and preventive services generally)
CIC section 10112.2 specifically requires health insurers to cover preventive care items
and services that have an “A” or “B” recommendation from the United States Preventive
Services Task Force (USPSTF)
rage of preventive care. State law
requirements prior to the adoption of AB 144 are detailed in this section.
A. Previous CIC section 10112.2 (immunizations and preventive services generally)
CIC section 10112.2 specifically requires health insurers to cover preventive care items
and services that have an “A” or “B” recommendation from the United States Preventive
Services Task Force (USPSTF).
With respect to women, infants, children, and adolescents, insurers must cover without
cost-sharing the evidence-informed preventive care services and screenings contained
in the comprehensive guidelines supported by the United States Health Resources and
1 This Bulletin applies to all health insurers as defined by California Insurance Code section 106(b),
including student health insurance, as defined under CIC section 10965.03.
2 E.g., the Advisory Committee on Immunization Practices (ACIP) of the federal Centers for Disease
Control and Prevention (CDC), the United States Preventives Services Task force (USPSTF), or the
United States Health Resources and Services Administration (HRSA).

Bulletin on Chaptered Assembly Bill 144 and Coverage of Preventive Care Services
September 30, 2025
Page 2 of 5
Services Administration (HRSA).3 Likewise, those sections require insurers to cover
immunizations recommended by the Advisory Committee on Immunization Practices
(ACIP) of the federal Centers for Disease Control and Prevention (CDC). These
coverage requirements include preventive care items and services, including
immunizations. Insurers must cover such services without cost-sharing, consistent with
section 10112.2.
B
SA).3 Likewise, those sections require insurers to cover
immunizations recommended by the Advisory Committee on Immunization Practices
(ACIP) of the federal Centers for Disease Control and Prevention (CDC). These
coverage requirements include preventive care items and services, including
immunizations. Insurers must cover such services without cost-sharing, consistent with
section 10112.2.
B. Previous CIC sections 10110.7 (COVID-19 preventive services and
immunizations) and 10110.75 (declared public health emergency)
CIC sections 10110.7 and 10110.75 specifically include coverage requirements for
items and services to prevent or mitigate COVID-19 or any other disease for which the
Governor has declared a public health emergency. Insurers must cover such services
without cost-sharing or utilization management in many cases, consistent with sections
10110.7 and 10110.75.
C. Previous CIC sections 10123.5 and 10123.55 (childhood and adolescent
immunizations and preventive services)
CIC sections 10123.5 and 10123.55 provided that group health policies must cover
periodic health evaluations, immunizations, and laboratory services as contained in the
Recommended Childhood Immunization Schedule/United States, jointly adopted by the
American Academy of Pediatrics, the ACIP, and the American Academy of Family
Physicians.
D. Recent Changes to FDA Approval for COVID-19 Vaccines
In August, the U.S. Food and Drug Administration (FDA) released approvals for several
COVID-19 vaccines.4 Unlike previous approvals, the FDA approved these vaccines only
for individuals 65 years of age and older or for people who are younger than 65 but
have at least one underlying condition that puts them at high risk for severe outcomes
from COVID-19.
II
FDA Approval for COVID-19 Vaccines
In August, the U.S. Food and Drug Administration (FDA) released approvals for several
COVID-19 vaccines.4 Unlike previous approvals, the FDA approved these vaccines only
for individuals 65 years of age and older or for people who are younger than 65 but
have at least one underlying condition that puts them at high risk for severe outcomes
from COVID-19.
II. AB 144 Provides that the Federal Recommendations in Effect on January 1,
2025 Serve as a Baseline, and Allows the California Department of Public
Health to Supplement those Recommendations
AB 144, available at this link, amends CIC sections 10110.7, 10110.75, 10112.2,
10123.5, and 10123.55. These amendments took effect immediately on September 17,
2025, when the Governor signed AB 144.The requirements of AB 144 are set forth
below.
3 Insurance Code section 10112.2.
4 The approved COVID-19 vaccines are: MNEXSPIK and SPIKEVAX (both manufactured by Moderna Tx,
Inc.); COMIRNATY (manufactured by BioNTech Manufacturing GmbH); and NUVAXOVID (manufactured
by Novavax, Inc.).

Bulletin on Chaptered Assembly Bill 144 and Coverage of Preventive Care Services
September 30, 2025
Page 3 of 5
A
Bulletin on Chaptered Assembly Bill 144 and Coverage of Preventive Care Services
September 30, 2025
Page 3 of 5
A. Amendments to CIC section 10112.2 (immunizations and preventive services
generally)
CIC section 10112.2, as amended by AB 144, requires health insurers to cover, without
cost-sharing all items, services integral to the provision of preventive items, and
services with a USPSTF “A” or “B” recommendation, a recommendation by ACIP and/or
those items and services consistent with HRSA guidelines as of January 1, 2025.5
Health insurers must continue to cover these services even if the USPSTF, ACIP, or
HRSA remove or downgrade their recommendations. The AB 144 amendments allow
CDPH to modify or supplement the USPSTF, ACIP, and HRSA recommendations and
require insurers to cover the modifications or supplements within 15 business days after
CDPH publishes the updated recommendations.
B. Amendments to CIC sections 10110.7 (COVID-19 preventive services and
immunizations), and 10110.75 (declared public health emergencies)
CIC section 10110.7, as amended by AB 144, requires health insurers to cover, without
cost-sharing or utilization management all items, services integral to the provision of
preventive items, and services to prevent or mitigate COVID-19 and with a USPSTF “A”
or “B” recommendation, or a recommendation by ACIP as of January 1, 2025. The
AB 144 amendments allow CDPH to modify or supplement the USPSTF, and ACIP
recommendations and require insurers to cover the modifications or supplements within
15 business days after CDPH publishes the updated recommendations
ion of
preventive items, and services to prevent or mitigate COVID-19 and with a USPSTF “A”
or “B” recommendation, or a recommendation by ACIP as of January 1, 2025. The
AB 144 amendments allow CDPH to modify or supplement the USPSTF, and ACIP
recommendations and require insurers to cover the modifications or supplements within
15 business days after CDPH publishes the updated recommendations.
Similarly, section 10110.75, as amended by AB 144, requires health insurers to cover,
without cost-sharing or utilization management, all items, services integral to the
provision of preventive items, and services to prevent or mitigate a disease when the
Governor of the State of California has declared a public health emergency due to that
disease with a USPSTF “A” or “B” recommendation, or a recommendation by ACIP as
of January 1, 2025. The AB 144 amendments allow CDPH to modify or supplement the
USPSTF and ACIP recommendations and require insurers to cover the modifications or
supplements within 15 business days after CDPH publishes the updated
recommendations. In addition to the CDPH recommendations and the USPSTF
recommendations, the AB 144 amendments also require that coverage of an item,
service, or immunization must be covered 15 business days after the the American
Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the
American Academy of Family Physicians, or CDPH makes a recommendation relating
to the item, service, or immunization.
C. Amendments to CIC sections 10123.5 and 10123.55 (childhood and adolescent
preventive services and immunizations)
5 Please note that the HRSA guidelines were updated in December 2024 for Screening and Counseling
for Intimate Partner and Domestic Violence, Breast Cancer Screening for Women at Average Risk, and a
new guideline for Patient Navigation Services for Breast and Cervical Cancer Screening was introduced
sections 10123.5 and 10123.55 (childhood and adolescent
preventive services and immunizations)
5 Please note that the HRSA guidelines were updated in December 2024 for Screening and Counseling
for Intimate Partner and Domestic Violence, Breast Cancer Screening for Women at Average Risk, and a
new guideline for Patient Navigation Services for Breast and Cervical Cancer Screening was introduced.
Because these changes occurred prior to January 1, 2025, health insurers must incorporate these
changes into practice for the 2026 plan year.

Bulletin on Chaptered Assembly Bill 144 and Coverage of Preventive Care Services
September 30, 2025
Page 4 of 5
The amendments to CIC sections 10123.5 and 10123.55 require group health insurance
products to cover the childhood periodic health evaluations, immunizations, and
laboratory services contained in the Recommended Childhood Immunization
Schedule/United States, jointly adopted as of January 1, 2025, by the American
Academy of Pediatrics, ACIP, and the American Academy of Family Physicians.6 CDPH
may modify or supplement such recommendations taking into consideration guidance
and recommendations from additional medical and scientific organizations, including,
but not limited to, the American Academy of Pediatrics, the American College of
Obstetricians and Gynecologists, and the American Academy of Family Physicians.
D. Health Savings Account-eligible High-Deductible Health Plans
For insureds in health savings account (HSA)-eligible high-deductible health plans
(HDHPs), insurers must cover preventive services in conformance with AB 144, unless
doing so would disqualify the HDHP from eligibility for an HSA pursuant to Internal
Revenue Code section 223 (26 U.S.C. § 223).
III
n Academy of Family Physicians.
D. Health Savings Account-eligible High-Deductible Health Plans
For insureds in health savings account (HSA)-eligible high-deductible health plans
(HDHPs), insurers must cover preventive services in conformance with AB 144, unless
doing so would disqualify the HDHP from eligibility for an HSA pursuant to Internal
Revenue Code section 223 (26 U.S.C. § 223).
III. CDPH Immunization Recommendations
On September 17, 2025, CDPH issued guidance regarding COVID-19, influenza, and
RSV immunizations. That guidance can be found here and provides as follows:
• COVID-19
o Children:
•
All children 6-23 months;
•
All children 2-18 years with certain risk factors; and,
•
All children with close contact with others with risk factors; All children
who choose protection.
o Adults:
o All adults age 65 years or older;
o All adults ages 18-64 years with certain risk factors;
o All adults with close contact with others with risk factors; and,
o All adults who choose protection.
o Pregnancy:
o All planning, pregnant, postpartum, or lactating.
• Influenza
o Children:
o All children 6 months or older.
o Adults:
o All adults 18 years or older.
o Pregnancy:
o All planning, pregnant, postpartum, or lactating.
• RSV
6 Please note that any changes made by ACIP after January 1, 2025, including the removal or
modification of prior recommendations for vaccinations and the timing of their administration, shall not be
considered when determining health insurance coverage.
dren 6 months or older.
o Adults:
o All adults 18 years or older.
o Pregnancy:
o All planning, pregnant, postpartum, or lactating.
• RSV
6 Please note that any changes made by ACIP after January 1, 2025, including the removal or
modification of prior recommendations for vaccinations and the timing of their administration, shall not be
considered when determining health insurance coverage.

Bulletin on Chaptered Assembly Bill 144 and Coverage of Preventive Care Services
September 30, 2025
Page 5 of 5
o Children:
•
All children 8 months or younger; and,
•
All children 8-19 months with risk factors.
o Adults:
•
All adults 75 years or older; and,
•
All adults 50-74 years with risk factors.
o Pregnancy:
•
Pregnant between 32-36 weeks gestational.
Health insurers must cover CDPH-recommended immunizations with the cost-sharing
and utilization management limitations consistent with AB 144. If the immunization is not
already encompassed within recommendations by ACIP or the USPSTF, health insurers
must begin covering the immunization by October 8, 2025, which is 15 business days
following CDPH’s publication of its recommendation.
Please note, the FDA currently recommends COVID-19 immunizations only for people
who are 65 years of age or older, or for younger people with at least one underlying
condition that puts them at greater risk for COVID-19. Notwithstanding the FDA’s
recommendation, per AB 144, health insurers must cover COVID-19 immunizations per
CDPH’s recommendations even if doing so could be considered “off label.”
If you have questions regarding this Bulletin, please contact Stesha Hodges, Chief of
the California Department of Insurance’s Health Equity and Access Office, at
Stesha.Hodges@insurance.ca.gov.

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/CA_INS_B_2025-14. Check the current official text before relying on it. Not legal advice.