The Overview

If you or someone you love has a rare disease, a new California law could determine how quickly a doctor-prescribed treatment actually reaches you. Starting with health plans and insurance policies issued, amended, or renewed on or after January 1, 2027, insurers will have 30 days to finish prior authorization, their approval step, for certain rare-disease drugs. ​

California's new law, Prescription drug coverage for rare diseases, AB 1887, was signed by Gov. Gavin Newsom (D) on Sept. 27. A survey of rare-disease patients found that 93 percent said prior authorization delayed their care, and 82 percent said it could push them to give up on treatment altogether, according to the American Journal of Managed Care.

What the Law Does

The 30-day clock only applies when three things are true: a specialist who knows the condition prescribed the drug, that specialist decided it is medically necessary, and it is the only FDA-approved treatment for that rare disease. If a health plan willfully violates this rule, that counts as a crime under existing law.

Legislative Status

Assembly Member Rick Zbur (D) wrote the bill. It drew 13 co-sponsors from both parties, including Republicans Juan Alanis (R), Diane Dixon (R), and Jeff Gonzalez (R), along with Democrats Jessica Caloza (D), Alex Lee (D), Sen. Josh Becker (D), and Sen. Catherine Blakespear (D).

The bill passed every recorded vote without a single "no," starting in the Assembly Health Committee, which approved it 15-0 on April 21.

The Assembly Appropriations Committee followed with a 14-0 vote on May 14, and the full Assembly passed it 77-0 on May 27. On Aug. 30, the Senate passed it 40-0, and the Assembly agreed to the Senate's changes 78-0. Zbur called the law a "30-day prior authorization backstop" for prescribed rare-disease treatments.

California Life Sciences called the signing "a critical step forward for California's rare disease community."

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