CA AB85

Requires health care service plans and health insurers to cover social determinants of health screenings in contracts issued, amended, or renewed on or after January 1, 2027.

Defines social determinants of health as conditions including housing, food, transportation, utilities, and personal safety under which people are born, grow, live, work, and age.

Mandates health care service plans and health insurers provide primary care physicians with adequate access to community health workers, peer support specialists, social workers, and lay health workers in their service areas.

Establishes a working group to develop standardized data documentation methods, create procedures for connecting patients with community resources, and assess gaps in research; requires a report to the Legislature by July 1, 2026.

Makes social determinants of health screenings a covered benefit for Medi-Cal beneficiaries, with federally qualified health centers and rural health clinics reimbursed at the Medi-Cal fee-for-service rate.