How California Could Improve Access to Bariatric Surgery and Weight Loss Treatments

Obesity is a chronic, multifactorial disease, yet many patients struggle to access treatment because coverage is restricted or insufficient. In 2025, California introduced Senate Bill 535, the Obesity Treatment Parity Act, which aims to change that.

SB 535 would require health insurance plans issued or renewed after January 1, 2026 to include coverage for the full spectrum of obesity interventions: intensive behavioral therapy, bariatric surgery, and at least one anti-obesity medication (AOM). In effect, this bill seeks to normalize obesity treatment as a standard benefit rather than an optional add-on.

If passed, SB 535 has the potential to transform access to care in California—and BASS Medical Group is positioned to support more patients with comprehensive, evidence-based obesity care.

What SB 535 Would Require & the Rationale

Under the proposed law:

• Insurance plans must cover intensive behavioral therapy (IBT), bariatric surgery, and at least one FDA-approved AOM for obesity management.
• Coverage criteria cannot be more restrictive than FDA labeling.
• The measure applies to new, amended, or renewed health plans starting in 2026.

The rationale behind SB 535 is that obesity is no longer a lifestyle choice—it is a chronic disease recognized by major medical groups. The bill is championed as a path toward health equity and better long-term cost control by preempting complications.

Fiscal Impact & Challenges

According to the bill’s fiscal summaries:

• State administrative costs are estimated between $3.7 million in 2025–26 and rising in subsequent years.
• CHBRP analysis found that adding comprehensive obesity treatment benefits would increase net expenditures for health plans, but likely deliver downstream savings through fewer complications.
• That said, benefit expansion mandates are often met with pushback from insurers concerned about cost and utilization.

Additionally, the Legislature must reconcile this expansion with proposals to cut Medi-Cal coverage for weight-loss drugs, making the timing and passage of SB 535 especially consequential.

How SB 535 Helps Patients & Aligns with BASS Care

Better Access & Choice

Currently, many patients are denied bariatric surgery or drug therapies until they meet stringent “morbid obesity” thresholds. SB 535 would allow earlier and more tailored intervention.

Integrated, Holistic Care Pathways

By mandating coverage across behavioral therapy, surgery, and medication, SB 535 supports “continuum of care” models — the exact approach BASS emphasizes in patient care.

Lower Long-Term Costs & Complications

SB 535 is rooted in preventive strategy: treating obesity before it causes diabetes, heart disease, or kidney problems reduces long-term cost burdens.

Equity & Health Justice

Because obesity disproportionately affects under-resourced and marginalized communities, SB 535 has the potential to level the playing field.

What Patients Should Do

• Check your insurance: When SB 535 becomes law, new policies covered under it must include obesity treatment benefits.
• Talk to your doctor now: If you’ve been denied weight-loss care, document your medical need and stay ready.
• Advocate & stay informed: Reach out to your state legislators, county advocates, and organizations supporting SB 535.
• Be prepared for gaps: The law may take time to fully roll out; patients should still explore existing options in the interim.

FAQs

Q: Does SB 535 guarantee free surgery coverage for everyone?‍

No — while it mandates coverage, patients may still face eligibility criteria or co-pays, as long as these are not more restrictive than FDA indications.

Q: When would SB 535 take effect?‍

It would apply to insurance plans issued, renewed, or amended on or after January 1, 2026.

Q: What happens to current Medi-Cal changes?‍

The proposed Medi-Cal cuts to weight-loss drug coverage are a conflicting policy push. SB 535’s success may counterbalance these cuts.

Conclusion

SB 535 represents one of California’s boldest moves toward treating obesity like the chronic disease it is. By requiring comprehensive coverage for therapies ranging from behavioral support to surgery and medications, the bill could expand access and improve outcomes for thousands.

At BASS Medical Group Bariatric Surgery & Weight Management, we strongly support SB 535 and are preparing our team to welcome more patients with high-quality, evidence-based care. If you’d like to learn how this policy might affect your options, request a consultation today, and we’ll help you navigate the changing landscape.