California has long been a national leader in health policy — from expanding coverage to advancing patient protections. Now, as Alzheimer’s disease and other dementias place a growing strain on families across our state, we face another defining moment.
Senate Bill 950, sponsored by Sen. Akilah Weber Pierson (D–San Diego), would require health plans in California to cover all medically necessary, FDA-approved treatments and medications for Alzheimer’s disease and other dementias. It would also prohibit insurers from imposing step therapy protocols before allowing access to these therapies.
This is not an abstract policy debate. It is about whether Californians facing a devastating neurodegenerative disease can access timely, appropriate care — or whether they will be forced to wait while their condition worsens.
As President and CEO of the California Chronic Care Coalition, which represents more than 30 leading consumer health organizations and provider groups, I hear regularly from families navigating the Alzheimer’s journey. The diagnosis itself is heartbreaking. The confusion, the gradual cognition loss, the subtle and not so subtle personality changes, the parent or partner who no longer knows who you are — these ripple through entire families. Adult children take time off work or have to give up their jobs. Spouses become full-time caregivers. Savings are drained. College is delayed. Futures are rewritten.
In a disease like Alzheimer’s, time is not neutral. Time brings devastating loss.
That is why SB 950 is so important. California has already taken meaningful steps to improve early detection. In recent years, the legislature mandated coverage of biomarker testing — an important move that helps patients receive a more timely and accurate diagnosis. But diagnosis alone is not enough. Identifying Alzheimer’s without ensuring access to treatment leaves patients and their families stranded in the devastation of their lives at the very moment they need support.
SB 950 is the logical next step. If we believe in early detection, we must also prioritize timely treatment.
Today, even when the Food and Drug Administration has approved therapies for Alzheimer’s or other dementias, patients can face insurance barriers that delay care. Chief among these barriers is step therapy — the practice of requiring patients to “fail” on one or more insurer-preferred treatments before gaining access to the therapy their clinician initially prescribed.
Step therapy may have a role in some situations. But in a progressive neurodegenerative disease, it can be profoundly harmful.
Alzheimer’s does not wait while paperwork is processed. It does not pause while patients cycle through therapies that may not work. Every month of delay means further cognitive decline that cannot be reversed. Families lose precious time to preserve memory, independence, and quality of life.
California lawmakers have recognized the potential harms of step therapy before. In 2021, the legislature passed AB 347, placing strict guardrails on step therapy and limiting its use to protect patients from unnecessary delays. SB 950 builds on that foundation by acknowledging the unique urgency of Alzheimer’s and other dementias.
Critics may raise concerns about costs. But we must ask: What is the cost of inaction? What is the cost of delayed treatment leading to an accelerated decline? Alzheimer’s already costs California billions each year in medical care and unpaid caregiving. It drives emergency visits, hospitalizations, and long-term institutional care. Delaying effective therapy can increase these downstream costs.
Ensuring coverage for medically necessary, FDA-approved treatments is not about opening the floodgates indiscriminately. SB 950 still requires medical necessity, as determined by clinicians. It simply ensures that when a therapy has met federal standards for safety and efficacy, and a physician determines it is appropriate; insurance coverage will not stand in the way.
Illinois recognized this in 2025, passing similar legislation to expand access to Alzheimer’s treatments. California — with its history of patient-centered reform — should not lag behind.
Sen. Weber Pierson, a board-certified OB/GYN and chair of the Senate Health Committee, understands firsthand the importance of aligning policy with clinical realities. Her leadership on SB 950 reflects a broader commitment to ensuring that coverage decisions support, rather than undermine, patient care.
At the California Chronic Care Coalition, we believe that people living with chronic conditions deserve coordinated, evidence-based, and compassionate care. Alzheimer’s and other dementias demand nothing less.
The number of Californians living with Alzheimer’s is projected to rise sharply in the coming decades as our population ages. We cannot prevent the disease. But we can decide how to respond. Will we create a system that offers timely access to emerging therapies and empowers clinicians to make patient-centered decisions? Or will we allow administrative barriers to dictate the course of care?
SB 950 offers a clear answer. It affirms that in California, when science advances, patients should not be left behind.
For families confronting Alzheimer’s, every day matters. The legislature should pass SB 950 and ensure that coverage keeps pace with innovation — giving patients the best possible chance to preserve memory, independence, and dignity for as long as possible.
Liz Helms is President and CEO of the California Chronic Care Coalition, an alliance of more than 30 consumer health organizations and provider groups dedicated to improving care for Californians living with chronic conditions.