Law to Require Insurance Coverage of Fentanyl Overdose Drug Clears First Hurdle

SACRAMENTO ― A proposed law to prevent more fentanyl overdose deaths passed out of the Assembly Health Committee with bipartisan support. Authored by Assemblymember. Liz Ortega (D-San Leandro), AB 1060 would require Medi-Cal and private insurers to cover the full cost of Naloxone, also known as Narcan, a safe and easy-to-administer drug that can reverse a fentanyl overdose within minutes. The bill has the support of more than a dozen public health organizations, as well as Attorney General Rob Bonta.

“As a mom of four and a legislator, this fentanyl crisis keeps me up at night,” said Assemblymember Ortega. “Fentanyl is now the leading cause of fatal poisoning among children under five. My bill would give parents the tool they need to protect their kids.” Fentanyl and synthetic opioid overdose is on the rise nationally and in California, with annual overdose deaths reaching more than 100,000 in 2021, making fentanyl the leading cause of
death among 18- to 45-year-olds in the United States. In California, 7,175 Californians died of overdose in 2021, an increase of 119% over 2019, according to a bill analysis by the California Benefits Health Review Program.

“The numbers are shocking,” said Assemblymember Ortega. “Over 150 people per day are dying in the US from opioid poisoning, with fentanyl being the deadliest. I applaud the FDA’s decision to make Narcan more accessible. My bill will make it more affordable.” Fentanyl, which is 50 to 100 times as potent as heroin, has permeated the illicit drug market because it is cheap to manufacture and highly addictive. Sixty percent of pills seized by the DEA
and tested for fentanyl contained at least 2 mg of fentanyl, considered a potentially lethal dose. But law enforcement and public health experts are reporting that an even deadlier opioid is becoming more common in the illicit drug supply: carfentanil, a drug used in veterinary medicine to tranquilize large animals. Carfentanil is a hundred times more potent than fentanyl.

Naloxone, which the Food and Drug Administration recently approved for over-the-counter sale, nasal spray is safe, easy to use, and can reverse a fentanyl or carfentanil overdose in minutes. But depending on the dosage and source, it can cost $100 or more.

Mareka Cole, a mother who lost her son to a deadly cocktail of fentanyl and carfentanil, shared her story as part of her testimony in support of the bill. When Cole found her son unresponsive in his bedroom after taking a drink that friends had given him, she tried to revive him using Narcan, but did not have the right dosage. “I gave him the two doses I had, but it wasn’t enough,” said Cole. “That’s all I could get because it’s so expensive. Narcan can save lives if it’s given at the right time and the right dosage. That’s why we need to make it more affordable.”

"Now is an especially unprecedented time when people without addiction are unknowingly and unwillingly exposed to high potency and lethal synthetic opioids, such as fentanyl and analogs including carfentanil,” said Dr. Neal Mehra with the California Society of Addiction Medicine, which is supporting the bill. “Everyone needs easy and low-barrier access to Narcan as any of us, at any time, may encounter a person, of any position in society, that may be experiencing a lethal opioid overdose!"

In addressing the cost of the bill, Assemblymember Ortega pointed to a state program that has distributed Narcan to nonprofits, law enforcement, and health services providers. Based on that usage rate, AB 1060 would potentially result in the reversal of over 5,000 overdoses.

“This bill would save over 5,000 lives for a total of $9 million. If you do the math, that’s $1800 per life saved,” Ortega said.“ The average cost of an E.R. visit in California is $2,900. How many opportunities do we get to save 5,000 lives for only $1800 each?”

“I’m grateful that the Assembly Health Committee recognizes how vital and urgent it is that we broaden our efforts to streamline access and more quickly respond to opioid overdoses by using naloxone,” said Assemblymember Dr. Joaquin Arambula (D-Fresno). “I’m proud to co-author Assemblymember Ortega’s legislation, which seeks to eliminate roadblocks regarding coverage costs of the medication. And I have authored AB 915, which would establish a training and certification program for students to prevent opioid overdoses. These two bills are proactive methods to combat the fentanyl and opioid epidemic crisis plaguing our nation.”

Assemblymember Liz Ortega is a member of the Assembly Committees on Higher Education, Insurance, Labor and Employment, Public Safety and Rules. She represents the 20th Assembly District, encompassing all or a portion of the cities of Hayward, San Leandro, Union City, Dublin, Pleasanton and the unincorporated areas of Ashland, Cherryland, Fairview, San Lorenzo, and Castro Valley.

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