California law to expand insurance coverage for cancer cooling caps in 2027

Hair loss can be one of the most difficult side effects of the cancer treatment journey. But starting in January 2027, more California patients will have access to scalp-cooling treatments designed to reduce hair loss during chemotherapy, with insurance coverage required under a new state law.

For Elk Grove breast cancer survivor Rebecca Dierssen, using a DigniCap cooling system during chemotherapy helped her maintain some privacy during an otherwise challenging time.

"It was my choice to tell someone and not have everyone feeling sorry for me," Dierssen said.

Dierssen underwent breast cancer treatment three years ago at Dignity Health Mercy Cancer Center in Sacramento. During each chemotherapy session, she used the cooling cap, which is fitted snugly over wet hair and connected to a machine that lowers the temperature of the scalp.

Looking back at a photo on her phone, Dierssen recalled seeing progress about a month into treatment.

"I was very pleased with the progress at that point," she said.

Dierssen said she did lose some hair but never lost all of it. She believes the treatment helped her maintain a sense of normalcy while going through chemotherapy.

The treatment can be uncomfortable at first. Dierssen said she bundled up before each chemotherapy session because of the cold, with the first 10 to 15 minutes often being the most difficult.

Scalp-cooling systems work by lowering the temperature of the scalp, which reduces blood flow to hair follicles and limits the amount of chemotherapy medication reaching them. That can help reduce hair loss for some patients.

Dr. Shahzad Siddique of Dignity Health Mercy Medical Group said hair loss is a major concern for many breast cancer patients.

"It's a big priority, and one of the first things they ask about. Unfortunately, most breast cancer chemo treatments result in 90% hair loss, and a cool cap for two-thirds of patients can reduce loss to less than 50%," Siddique said.

California's AB 1682 will require insurance coverage for certain machine-based scalp-cooling treatments beginning in January 2027. The law covers systems such as DigniCap and Paxman, potentially saving patients thousands of dollars in out-of-pocket costs.

Medicare already covers some scalp-cooling treatments.

Dierssen hopes the expanded coverage will make the option more accessible to patients who want to try it.

"Ask your oncologist and if they say no, ask why. Be your own advocate. I think this bill will help, since the cost will be reduced," she said.