Key takeaways:
- California’s tortilla rule shows how state-level market power can effectively set national food manufacturing standards without federal mandates.
- Folic acid fortification is entering a second phase, shifting from wheat-based staples to foods that better reflect real-world diets.
- Political opposition, led by Robert F Kennedy Jr, is colliding with decades of scientific consensus and established public health policy.
When America’s largest state economy confirmed that folic acid would be mandatory in corn masa products from 1 January 2026, the move was hailed as a long-overdue public health intervention. It also triggered unusually sharp political backlash. US Health and Human Services Secretary Robert F Kennedy Jr dismissed the policy as ‘insanity’, arguing it targets vulnerable communities and represents government overreach.
The contradiction is hard to ignore: while RFK Jr attacked California’s mandate, the federal dietary guidance issued through his own department continues to support folic acid intake before and during early pregnancy. It recommends folate-rich foods and makes it clear that folic acid from fortified foods or supplements plays a critical role in preventing neural tube defects.
What’s shifting now isn’t the science, but where power sits in applying it. California has increasingly positioned itself as a regulatory front-runner, using its economic weight to push through food policy changes that extend far beyond state lines. From additive bans to restrictions on synthetic dyes and ultra-processed foods in schools, the state has repeatedly moved ahead of federal action – and industry has adjusted accordingly.
California’s scale means its policies rarely remain contained within its borders, particularly in high-volume categories where running separate supply chains isn’t commercially practical. That dynamic is already influencing other states. Joaquin Arambula, the assemblymember behind the 2024 legislation, framed California as a first mover capable of accelerating wider adoption. Alabama is set to introduce a similar requirement in June, while proposals are being considered in Florida, Georgia, Oklahoma and Oregon. Policymakers in Texas, Delaware, New Jersey and Pennsylvania have also signalled interest, according to the Food Fortification Initiative.
California’s market power
For much of the past 30 years, fortification policy in the US has been shaped at the federal level and centred on a narrow set of staples. The FDA’s 1996 rule, implemented in 1998, mandated folic acid in enriched cereal grains such as bread, cereals and pasta. That intervention delivered measurable results, with neural tube defect rates falling by around 30%, preventing thousands of cases each year.
What that system didn’t do was reflect how people actually eat. Corn masa, the base for tortillas and a staple across many Latino diets, wasn’t included in the original mandate. That wasn’t a scientific oversight but a regulatory one: fortification policy focused on enriched cereal grains, effectively centring on wheat and overlooking other staples.
Regulators moved in 2016 to allow folic acid to be added to corn masa flour, but the decision remained voluntary and uptake remained limited. By 2023, only a minority of products were fortified, and tortillas, despite their scale and frequency of consumption, were still largely untouched.
California’s 2024 legislation, Assembly Bill 1830, shifts that model from optional to mandatory. From 2026, folic acid will be required in corn masa flour and wet masa products sold in the state, bringing corn-based staples into line with wheat.
This isn’t an isolated intervention but a continuation of a broader pattern. California has repeatedly used regulation to set de facto national standards in foods. Manufacturers supplying the state are unlikely to maintain separate fortified and non-fortified product lines. In categories such as tortillas, where margins are tight and volumes are high, duplication adds cost with little commercial return.
Major producers have already adjusted their runs. Mission Foods says it now adds folic acid to all of its corn tortillas sold in the US, including private-label products. Gruma reported that around 97% of its US retail portfolio is already fortified, with full coverage expected by the end of this year. Once leading suppliers standardise, the rest of the market typically follows.
Fortification is spreading
California’s move sits within a broader global shift in how fortification is being applied. The first phase focused on proving that adding micronutrients to staple foods could reduce deficiency-related conditions. The next phase is focused on coverage, ensuring those interventions reach the populations that need them most.
More than 80 countries now mandate folic acid fortification of wheat flour, often under guidance from the World Health Organization. These programmes have consistently reduced neural tube defects, in some cases by as much as half. In the US, the CDC continues to attribute around 1,300 prevented cases each year to fortification.
The limitation is that many of these programmes are built around wheat and in markets where maize, rice or other staples dominate, that approach leaves gaps. California’s inclusion of corn masa is a direct response to that mismatch.
The UK illustrates a different kind of lag. After years of consultation, the government confirmed in 2021 that folic acid would be added to non-wholemeal wheat flour, with implementation expected by the end of 2026. The delay reflects the pace of policy development rather than any uncertainty around the science.
That pattern shows up across various regions. While the evidence is well established, implementation often trails behind, shaped by regulatory scope, industry readiness and political appetite.
Kennedy turns a settled science issue into a political fight
RFK Jr’s criticism of the policy places him at odds with long-standing guidance from US health authorities. The CDC continues to recommend folic acid intake before and during early pregnancy and states clearly that folic acid from fortified foods is effective in preventing neural tube defects. It also confirms that individuals with common genetic variants, including MTHFR, can process folic acid.
Despite that, claims that folic acid is ‘toxic’, poorly metabolised, or linked to cancer risk continue to circulate online, often without scientific backing. That divergence between evidence and perception adds complexity for regulators and manufacturers, particularly as fortification moves into more visible and culturally significant food categories.
California’s tortilla mandate doesn’t introduce new science but reinforces a shift that’s been building for years. Policy is no longer shaped solely in Washington or by scientific consensus alone. It’s increasingly being driven by where market power sits – and how quickly that power can translate evidence into action.
