CALIFORNIA — In January 2026, California became the first state to require food makers to add folic acid to corn masa flour used to make tortillas and other traditional foods.

Alabama's law requiring folic acid fortification of corn masa flour takes effect in June 2026. Legislation to require folic acid fortification of corn masa flour is pending or being considered in Florida, Georgia, Oklahoma and Oregon. Texas, Delaware, New Jersey and Pennsylvania have expressed active interest in folic acid fortification of corn masa flour, according to the Food Fortification Initiative.

"All women and children in the United States should have access to folic acid and have healthy babies," said Scott Montgomery, director of the Food Fortification Initiative.

Since 1998, U.S. federal regulations have required folic acid to be added to enriched wheat and white breads, cereals and pastas, but corn masa flour was not included in the original requirement. In 2016, federal regulators allowed, but did not require, folic acid to be added to corn masa products. By 2023, about one in seven corn masa flour products and no corn tortillas contained folic acid.

Nationwide, Hispanic women have the highest rates of neural tube defects during pregnancy compared with other racial and ethnic groups. In California, Hispanic mothers experience neural tube defects at twice the rate of white or Black mothers, according to state data. Neural tube defects affect about 2,000 babies each year in the U.S. The CDC website states that folic acid fortification of corn masa flour could help prevent neural tube defects.

California legislation requiring folic acid fortification of corn masa flour was passed in 2024. State Assemblymember Joaquin Arambula sponsored the legislation. "You have to be the first oftentimes to get the ball rolling. So, I'm glad other states have taken up that mantle," Arambula said.

Major manufacturers have already begun fortifying their products. Azteca Milling began selling some varieties of its Maseca brand corn masa flour fortified with folic acid in 2016. Mission Foods began adding folic acid to its corn masa products in 2024 and now adds folic acid to all of its branded and private label corn tortillas sold in the U.S. As of 2026, 97% of Gruma Corp.'s U.S. retail sales of corn masa flour include folic acid.

"At fortification doses, folic acid has never been shown to harm individuals or populations," said Jeffery Blount, a pediatric neurosurgeon at the University of Alabama at Birmingham. More than 40% of U.S. pregnancies are unintended.