It is due to the ultra restrictive Super Ultra Low Emissions Vehicle (SULEV) rating which is near the Partial Zero Emissions Vehicle (PZEV) level. Most vehicles of that generation are ULEV or LEV, but the 2003 Accords with the K24 engine in the EX/EX-L trim were SULEV rated. Here is a good video that shows the process for using the CA Executive Order exemption relative to the Honda cat. shortage in 2021.There is something specific to this particular engine that is giving them a hard time.
Other engines have more options for aftermarket cats with CARB approval, including from Walker.
With the CA Executive Order now rescinded, it is unclear whether the cats. installed prior to August 1, 2023 have to be retrofitted with a $2000+ Honda OEM cat. to pass smog testing.