SFAF co-sponsors four state bills to protect PrEP access, improve HIV care, lower drug costs, and more
As systems of HIV care and support are dismantled and defunded at the Federal level, SFAF’s policy team is hard at work shoring up protections, funding, and care for people living with and affected by HIV across the state and locally.
The California State Legislature came back together in January for another session of lawmaking, and as always, SFAF’s Public Policy team is actively advancing and defending the interests of people affected by HIV. This year, SFAF is “sponsoring” (i.e., leading advocacy on) four bills:
Assembly Bill 309—Preventing HIV Transmission via Injection Drug Use
Every year, hundreds of Californians are infected with HIV by sharing hypodermic needles to inject drugs. That’s why making clean needles easy to get is an important HIV-prevention strategy. Current state law allows people age 18 or older to obtain sterile needles and syringes for personal use from physicians and pharmacists. However, that law will go out of effect on January 1 of next year. AB 309 will extend the law indefinitely, ensuring that people who inject drugs can continue to keep themselves safe from HIV, as well as hepatitis C and other blood-borne illnesses.
Assembly Bill 554—Protecting and Expanding PrEP Access
As new forms of PrEP come onto the market and new threats to PrEP arise, new laws are needed to ensure that every Californian who needs this powerful HIV-prevention tool can easily obtain it. Enter: AB 554, which will improve access to PrEP in two important ways:
- The bill will require insurers to cover, at no cost to patients, any form of PrEP that has been approved by the FDA or recommended by the CDC. Right now, state law requires that insurers provide no-cost coverage of any form of PrEP recommended by the U.S. Preventive Services Task Force, but a lawsuit that is currently before the U.S. Supreme Court (Braidwood v. Becerra) could nullify that task force’s recommendations.
- The bill will also require insurers to pay for injectable forms of PrEP at the time a prescription is filled at a pharmacy (just like for oral forms of PrEP). Currently, insurers usually pay for injectable PrEP by reimbursing providers after the provider has administered the drug to their patient. This means that providers have to pay up front for these expensive drugs—and that means many providers can’t afford to offer injectable PrEP. AB 554 will make it financially feasible for more clinics to provide injectables for patients at risk of HIV.
Senate Bill 41—Lowering HIV Drug Costs
Proposed by San Francisco’s state senator, Scott Wiener, this legislation would put in place California’s first significant rules about companies called “pharmacy benefit managers,” or PBMs. These companies are supposed to negotiate lower drug prices from manufacturers for insurers and their customers—but in reality, they take most of the savings they negotiate for themselves and drive up drug costs for consumers. PBMs’ behavior is especially harmful to people affected by HIV because
HIV drugs are already among the most expensive on the market, and the high cost to consumers of these medications causes many people to stop taking their HIV-treatment meds or PrEP. By cracking down on PBM profiteering, SB 41 will help make HIV drugs and other vital medications more affordable.
Senate Bill 278—Improving HIV Care for People on Medicaid
More than 40,000 people living with HIV in California are on Medicaid, and data suggests that one out of every four is not engaged in HIV care. Our state Medicaid program could improve these numbers by using data on which patients are virally unsuppressed (i.e., have a detectable amount of HIV in their body) to direct extra help to those patients. The problem is, state law bans the sharing of that data (and other HIV lab-test results) with California’s Medicaid agency and the organizations that manage Medicaid patients’ care. SB 278 will eliminate this barrier, while maintaining and strengthening HIV privacy protections. The bill will provide our state Medicaid program with the information it needs to focus on people living with HIV who may need additional support.
Right now, the bills that SFAF is sponsoring are receiving their first public hearings in front of various legislative committees. Between now and the end of the legislative session in September, there will be a number of opportunities for community members to support these pieces of legislation. To stay up to date, sign up for SFAF’s newsletter and join our HIV Advocacy Network.
