Two out California lawmakers saw bills relating to LGBTQ health concerns run into legislative hurdles this month. Both hope they can be revived and passed during next year's legislative session.
Gay state Senator Scott Wiener (D-San Francisco) announced September 8 that he would revisit his Senate Bill 339 after the Assembly Appropriations Committee inserted language into it he considered to be a "poison pill amendment" counter to his legislative aim of expanding access to the HIV prevention medication known as PrEP. The bill sought to increase the amount of PrEP that pharmacists are authorized to provide without a doctor's prescription.
It also would have required health plans to reimburse pharmacists for PrEP services. It built on Wiener's first-in-the-nation legislation passed in 2019 that authorized people to acquire PrEP from a pharmacist without a doctor's prescription.
Yet the amendments made to his bill allowing insurance companies to impose prior authorization and step-therapy for PrEP and PEP, which are significantly limited under existing law and regulations, would result in reducing patient protections, contended Wiener. Unless there is a legislative path forward to remove the amendments so SB 339 can be taken up again next year by state lawmakers, Wiener said he would abandon the bill.
"It's heartbreaking to see a straightforward, critically important HIV prevention bill stall this way," stated Wiener. "Thousands of Californians contract HIV each year, and we need common sense measures like SB 339 to improve access to PrEP."
San Francisco AIDS Foundation CEO Tyler TerMeer, Ph.D., expressed shock at the committee's action, which he argued would result in rolling back essential protections for people at risk of acquiring HIV.
"For decades California has been at the forefront of HIV prevention, ensuring that people had access to PrEP, our most effective form of HIV prevention, without delays caused by insurance red tape and greed. The language changes added by the Appropriations Committee would undo that work and leave people at the highest risk of HIV vulnerable to pointless bureaucratic delays and denials, increasing HIV transmission and undoing our work to get to zero new HIV infections in California," stated TerMeer, a gay man living with HIV.
Fertility bill stumbles
Lesbian state Senator Caroline Menjivar (D-San Fernando Valley) last week saw her SB 729 aimed at easing access to fertility care, especially for LGBTQ people, be turned into a two-year bill by the powerful Assembly Appropriations Committee. It means the chamber will take up the legislation in the new legislative session next year, as early as January.
The bill aims to require health plans to provide coverage for fertility care, including treatment for infertility and in vitro fertilization. It would also ensure that LGBTQ+ people are not excluded from such coverage.
"A two-year bill is not the outcome we hoped for, but it does allow us to continue our fight," stated Menjivar. "SB 729 progressed further in the legislative process than any similar bills attempting to decrease inequities in fertility care coverage, which is why I am optimistic and will not give up. Californians who wish to build a family deserve equity and justice, not the current discriminatory law that withholds the safest and most reliable methods of fertility care from many of them. Soon, we will make California the true leader in reproductive justice."
Among those co-sponsoring SB 729 is gay state Insurance Commissioner Ricardo Lara. Fourteen states have passed similar IVF insurance laws.
"Infertility affects people of all socioeconomic levels, racial identities, ethnic backgrounds, sexual orientations, gender identities, and religious beliefs," stated Lara, a former legislator. "As someone who has fought for affordable and more equitable access to health care services during my time in the California State Legislature and as Insurance Commissioner, I am proud to co-sponsor SB 729 to ensure fair and equal access to fertility treatments."
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