SACRAMENTO, CA – Today, Assemblymember Mark González (D-Los Angeles) introduced AB 554, a bill that prevents health care plans and insurance companies from requiring prior authorization or step therapy for all antiretroviral drugs, including injectable medications, used for HIV/AIDS prevention. AB 554 also requires these lifesaving drugs to be covered without cost sharing or utilization review for individuals with private insurance.
"Under the chaos of this new federal administration, California must take steps toward safeguarding and expanding access to critical, life-saving healthcare such as long-lasting injectable HIV prevention medications," said Assemblymember Mark González (D-Los Angeles). "AB 554 safeguards patient and provider choice—ensuring flexibility in selecting the most suitable medication for patient adherence, while also allowing small, local clinics to receive reimbursement for these services. Together, these will help reduce the risk of HIV/AIDS, and address the disproportionate health risks of HIV in marginalized communities."
"I am proud to co-sponsor this critical legislation that removes barriers to life-saving HIV prevention medication," said Insurance Commissioner Ricardo Lara. "No one should have to jump through hoops or face financial burdens to access FDA-approved and CDC-recommended treatments that can prevent the spread of HIV/AIDS. By eliminating cost-sharing for these essential medications, we are taking a significant step toward health equity—especially for communities disproportionately impacted by the HIV epidemic. This bill is about saving lives, breaking down systemic barriers, and ensuring that all Californians have access to the care they need."
Despite the efficacy of injectable PrEP, commercial plans are only required to cover formulations with Grade A or B recommendations from the United States Preventive Services Task Force (USPSTF). This does not account for existing or future formulations that the FDA approves, formulations that may be even better at promoting adherence and thus all but eliminating HIV risk. By specifying in state law that safe and clinically effective medications will be fully covered, patient access will be protected in an uncertain future.
AB 554 also addresses the disproportionate impacts and higher rates of HIV transmission among ethnically or racially marginalized Californians due to limited healthcare access and awareness of this infection. For example, 2022 CDC data found Black/African Americans represent 14% and Latinx represent 17% of PrEP users compared to white people, who represent 64% of PrEP users. Further, the Latinx community comprised 57% of the total HIV diagnoses in California for 2022.
While small, local clinics and community-based providers are trying to provide services to these disproportionally impacted groups, they often are unable to receive full reimbursement for injectable PrEP medications from private insurance plans. This often leads to clinics and community-based providers not offering this medication, limiting overall access. When a patient goes to these providers, they should be able to choose which prevention path is right for them—all at no cost sharing or prior authorization.
"Injectable PrEP is revolutionizing HIV prevention," said Craig E. Thompson, CEO of APLA Health, "but providers face hurdles in administering it, meaning delays for patient initiation. The costs and logistical challenges of purchasing and billing for injectable PrEP are high for community-based providers that specialize in LGBTQ+ care and HIV treatment and prevention. APLA Health strives to provide the PrEP formulation of our patients' choice, despite the strain on our resources. Many other small providers will not even offer injectable PrEP because of these financial strains—and this risks alienating patients from a PrEP intervention that works for them. Equipping providers to bill under the pharmacy benefit not only makes injectable PrEP access more sustainable with real-time pharmacy transactions, but also, more importantly, lets patients begin their regimen day-of and with the formulation of their choice. Providers that already prescribe injectable PrEP need this support, and potential injectable PrEP providers ought to be supported to do so too. We are grateful to Assemblymember Gonzalez for championing AB 554, and we look forward to advocating for its passage."
"The Los Angeles LGBT Center is proud to co-sponsor AB 554, a groundbreaking bill that will empower healthcare providers and expand access to PrEP. This legislation removes the reimbursement barriers that have long hindered providers from effectively delivering all forms of PrEP—including long-acting injectables—by allowing seamless billing through a patient's pharmacy or medical benefit. Most importantly, it ensures that individuals with private insurance can access PrEP without cost-sharing, eliminating financial hurdles that put lives at risk," said Joe Hollendoner, CEO of the Los Angeles LGBT Center." At a time when the federal government is actively threatening healthcare access, we must take bold action to protect our community's right to essential, life-saving medication. AB 554 is a crucial step toward ensuring that everyone—regardless of income—has uninterrupted access to PrEP, strengthening the fight against HIV and safeguarding the health of our community."
"California leads the nation with the strongest laws ensuring patients can access PrEP without financial barriers or delays. Yet, if Donald Trump is willing to erase webpages that merely mention PrEP, his administration certainly can't be trusted to protect access to these life-saving HIV prevention medications," said Equality California Executive Director Tony Hoang. "No matter who is in the White House, California will safeguard PrEP access for all who need it. Equality California is proud to partner with Assemblymember González and Insurance Commissioner Lara to advance this critical and timely legislation."
"We are pleased to co-sponsor this important legislation from Assemblymember González," said Jonathan Frochtzwajg, the Director of Health Justice Policy for San Francisco AIDS Foundation. "Long-acting injectable PrEP has tremendous potential to help prevent HIV infections, especially among communities that face barriers to healthcare. Assembly Bill 554 will help make this emerging tool available in more clinics, for more patients."
Assemblymember Mark González is the Assembly Majority Whip. He represents the 54th Assembly District composed of the cities of Los Angeles, Commerce, Montebello, and Vernon.
CONTACT: Jaspreet Johl; Jaspreet.Johl@asm.ca.gov; (916) 335-8871
