SACRAMENTO – To address insurance reimbursement barriers that make it difficult for community health providers to offer HIV prevention medication, Senator John Laird (D–Santa Cruz) today introduced Senate Bill 1023 to expand access to injectable Pre-Exposure Prophylaxis (PrEP), a highly effective medication used to prevent HIV infection.

SB 1023 increases access to injectable PrEP by requiring health plans that already cover the medication to also reimburse it through their outpatient prescription drug benefit.

“Forty-one years ago, I helped found the Santa Cruz AIDS Project, when there were no effective treatments, and we were regularly losing friends and neighbors to HIV. Today, we have powerful prevention tools like PrEP, including long acting injectables that can be administered every few months,” said Laird. “Senate Bill 1023 will help more people access these lifesaving medications by removing administrative and financial barriers that make it difficult for community clinics to offer them. Expanding access to PrEP is essential to protecting public health and ensuring that everyone can benefit from advances in HIV prevention.”

Currently, some health plans restrict injectable PrEP coverage to the medical benefit. Under this structure, healthcare providers must purchase expensive specialty medications upfront, navigate complex billing procedures, and wait for reimbursement. These requirements can create significant financial and administrative burdens for smaller community clinics and HIV prevention providers.

SB 1023 addresses this barrier by requiring health plans that already cover injectable PrEP under the medical benefit to also cover the medication through the outpatient prescription drug benefit. This approach allows the medication to be filled through a pharmacy while the clinical administration is billed separately, reducing upfront costs and inventory risks for providers.

While state-regulated health plans and insurers are required to cover PrEP, the bill does not require health plans that do not currently cover PrEP to add new coverage.

Human immunodeficiency virus (HIV) attacks the body’s immune system and, if untreated, can progress to acquired immunodeficiency syndrome (AIDS). While oral PrEP requires daily adherence, long-acting injectable options administered every two to six months have emerged as a powerful prevention tool, particularly for individuals who face barriers related to stigma, housing instability, or treatment fatigue.

SB 1023 is a California Legislative LGBTQ Caucus priority sponsored bill and is principal co-authored by Assemblymember Mark González (D–Los Angeles).

“Under a chaotic federal administration whose goals are to destroy DEI and question fact-based science, SB 1023 provides a sense of security to Californians that PrEP will remain accessible for all,” said González. “Thank you to Senator Laird for continuing this fight and pushing forward a bill that ensures we do not return to the horror our community faced during the height of the HIV epidemic. Together, we can unite and end the epidemic.”

Co-sponsors of SB 1023 include Insurance Commissioner Ricardo Lara, the San Francisco AIDS Foundation, APLA Health, Equality California, and the Los Angeles LGBT Center.

“I am proud to co-sponsor SB 1023, legislation that removes barriers to accessing life-saving HIV prevention medication,” said Insurance Commissioner Ricardo Lara. “No one should face administrative hurdles when seeking preventive care. By ensuring coverage under the outpatient prescription drug benefit, we are expanding access, strengthening consumer protections, and advancing health equity for communities disproportionately impacted by HIV. I thank Senator Laird for his leadership in authoring this important measure.”

“We are proud to cosponsor SB 1023,” said Craig E. Thompson, CEO of APLA Health. “Against the backdrop of calculated federal cuts to health care coverage and capricious cuts to HIV prevention funding, laws that give providers the flexibility to seek timely reimbursement—in whichever way allows them to sustain their operations—are essential for bolstering essential preventive care while it is under attack.”

“Injectable PrEP has the potential to transform HIV prevention, but only if people can actually access it,” said Tony Hoang, Executive Director of Equality California. “Right now, reimbursement barriers in some insurance plans are forcing small, community-based clinics to front the cost of this medication and wait weeks for payment, putting enormous strain on providers and threatening access for patients who rely on these clinics for care.”

“We’re grateful to Senator Laird for championing SB 1023. This bill is about making HIV prevention easier to get—plain and simple,” said Nicole Thibeau, PharmD, Director of Pharmacy Services at the Los Angeles LGBT Center. “By allowing pharmacies to provide and bill for long-acting injectable PrEP, we’re opening the door for more people—especially those in underserved communities and so-called ‘PrEP deserts’—to get the protection they need close to home.”

“Injectable PrEP has tremendous potential to empower more Californians to protect themselves from HIV, but the way insurance companies cover the medication is preventing many healthcare providers from offering it to their patients,” said Dr. Tyler TerMeer, CEO of the San Francisco AIDS Foundation. “Senate Bill 1023 fixes this problem by requiring insurers to cover injectable PrEP in the same way they cover the oral form of the drug—a common-sense solution that will expand access to a vital HIV prevention tool.”