Health and Wellness

California becomes first state to require insurance to cover the cost of at-home STD tests

Process of coronavirus testing examination at home, COVID-19 swab collection kit, test tube for taking OP NP patient specimen sample, testing carried out, patient receiving a corona test
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New legislation went into effect in California requiring health insurance to cover the costs of at-home test kits for sexually transmitted infections (STI), including HIV, syphilis and chlamydia.

Senate Bill 306, also called the STD Coverage and Care Act, was authored by Sen. Dr. Richard Pan (D) and co-authored by out Sen. Scott Wiener (D). It passed both chambers of the California Assembly in September and was signed into law by Gov. Gavin Newsom (D) in October.

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It made several health care updates to California’s codes, specifically related to changes lawmakers felt necessary in light of the COVID-19 pandemic, including finding ways to address the rising STI rates in California.

In San Francisco, for example, while the number of cases of chlamydia slightly went down, the number of cases of gonorrhea and syphilis had increased by July 2021 as compared to July 2020.

Statewide, congenital syphilis — which babies contract from their mothers —rose 232 percent in California from 2015 to 2019, according to the CDC. More than 8 percent of California’s congenital syphilis cases resulted in stillbirths in 2019.

“STI rates across the country have reached crisis levels and it has become worse as an antibiotic-resistant strain of gonorrhea spread across the country,” Dr. Pan, a pediatrician, said in an October statement. “SB 306 is an essential public health measure, and I am proud to have partnered with such a strong coalition of community health organizations to strengthen public health and expand access to STI diagnosis and treatment in California.”

Currently, according to Kaiser Health News, residents in Alabama and the District of Columbia can request free STI test kits from public health departments, but insurances are not legally obligated to cover the cost.

Additionally, Iwantthekit.org, a project of Johns Hopkins University, offers free kits to residents of Maryland and Alaska, and The National Coalition of STD Directors (NCSD) offers free kits in partnership with health departments in Philadelphia, Pennsylvania and Navajo County, Arizona, in addition to Iowa, Virginia, Indiana, and Puerto Rico.

NCSD surveys have found that several medical professionals have been reassigned or had their roles redefined to accommodate for the ongoing pandemic. The first found that 78 percent of STD programs’ staff “were redeployed to assist with their jurisdiction’s COVID-19 response.” The NCSD’s January 2021 survey found that 37 percent of STD programs’ staff were still redeployed.

“This is the first law of its kind, and I’d say it’s kind of cutting-edge,” Stephanie Arnold Pang, the NCSD’s senior director of policy and government relations said “We want to bring down every single barrier for someone to get STI testing, and out-of-pocket cost is a huge factor.”

In addition to requiring coverage of costs for at-home test kits, the new legislation calls for increasing the number of health care providers that can offer STI tests and promoting expedited partner therapy so partners of patients regularly testing for STIs can also access testing. Syphilis screenings will be required in the first and third trimester pregnancy screenings.

While the law has already  gone into effect, the state’s Medicaid program is still in the process of amending its billing procedures to accommodate the changes, and most self-administered tests have yet to receive approval by federal regulators. Still, private state-funded insurance companies have begun to apply the changes and at-home tests could be widely available to Californians within a year.

“STI rates in CA reached record highs in past 6 years,” Essential Access Health, a sexual and reproductive health non-profit, tweeted in October. “SB 306 takes critical steps toward addressing state’s STI crisis, will expand access to testing + treatment options.”

A separate law, Assembly Bill 489, requires any adult patient receiving primary care service at a California medical facility to be offered a test screening them for hepatitis B and C. Newsom also signed it into law in October, and it took effect on January 1.

A.B. 489 was authored by out Assemblymember Evan Low (D) and Assemblymember Mike Gipson (D), and sponsored by Dr. Pan in the Senate. It passed the Assembly and Senate in the last week of August.

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