NCSD’s May/June edition of This Month in State Policy summarizes legislative activity from the past two months and closes our analysis for the year as most state legislatures adjourn. Follow NCSD and the STI Weekly for any special editions responding to bills or state elections later this year.

Sexually Transmitted Infections

Legislation that would overhaul parts of Delaware’s STI prevention and control act advanced on June 23 when the Senate voted unanimously to pass it, 21-0. The bill, HB346, already passed the House earlier in May and was included in a previous This Month in State Policy publication. In addition to changing “STD” to “STI” in statute, the bill would redefine how the state regulates disease intervention specialists by repealing a section that permits individuals without a medical license to draw blood for testing. In addition, it would modify prenatal syphilis screening rules by adopting recommendations from the American College of Obstetricians and Gynecologists (ACOG). Governor Matt Meyer (D) will have up to 10 days to sign it into law.

State Vaccine Authority and Funding

Colorado lawmakers took steps to ensure the human papillomavirus (HPV) vaccine is continuously covered and recommended, even if the federal agency tasked with advising on vaccines happens to issue different guidance. SB26-32, which passed along party-lines in the state’s Democrat-controlled legislature, was signed into law by Governor Jared Polis (D) and prompts the state insurance commissioner to adopt coverage rules for the HPV vaccine, should the Advisory Committee on Immunization Practices (ACIP) no longer recommend it. In addition, Colorado’s new bill directs the board of health to consider the American Academy of Pediatrics when establishing the childhood vaccine schedule.

ACIP members voted last December to stop recommending the hepatitis B vaccine for infants, a decision several state health departments and agencies chose not to adopt, though responses varied across state legislative bodies. In New Hampshire, for example, state Senators shelved a bill for interim study that would have eliminated hepatitis B vaccination requirements. In contrast, Illinois lawmakers considered a bill introduced by State Senator Mattie Hunter (D – Bronzeville) that would have established a working group to increase hepatitis B vaccine uptake; the bill died automatically when the state session ended.

Meanwhile, Oregon policymakers passed a bill that authorizes the state to make recommendations for preventive services through standing orders, including vaccine coverage. Governor Tina Kotek (D) signed SB1598 into law alongside two other healthcare bills aimed at expanding the state’s protection for certain health care services, one of which made Oregon the first state in the U.S. to replace the loss of Medicaid dollars for Planned Parenthood if federal funding is permanently discontinued. As NSCD reported last month, Maine’s legislature passed similar replacement funding for entities providing reproductive health care, making it the second after Oregon.

HIV

Florida lawmakers negotiated a $115 billion budget bill over Memorial Day weekend that includes $75 million to expand income eligibility for the state’s HIV/AIDS Drug Assistance Program up to 400% of the Federal Poverty Level (FPL). This marks the second time this year the Legislature re-established eligibility levels after the Florida Department of Health sought to reduce qualifying income thresholds in response to a budget shortfall. The bill goes beyond the temporary funding fix enacted in March by also restoring Biktarvy, a commonly prescribed HIV treatment drug, to the program’s formulary for uninsured patients. Governor Ron DeSantis (R) signed the bill into law on June 29 after cutting $1.7 billion in line-item vetoes; HIV funding was not one of the vetoed provisions.

Just north of Florida, Georgia legislators also expanded HIV policy initiatives when they passed SB195, which allows pharmacists to prescribe and dispense HIV pre-exposure prophylaxis or PrEP; Governor Brian Kemp (R) signed the bill into law on May 5. Georgia now joins dozens of other states who authorize pharmacists to prescribe, dispense, and administer HIV PrEP medications, and is one of three in the South following similar legislation enacted in Arkansas and Louisiana in 2023 and 2024, respectively.  Florida, Tennessee, and North Carolina more narrowly allow pharmacists to dispense post-exposure prophylaxis, or HIV PEP, for individuals who have been exposed to HIV and are within the imperative 72-hours window for effective prophylactic therapy.

Contraceptives and Maternal Health Care

While many states allow a person to pick up a year’s worth of birth control at once, Missouri has not historically been one of them. This could change after Missouri lawmakers passed a sweeping bipartisan health care bill that, among other provisions, allows patients pick up an annual supply of birth control instead of having to go to the pharmacy more frequently. The bill, introduced by Tara Peters (R – Rolla), also extends maternal care support through Show-Me Healthy Babies, a state Medicaid program for pregnant and postpartum women and it now includes insurance coverage for childbirth education classes. Because Missouri’s legislative session adjourned on May 15, Governor Mike Kehoe (R) has up to 45 days to sign or veto the bill. (Fun fact: Missouri is tied with Hawaii for the second-longest gubernatorial review period, surpassed only by Illinois’ 60 days!)