This Month in State Policy

NCSD’s This Month in State Policy is a corresponding series intended to complement state-specific policies outlined regularly in This Week in Congress. NSCD will post This Month in State Policy through early June to provide peak coverage and analysis of state legislative sessions. For more information about this summary or other state policy trends, please contact NCSD’s Policy Team.

Prenatal Syphilis Screening: 

In Georgia, a bipartisan coalition came together to jointly pass SB46, which strikes certain language from the state’s HIV/Syphilis Pregnancy Screening Act of 2015. It maintains original language stating that a person who is pregnant should be tested three times for syphilis: at the first prenatal visit, during the third trimester (28-32 weeks), and at delivery. Previous rules, however, allowed a doctor to not test at delivery if the patient already had documentation of syphilis screening during the third trimester and did not disclose risk factors when questioned. The bill eliminates this language to support more universal testing and accommodate the reality that disclosure of risk does not always indicate reality of risk. It passed in the Senate unanimously and in the House 169-2.  

Lawmakers in Oklahoma—one of many states managing record-breaking congenital syphilis rates—introduced SB292, which would mirror Georgia’s law and require providers to test three times: at the first visit, during the third trimester, and at delivery.  

STD and Abortion Insurance Coverage: 

SB132 in New Mexico, which would eliminate cost-sharing for STI treatment and preventative care, made swift progress last month along party lines. It passed the democratically controlled Senate 26-13 and the House of Representatives 42-23. Governor Lujan Grisham has already signed a number of bills expanding health care into law, elevating the prospects of SB132. The legislation moved forward after a floor amendment excluded high deductible health plans from the new STI insurance coverage requirements. High-deductible health plans are paired with Health Savings Accounts (HSAs), allowing eligible insured patients to use tax-free savings to pay for expensive health care costs. Still, research has shown that one third of adults enrolled in high-deductible health plans do not actually contribute to HSAs, which means the impact of the legislation’s expansion and exclusions could vary depending on the type of plan a person is enrolled in and their own individual health literacy about how to use their plan.  

In Colorado, SB189 was introduced by Senate Majority Leader Dominick Moreno and passed its committee hearing on a party-line vote, 6-3. The bill would eliminate cost-sharing for not only STI treatment and prevention care, but also for reproductive health care services, including abortion and medical transportation. The bill sponsors emphasized that while federal law prohibits state Medicaid dollars to pay for abortion, it does not apply to transportation taken to the appointment. Similar to New Mexico, Colorado Democrats hold a trifecta in state control, which could advance the legislation forward.  

HIV Criminalization: 

In 2021, Virginia lawmakers tried to modernize HIV criminalization laws by removing testing requirements for individuals accused of sexual-related crimes and instead, providing survivors more immediate access to resources, such as post-exposure prophylaxis (PEP). This led to disagreements within survivor groups, including a rape survivor who was upset her attacker was not required by law to get an HIV test. In response, Virginia lawmakers in both chambers unanimously passed HB1416, which puts Virginia back into the position it was before 2021 and allows required testing of both survivors and suspects in allegations of sexual assault, child offenses, and any other charge involving exchange of bodily fluids. Importantly, test results will still not be admissible as evidence in criminal proceedings. However, the bill does not address concerns raised by the 2021 law sponsors, which stated that testing requirements can reinforce HIV stigma. 

PrEP and PEP at Pharmacies: 

Arkansas lawmakers made their state the second in the south to authorize pharmacist-initiated PrEP and PEP for HIV prevention. HB1007 received bipartisan support in both Arkansas’ House and Senate and has been signed by the Governor after passing both chambers unanimously. According to AIDSVu, Arkansas ranks as one of the seven states with the greatest unmet need for PrEP among Black people. Studies have demonstrated that patients strongly support the idea of getting PrEP at the pharmacy, which means pharmacies could be accessible intervention sites for people vulnerable to HIV acquisition. What this specifically means for Black people in Arkansas who are disproportionately underrepresented in PrEP uptake remains to be seen and will likely depend on equitable implementation strategies.  

Adolescent Policy: 

As cited in NCSD’s analysis last month, “parental rights” continue to dominate the adolescent health landscape across state legislatures, often coupled with measures aimed at curbing the rights of LGBTQ minors. 

In Kentucky, SB150 passed after extensive debate in a 75-22 vote. The controversial legislation includes a number of provisions after absorbing components of previous bills from the Kentucky House of Representatives. The latest version would require parents to be notified of any curriculum about sexuality and allow their students to not participate. Furthermore, it would not require or recommend an instructor in any local school district use a student’s pronouns if they do not conform to their sex assigned at birth. This directly affects transgender or non-binary students who often use pronouns that correctly match their gender identity instead of their sex assigned at birth. It is widely expected that Gov. Andy Beshear, a Democrat, will veto the legislation, but Republican lawmakers could override the veto with their supermajority.  

In addition to adolescent health policies targeting sex education, bathroom usage, and pronouns, transgender youth have also been the subject of debate in gender-affirming care discussions. Gender-affirming care usually refers to the scope of health services that support a transgender or non-binary youth as they either transition or take time to better understand their gender identity. This could mean a range of services, from pubertal blockers like gonadotropin-releasing hormone (GnRH) analogues, hormone therapies, or other services. In 23 states thus far, local lawmakers have introduced or passed legislation through at least one chamber that limits or bans gender-affirming care; eight states already have such laws enacted.   

Both the American Academy of Pediatrics and the American Medical Association oppose restrictions on gender-affirming care.