STIs and Insurance

Nevada policymakers may enact legislation that bolsters insurance coverage for preventive healthcare services, including STIs. AB522 includes language that stipulates insurance carriers must provide STI screening, testing, treatment, and prevention services without copays or coinsurance. The bill also separately states that plans must include coverage for HIV testing in any person who is pregnant. The bill was endorsed by ACLU Nevada, who stated that it “promotes health equity, supports families, and strengthens Nevada’s commitment to affordable, preventive care for everyone.”

If AB522 becomes law, Nevada will join a number of other states that have required insurance carriers to cover STI-related services without cost-sharing. Several state legislatures have enacted similar legislation in recent years, as highlighted in NCSD’s STI Insurance Policy Aid.

Point-of-Care Syphilis Testing at the Emergency Department

In addition to the insurance bill circulating in Nevada’s General Assembly, policymakers in the “Silver State” also have a chance to expand screening for syphilis in emergency rooms.

AB360 builds upon current state requirements for serological testing during prenatal syphilis screening by authorizing emergency department personnel to use rapid or point-of-care (POC) testing in pregnant patients, as these tests provide faster results than standard serological tests. The bill states that serological antibody testing may still be used in EDs if the results are available before the pregnant patient is discharged or if the patient reports previous syphilis infection. AB360 passed the Nevada Assembly unanimously, 42-0.

Although research has been limited, initial studies from the CDC indicate that rapid tests’ sensitivity and specificity are comparable to the current tests used in clinical settings. Importantly, rapid tests can help ensure patients with syphilis who may not regularly access the healthcare system are captured more immediately and receive expedited treatment.

Jen Howell, who works as the Sexual Health Program Supervisor for North Nevada Public Health, provided data to policymakers on the state’s congenital syphilis rates. “This bill builds on progress made during the 2021 Nevada legislative session, which expanded STI screening among pregnant individuals—including required syphilis testing at delivery,” she stated. “By extending that policy, this bill ensures rapid syphilis testing in emergency departments. Strengthening early detection at every point of contact in the healthcare system is essential to protecting maternal and infant health and ending congenital syphilis in Nevada.”

Minor Consent

Several state legislatures recently debated measures that would either expand or restrict adolescents’ ability to consent to sexual health services.

In Florida, companion bills SB1288 and HB1505 were introduced in the state’s two chambers as part of a “parental rights” package aimed at expanding parents’ authority to approve healthcare services and related materials for their children. For example, the bill included a provision that would allow parents to review any survey being distributed to their child in school.

Current Florida law allows minors to consent to STI treatment after diagnosis. The proposed legislation would change this existing rule and require parental consent for adolescents seeking STI treatment. It would also prevent adolescents from accessing prescribed contraceptives without parental approval. The two bills received backlash for their impact on adolescent health, including from the American College of Obstetricians and Gynecologists.

HB1505 passed the House 80-28 on April 25. While SB1288 passed both the education and judiciary committees, it was ultimately scrapped along with the House version by the Senate Rules Committee, indefinitely postponing both.

Meanwhile, in New York State, Assemblymember Amy Paulin (D – Westchester) introduced A6866, which would modify existing law by lowering the age required for STI testing and treatment consent from 21 to 18 and include the right to consent to STI-related vaccines, such as the one to prevent HPV.

HIV Pharmacy Access

Maine lawmakers may have an opportunity to strengthen mechanisms for accessing HIV prevention drugs at the pharmacy. HP1122, introduced by Representative Matt Moonen (D – Portland), would establish a reimbursement model through the state’s Medicaid system to adequately compensate pharmacists prescribing pre-exposure prophylaxis (PrEP) medications. The model must be created and implemented by January 31, 2027, if approved by policymakers.

While around a dozen states allow individuals to access PrEP directly at the pharmacy, uptake can be slow and challenging. NASTAD clarified in their pharmacist-initiated PrEP document that reimbursement policies remain critical, noting “statutes should either define pharmacists as providers or require equitable reimbursement rates” to guarantee pharmacists have a logistical and fiscal incentive to prescribe PrEP.