Policy priority: Expanding access to injectable PrEP

March 17, 2026, SAN FRANCISCO–San Francisco AIDS Foundation is proud to co-sponsor California SB 1023, authored by Senator John Laird (D-Santa Cruz), that would expand access to injectable PrEP options.

The bill would change the way that health insurers pay for long-acting injectable PrEP for their enrollees. Currently, some health plans cover injectable PrEP under the medical benefit rather than through an outpatient prescription drug benefit. This practice means that healthcare providers must purchase injectable medications upfront, navigate complex billing procedures, and wait for reimbursement–which may create financial and administrative burdens for smaller clinics. SB 1023 would require insurers that already cover injectable PrEP to pay for injectable drugs in the same way that they pay for oral PrEP medications.

There are two long-acting injectable PrEP options approved by the FDA: Apretude (cabotegravir) and Yeztugo (lenacapavir). Both of these highly effective medications  carry a high list price (over $20,000 annually) that has been found to limit the number of clinics and pharmacies that can purchase and provide these medications. Sponsors of SB 1023 are optimistic that the bill, if passed and signed into law, would help improve access and uptake.

“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.”

“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 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.” 

The co-sponsors of SB 1023 are:

• APLA Health
• California Department of Insurance
• Equality California 
• Los Angeles LGBT Center
• San Francisco AIDS Foundation

In addition, SB 1023 is a priority bill for the California Legislative LGBTQ Caucus and is co-authored by Mark González (D–Los Angeles).