CA Leaders Leave Low-Income, Uninsured LGBTQ+ Patients Without a Pathway to No-Cost STI Care

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Emma Hodson / (510) 486-0412, x2326

Statement by Co-Sponsors of SB 306 (Pan) The STI Coverage + Care Act on the Failure to Address Inequities in Our State’s Health System

July 28, 2021 –  Yesterday a final state budget was signed for FY 2021-22 that includes additional funding to combat rising rates of sexually transmitted infections (STIs). The funding will increase support for local health jurisdictions that have experienced cuts in STI prevention dollars over the past decades, and reassignments for STI staff during the COVID-19 public health emergency.

While this is a positive step toward addressing a public health crisis that has gone ignored for far too long, unfortunately the final budget deal failed to fund the expansion of the state’s Family PACT program to increase access to STI testing and treatment services for low-income and uninsured members of the LGBTQ+ community, as outlined in SB 306 (Pan).

Funds to support this critical policy change were included in the legislature’s initial budget bill, but the Department of Health Care Services (DHCS) quietly but definitively closed the door on the proposal in the final stages of budget negotiations. 

SB 306 Co-Sponsor Statement in Response 

“We are deeply disappointed that DHCS missed this opportunity to meet this moment, and make our health system more equitable for LGBTQ+ Californians. The department shut down the possibility of creating a pathway to STI coverage and care for low-income and uninsured LGBTQ+ patients this year, a move that is completely out of step with their stated goals related to health access and equity.

Uninsured and low-income LGBTQ+ Californians are disproportionately impacted by the state’s STI crisis. Extending access to care is both the right thing to do and a necessary action to curb rising rates. Instead of taking the opportunity to improve the reach and efficacy of our state’s public health programs, DHCS has maintained structural barriers that result in unequal health outcomes for LGBTQ+ Californians. The challenges of the past year have only underscored the need for California to invest in strengthening our public health infrastructure and ensure that everyone can get the care they need, when they need it – particularly individuals that have been historically disenfranchised, including LGBTQ+ patients. We will continue to advocate for improved access, coverage, and health equity for all Californians, regardless of how they identify or who they love.”

Background

Family PACT currently covers STI services for low-income, uninsured individuals, but only within the context of a family planning visit, therefore rendering many LGBTQ+ Californians ineligible for no-cost care through the program. California does not have a stand-alone STI program, so LGBTQ+ Californians without health coverage are often left paying out-of-pocket for STI care, or forgo care entirely because of a lack of affordable options. Although our STI public health crisis is effecting communities across the state, California youth, people of color, bisexual and transgender women, and gay and bisexual men are disproportionately impacted.

The COVID-19 pandemic has exacerbated STI rates that were already skyrocketing to epidemic proportions prior to the public health emergency. Recent data published by the Centers for Disease Control and Prevention (CDC) revealed that STI rates across the country increased for the 6th consecutive year and estimates that 1 in 5 people in the U.S. have an STI. More than 325,000 Californians were infected with syphilis, chlamydia, or gonorrhea in 2019. In terms of rates per population, California ranks 4th in the country for syphilis rates, 15th for chlamydia and 18th for gonorrhea. Nearly 7 out of 10 early syphilis male cases were among men who have sex with men in 2018, and men who have sex with men accounted for 64 percent of male gonorrhea cases. Untreated STIs can lead to serious long-term health consequences, including infertility, blindness in the case of gonorrhea, cervical cancer related to human papilloma virus (HPV) infections, and negative maternal and child health outcomes. STIs also increase both the transmission and acquisition of HIV.

The CDC also determined that new STI infections acquired in 2018 totaled nearly $16 billion in direct lifetime medical costs nationwide. Chlamydia, gonorrhea and syphilis combined accounted for more than $1 billion of the total cost. Sexually acquired HIV and HPV were the costliest due to lifetime treatment for HIV at $13.7 billion and treatment for HPV-related cancers at $755 million. Approximately $1 billion is spent annually on health costs associated with STIs in California.

More details about the budget agreement can be found here.