Assembly Health Committee advances bills on HIV prevention, clinician-dispensed drugs, wildfire air devices and benchmark benefits; naloxone contracting measure

The Assembly Health Committee met April 29 in Sacramento and considered a broad slate of health legislation, moving several measures to the Appropriations Committee for further review and debate while rejecting at least one high-profile measure tied to state naloxone contracting.

In front of a packed hearing room, members debated bills that ranged from expanding access to injectable HIV pre-exposure prophylaxis (PrEP), to rules that affect how physicians can dispense medications in-office, to targeted disaster-response benefits such as coverage for portable HEPA air purifiers and additional behavioral health visits after wildfires. Lawmakers and witnesses repeatedly framed the discussion around access to care, equity for affected communities, and fiscal and operational impacts on hospitals and health plans.

The most-discussed measures included: - AB 554 (Gonzales), the PREPARE Act: sponsors said the bill clarifies and strengthens state protections that prevent prior authorization and step therapy for PrEP, extend no-cost coverage requirements to more plans and improve reimbursement for injectable PrEP so small community clinics can offer it. Supporters included Equality California and the California Department of Insurance; opposition from insurers raised concerns about potential premium impacts and the state's current affordability targets. Committee members advanced the bill to appropriations.

- AB 577 (Wilson): aimed at preserving physicians' ability to administer and dispense medications in-office when medically necessary. The author accepted committee amendments that narrow the bill to in-network providers, require patient consent and cost transparency, and exempt hospital outpatient settings. Physician groups and oncology and rheumatology associations strongly supported the changes; insurers and pharmacy-benefit managers opposed, citing drug-cost and patient-safety concerns. The committee advanced the bill to appropriations as amended.

- AB 546 (Bauer-Kahan) ' "Clean Air for All": would require health plans to provide coverage for effective portable HEPA purifiers for specified vulnerable beneficiaries during declared wildfire emergencies. Supporters cited CalHHS and multiple public-health studies tying…