A new law requiring health insurance plans in California to cover clinician ordered at-home testing for sexually transmitted infections is one among the 770 laws that went into effect on Saturday. 

Governor Gavin Newsom signed Senate Bill 306 into law which would strengthen California’s public health infrastructure and provide greater testing and treatment for sexually transmitted infections (STI). Authored by Senator Dr. Richard Pan, SB 306 will expand access to STI testing remotely at home and in the community, increase access to STI treatment for patients and their partners, and update state law to boost congenital syphilis screening in the face of alarming increases in maternal-child transmission.

With this, the state becomes the first to cover at-home testing for STIs such as chlamydia, gonorrhea and syphilis in the nation.This comes during an ongoing STD epidemic which has been further exacerbated by the COVID-19 pandemic, according to the bill. 

Those enrolled in the state’s Medicaid program will have access to the free at-home tests first. People with state-regulated private insurance plans are anticipated to have access shortly after. Though, a state analysis predicts that most in-network healthcare providers may not be prescribing at-home testing for at least a year until the bill clarifies billing and other practices. 

According to infectious diseases experts, creating affordable and more accessible options for Californians to self-test in the privacy of their own homes could result in better disease surveillance to rural and underserved parts of the state, reducing the stigma patients experience when seeking care. 

"STI rates across the country have reached crisis levels and it has become worse as an antibiotic-resistant strain of gonorrhea spread across the country,” said Dr. Pan. “SB 306 is an essential public health measure, and I am proud to have partnered with such a strong coalition of community health organizations to strengthen public health and expand access to STI diagnosis and treatment in California."

While they have been approved by the Food and Drug Administration, none have been approved for use at home, according to the California Health Benefits Review (CHBR) report of the bill. Some laboratories cannot analyze samples collected from at-home tests, and require collection within the walls of a healthcare facility. 

Additionally, public health officials have raised concerns regarding the accessibility of counselling, treatment and other services patients may receive at clinics.Those who take the test are required to self report, and the possibility remains for some to not be able to follow through. 

The Centers for Disease Control and Prevention (CDC) estimates that one in five people in the U.S. have an STD. In 2018, nearly 68 million STD infections were reported nationwide, and rates of syphilis, chlamydia, or gonorrhea are up 40 percent since 2013. The state of California had the second highest syphilis rates in the nation in 2018. The syphilis rate among women of reproductive age increased by 743 percent between 2008 and 2018, according to the CDC.

The COVID-19 pandemic further has exacerbated STD infection rates across the country, according to the bill. Last year, the CDC announced that a new, antibiotic-resistant strain of gonorrhea began to spread across the country amidst the COVID-19 crisis. 

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