After successfully making it through the state Senate, House Bill 5577 continues to progress, following its passage by the House Committee on Health Care & Wellness on March 19. At the public hearing on March 14, numerous advocates highlighted the need for this legislation.

"This is more than just an access issue — it's an equity one," said David Ramos, public policy manager at Cascade AIDS Project, the oldest community provider of HIV services, housing, education, and advocacy in southwestern Washington and Oregon. "Historically, marginalized communities are at disproportionate risk for HIV transmission. They are also disproportionately likely to be insured in Medicaid."

Ramos said there is a need that will remain for the foreseeable future as HIV continues to spread, and that the bill would act as a critical strategy in fulfilling the state's goal to end HIV.

HB 5577 would direct the Health Care Authority (HCA), which oversees the Washington Medicaid program, to provide coverage for all FDA-approved HIV antiviral medications without prior authorization or step-therapy requirements. It would apply to people on both fee-for-service and managed care plans under Medicaid.

Katie Cullen spoke on behalf of the AIDS Healthcare Foundation, which has a facility in Seattle and a more recent one in Tacoma. The foundation offers mobile testing and case management programs.

"We serve and treat people with HIV regardless of their ability to pay," Cullen said. "We're serving roughly 2,000 people with testing alone in the Seattle and Tacoma area, in addition to the treatment we provide at our centers."

Back in 2023, the biennial operating budget directed the HCA to cover all FDA- approved HIV antiviral drugs and PrEP without any prior authorization. The proposed bill would codify those requirements and also prohibit step therapy. If signed into law, HB 5577 would become effective on July 1.