OLYMPIA — Bipartisan legislation mandating all Washington health plans issued or renewed on or after Jan. 1, 2027, cover all HIV antiviral drugs without prior authorization or step therapy was signed into law March 14.

The bill, sponsored by Sen. Marko Liias (D-Edmonds), builds on the state’s efforts to reduce transmission and expand access to lifesaving HIV care for Washingtonians, including post-exposure drugs and Medicaid prescription coverage.

“Doctors will no longer face unnecessary barriers when prescribing the best HIV antiviral drugs for their patients. This is another step forward in our fight to eradicate HIV and AIDS in Washington and will ensure those living with the disease can live long, healthy lives,” Liias said.  

Between 2020 and 2024, newly diagnosed HIV cases in Washington increased by 24%. In addition, more than one-quarter of newly diagnosed HIV cases in the state were diagnosed late in the course of the illness. 

Laura Boudreau, chief of operations/risk management and quality improvement at the AIDS Healthcare Foundation, said the new law will remove roadblocks that doctors have faced when determining the best medication for patients with HIV.

“HIV is a complex disease. Many HIV drugs are single source brand drugs, and many people are responsive to one drug but not another. Doctors need to have the ability to select the best drug for their patient without having to jump through unnecessary hoops just to keep their patients healthy,” Boudreau said. “We are grateful for Senator Liias’s work to protect access to these medications by removing barriers, such as prior authorization and step therapy.” 

Consistent use of HIV antiviral drugs reduces the amount of virus in the body, making it non-transmittable through sex. Research has found HIV treatment also significantly reduces the risk of transmission through pregnancy and breastfeeding. 

Dr. Peter Shalit, a Seattle-based physician who has been treating people with HIV since the 1990s, said the new law will ensure his patients can get the care they need without pushback from insurance companies. 

“HIV care is not a ‘one-size-fits-all’ process. Some strains of the virus are not susceptible to certain antivirals, limiting treatment options. Side effects and interactions with other medications may also limit which HIV medications are appropriate for a given person,” Shalit said. “It has been frustrating and demoralizing for me to have to spend hours fighting with insurance companies to get the most appropriate HIV medicines approved for my patients. Senate Bill 6183 will guarantee that my patients are able to receive the most appropriate combination of HIV medicines for their particular situation, without my having to do battle on their behalf.” 

The new law goes into effect June 11.