WASHINGTON, D.C. [6.29.23] – This month, U.S. Senator Tina Smith (D-Minn.) and U.S. Representative Adam B. Schiff (D-Calif.) introduced legislation that will expand access to lifesaving HIV prevention medications.
The PrEP Access and Coverage Act addresses the underutilization of HIV prevention drugs – known as PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis) – by ensuring these medications and any associated costs are covered by health insurance. The measure also establishes community public health campaigns, and it expands access to the drugs for uninsured individuals and underserved communities.
“Every person deserves access to affordable, high quality health care,” said Sen. Smith. “Too many people in Minnesota and across this country are unduly burdened by the high costs of HIV prevention drugs, and many others are going without this lifesaving preventative medication. This bill takes an important step towards ensuring that these highly effective medications are accessible and affordable for every patient who needs them.”
“HIV prevention drugs shouldn’t be inaccessible and unaffordable,” said Rep. Schiff. “Senator Smith and I are reintroducing the PrEP Access and Coverage Act so that LGBTQ Americans – especially those from communities of color who experience disparities in health care – have access to the HIV medications and services they need.”
“To end the HIV epidemic by 2030, we must expand our efforts to improve PrEP education and access,” said Torrian L. Baskerville, Director of HIV & Health Equity for the Human Rights Campaign Foundation. “It is especially critical to address decades-long inequities that disproportionately impact Black and Latine LGBTQ+ communities by guaranteeing equitable insurance coverage for preventive services, mandated in the same manner as life-saving treatment. We believe the PrEP Access and Coverage Act is a clear step in the right direction towards increasing access and placing a permanent halt to the HIV epidemic. The Human Rights Campaign thanks Senator Tina Smith and Representative Adam Schiff for their continued leadership on this issue.”
“We thank Sen. Smith, Rep. Schiff, and their colleagues for their leadership in re-introducing the PrEP Access and Coverage Act,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “Passage of this bill will greatly expand access to PrEP for those who have health coverage across all payers, and create a national PrEP program that includes community and provider outreach, as well as PrEP drugs and associated services for the uninsured. Recognizing that many current PrEP users with private insurance are being wrongfully charged cost-sharing, we are pleased that the bill has been revised to include a new compliance and enforcement section.”
“When we have the tools to end HIV, it’s a disgrace that these drugs are not available for those who want and need it,” said Jeremy Hanson Willis, CEO of Rainbow Health, Minnesota’s first HIV/AIDS organization. “Every case of HIV prevented means another person, another family, another community not grappling with a lifetime of HIV-related medical costs, complicated drug regimens, and social injustice. We are grateful and proud to stand with Senator Smith and her fight to make effective medicine that prevents HIV like PrEP available to more people.”
The PrEP Access and Coverage Act would address the significant disparity between those who are recommended to take HIV prevention drugs and those who are prescribed the medication by:
- Ensuring comprehensive health insurance coverage of HIV prevention drugs by eliminating out-of-pocket costs for the medications and associated costs for individuals who are enrolled in federally-regulated private and public health insurance.
- Prohibiting prior authorization requirements for HIV prevention drugs under private and public health insurance plans.
- Prohibiting denying coverage or increasing premiums for disability insurance, long-term care insurance, or life insurance policies based on a person taking medication for HIV prevention.
- Directing the Department of Health and Human Services to establish public health education campaigns to increase utilization of PrEP and PEP among individuals at risk of contracting HIV.
- Establishing a grant program for States, Territories, Tribes, and health care facilities, such as Federally Qualified Health Centers and family planning centers, to expand access to PrEP and PEP for uninsured individuals and underserved communities.
- Directing the Departments of Health and Human Services, Labor, and Treasury to monitor compliance with PrEP and PEP coverage requirements among private insurers and take appropriate enforcement actions.
The legislation has been endorsed by the HIV+Hepatitis Policy Institute, the Human Rights Campaign, Rainbow Health, the Whitman-Walker Institute, the AIDS Institute, and the Aliveness Project.
You can read more about the legislation here.