Smith and Schiff’s “PrEP Access and Coverage Act” Would Expand Health Coverage, Education and Access to Highly-Effective HIV Prevention Medications

WASHINGTON, D.C. [12/1/21]—Today, 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 of 2021” addresses the underutilization of HIV prevention drugs - known as PrEP (Pre-exposure prophylaxis) and PEP (Post-exposure prophylaxis) - in high risk communities 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.

The PrEP Access and Coverage Act of 2021 is co-sponsored in the Senate by Senator Amy Klobuchar (D-Minn.) and in the House by Chairman Jerrold Nadler (D-N.Y.) and Representatives Bobby Rush (D-Ill.), Barbara Lee (D-Calif.), Steve Cohen (D-Tenn.), Peter Welch (D-Vt.), Jackie Speier (D-Calif.), Paul Tonko (D-N.Y.), Mike Quigley (D-Ill.), Terri Sewell (D-Ala.), Dina Titus (D-Nev.), Mark Pocan (D-Wis.), Mark Takano (D-Calif.), Bonnie Watson Coleman (D-N.J.), Ro Khanna (D-Calif.), Sean Casten (D-Ill.), Katie Porter (D-Calif.), Ayanna Pressley (D-Mass.).

“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 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.”

“The high cost of prescription drugs is an urgent problem impacting Americans across the country,” said Klobuchar. “With this legislation we are taking action by making crucial HIV prevention drugs more affordable. As a longtime advocate for lowering health care costs, I’ll keep working to help people access the medications they need.”

“Preventative medications like PrEP and PEP are one of the easiest and most effective ways to protect individuals against HIV. But what isn’t always easy, especially for those at the highest risk of infection, is obtaining that medication. High out-of-pocket costs, lack of comprehensive coverage, and underfunded public awareness and outreach campaigns still stand between at-risk communities and life-saving medication,” said Rep. Schiff. “Our health care system must provide access to these preventative treatments for every patient who needs them -- regardless of their race, ethnicity, sexual orientation, gender identity, income level, or health care coverage. The PrEP Access and Coverage Act would help us close those gaps, so that no one has to suffer from a now-preventable disease.”

“If we are to meet the nation’s goal of ending the HIV/AIDS epidemic by 2025, it is imperative that we expand access to pre-exposure prophylaxis (PrEP), a daily medication to reduce the risk of HIV infection,” said J. Maurice McCants-Pearsall, Director of HIV and Health Equity for the Human Rights Campaign Foundation. “The PrEP Access and Coverage Act removes barriers for individuals seeking to utilize this crucial preventive measure and will address the current disparities among those who can access this effective medication. The Human Rights Campaign thanks Senator Tina Smith and Congressman Adam Schiff  for their leadership on this issue.”

“HIV+Hepatitis Policy Institute fully supports this bill and urges Congress to swiftly pass it. It addresses many of the coverage and affordability issues responsible for low uptake of PrEP and will be essential as new PrEP drugs become available.  While there are government programs for people living with HIV and other prevention programs, there isn’t a comprehensive nationwide program for PrEP,” said HIV+Hepatitis Policy Institute Executive Director Carl Schmid. “The PrEP Access and Coverage Act” would help fill that void by providing grants to states, community-based organizations, community health centers, and others to establish and support PrEP programs. Not only would these programs provide PrEP and associated medical services, but also much needed community and provider outreach programs.”

“PrEP is still under-utilized by many who would benefit from it, and Post-Exposure Prophylaxis (PEP) is even less understood, even by many health care providers and hospital staff,” said Daniel Bruner, Senior Director of Policy at the Whitman-Walker Institute. “This ground-breaking bill promises to advance a more equitable fight against new HIV infections by making PrEP and PEP more affordable, protecting PrEP and PEP users, and educating providers as well as the general public about these life-changing HIV prevention tools.”

“The PrEP Access and Coverage Act ensure that all people, regardless of what type of healthcare they receive, have access to PrEP without paying anything out of pocket,” said AIDS Institute Executive Director Michael Ruppal. “Since PrEP was approved by the FDA, uptake has skewed towards privileged groups with better insurance and the ability to pay for the medication and associated costs. This bill will help to create more equitable access to this life-saving medication by requiring nearly all public and private insurers cover the medication as well as the labs and doctors visits that are required to start and maintain a PrEP prescription.”

“We are grateful to Senator Smith for her leadership in reintroducing the PrEP Access and Coverage Act,” said Sarah Stoesz, President and CEO of Planned Parenthood of North Central States. “For too long, HIV has disproportionately impacted gay and bi-sexual men, transgender women, and people of color and it is critical that we act now to remove barriers to life-saving treatments like PrEP.  As the state’s largest sexual and reproductive health care provider, we support and fully endorse this legislation and look forward to a time when all people have full access to the lifesaving care they need.”

“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.”

“Expanded PrEP access will transform the fight against the HIV & AIDS epidemic,” said The Aliveness Project Executive Director Matt Toburen. “The high cost of PrEP has been a significant barrier which disproportionately affects BIPOC LGBTQ individuals, who are more likely to be low-income than white individuals. We are excited to work with Senator Tina Smith to end this cycle of oppression and provide comprehensive care to folks who need it most.”

“Policies that decrease barriers to care for those at risk or exposed to HIV are important to the health of our communities,” said WeARE The Clinic Executive Director Becky Twamley. “Increasing access to these life changing medications is critical to the wellbeing of many of our most vulnerable and at risk clients. WeARE-The Clinic (Brainerd MN) is a member of the Reproductive Health Alliance, working to increase access to funding for sexual health programming and we fully support this legislation.”

The PrEP Access and Coverage Act of 2021 would address the significant disparities among 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 medication 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 (HHS) Secretary to establish public health education campaigns to increase utilization of PEP and PrEP 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.

The legislation has been endorsed by the following organizations: National Alliance of State & Territorial AIDS Directors (NASTAD), HIV + Hepatitis Policy Institute, The AIDS Institute, Whitman-Walker Health, Human Rights Campaign (HRC), Planned Parenthood North Central States, Rainbow Health, The Aliveness Project, WeARE The Clinic, APLA Health.

You can read a summary of the bill here.

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