PrEP Access and Coverage Act reintroduced in Congress

PrEP Access and Coverage Act

Truvada, or PrEP, is a medication that can reduce HIV infection by more than 90 percent. Health officials consider it an important HIV prevention tool. Democrats in the U.S. House of Representatives and the Senate have collaborated to reintroduce the PrEP Access and Coverage Act of 2023 to help reduce HIV. Photo: Gilead Sciences.

Democrats in the U.S. House of Representatives and the Senate have collaborated to reintroduce the PrEP Access and Coverage Act of 2023 to help reduce HIV.

Minnesota Sen. Tina Smith and California Rep. Adam Schiff authored the bills that were introduced on Tuesday.

Initially introduced by then-Senator Kamala Harris, the updated bills would provide zero-cost sharing coverage of PrEP to private and public payers and establish a national grant program that provides PrEP to the uninsured.

“Passage of (the PrEP Access and Coverage Act) will greatly expand access to PrEP for people 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,” Carl Schmid, executive director of the HIV+ Hepatitis Policy Institute, said in a statement. “We must address head-on the wide disparities in PrEP use, and these bills do that.”

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Even though improving PrEP use is a pillar of the Biden administration’s plan to end HIV, less than 30 percent of people who could benefit from PrEP take it, and significant disparities exist, according to data from AIDSVU.

  • 64% of white people
  • 17% of Latinos
  • 14% of Black people
  • 8% of women

“Every person deserves access to affordable, high-quality health care,” Smith said in a statement. “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.”

Schiff added: “HIV prevention drugs shouldn’t be inaccessible and unaffordable.”

Biden proposed 10-year mandatory spending of $9.7 billion for a national PrEP program as part of his current budget.

A federal judge in Texas recently ruled that covering PrEP under insurance plans is unconstitutional, but an appeals court stayed that ruling.

As in previous versions of the bills, the PrEP Access and Coverage Act would include several parts:

  • Cover and eliminate out-of-pocket costs for the medication and testing required to take it for people who are enrolled in federally regulated private and public health insurance plans, including Medicaid, Medicare, CHIP, and TRICARE.
  • Eliminate prior authorization requirements for HIV prevention medications covered by private insurance and public insurance.
  • Prohibit health insurance companies from denying coverage or raising premiums for people who take HIV prevention medications.
  • Direct the secretary of health and human services to establish public education campaigns to increase the utilization of PrEP and PEP drugs.
  • Establish a grant program to assist states, territories, tribes, and healthcare facilities in expanding access to PrEP and PEP through Federally Qualified Health Centers and family planning centers.

About the author

Phillip Zonkel

Award-winning journalist Phillip Zonkel spent 17 years at Long Beach's Press-Telegram, where he was the first reporter in the paper's history to have a beat covering the city's vibrant LGBTQ. He also created and ran the popular and innovative LGBTQ news blog, Out in the 562.

He won two awards and received a nomination for his reporting on the local LGBTQ community, including a two-part investigation that exposed anti-gay bullying of local high school students and the school districts' failure to implement state mandated protections for LGBTQ students.

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