June 27, 2019

Senate Bill Introduced for Universal Access to PrEP

Last Thursday, Senator Kamala Harris (D-SC) introduced the PrEP Access and Coverage Act (Bill number not yet assigned).

In a press release, Senator Harris said that “We must truly commit ourselves to HIV prevention by finally requiring every health insurance plan—public and private—to cover PrEP and all of the required tests and follow-up doctors’ visits. We must also provide the resources necessary to help people without insurance access PrEP.”

Specifically the bill proposes to:

• “extend cost-free coverage of the medication and related clinical services, such as testing and follow-up visits, to all public and private insurance plans;
• facilitate access to PrEP for uninsured people and populations in which PrEP is underutilized;
• prohibit discrimination against PrEP patients in the sale of life, disability, and long-term care insurance; and
• fund a public education campaign to increase understanding of PrEP and combat stigma associated with its use.”

A lower-cost generic form of PrEP is due to enter the U.S. market in 2020, which may contribute to the bill’s chances of passage. But the quarterly medical check-ups and lab tests that PrEP users undergo are still costs that must be covered. SB XX proposes to do this with a grant managed by the Department of Health and Human Services (DHHS). It will fund states, territories or tribes to make PrEP accessible to uninsured people.

Thanks to ACA rules and the U.S. Preventive Services Task Force (USPSTF) decision to give PrEP an “A” rating, private insurance companies starting in 2021 will have to cover PrEP for ACA participants without cost-sharing, just as they do with contraception and other preventive services.

In a press release issued by the Academy, Executive Director Bruce Packett observed that introduction of this bill offers new hope to our field. “The combination of Senator Harris’s legislation and the USPSTF announcement represents a seismic shift in governmental support for building up access for PrEP and breaking down stigma,” Packett observed. “With the Administration’s stated goal to end the epidemic by 2030, congressional and presidential support for this bill should be sweeping and unanimous.”