Democrats Introduce Bill to Make PrEP Available to More Americans

Democrats in the U.S. House of Representatives and the Senate have joined together to reintroduce the PrEP Access and Coverage Act of 2023 to improve the uptake of PrEP to prevent HIV.

Minnesota Sen. Tina Smith and California Rep. Adam Schiff are leading the effort.

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

Even though improving PrEP uptake is one of the main pillars of the Trump and Biden administrations’ plans to end HIV, only 30 percent of those who could benefit from PrEP take it. Nevertheless, there are significant disparities. PrEP is used by 78 percent of white people who are eligible. However, only 11 percent of Black people in America, 21 percent of Latinos, and 12 percent of women access this lifesaving medication.

As in previous versions of the bills, the PrEP Access and Coverage Act would 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.

Additionally, it seeks to eliminate prior authorization requirements for HIV prevention medications covered by private insurance and public insurance.

In addition, the bill prohibits health insurance companies from denying coverage or raising premiums for people who take HIV prevention medications.

Regarding outreach and education, the bill directs the Secretary of Health and Human Services to establish public campaigns that increase the utilization of PrEP and PEP drugs.

Furthermore, it would 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.

“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. 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.”

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

“We thank the leadership of Sen. Smith, Rep. Schiff, and their 53 colleagues in reintroducing the PrEP Access and Coverage Act,” executive director of the HIV+Hepatitis Policy Institute Carl Schmid said in a statement. “Passage of these bills 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. We must address head-on the wide disparities in PrEP use, and these bills do that.”

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