# PrEP Access and Coverage Act

This bill makes it easier and more affordable for people to get PrEP (pre-exposure prophylaxis), a medication that prevents HIV infection. Right now, PrEP can be expensive and hard to access, even though it's highly effective at stopping HIV transmission when taken regularly. The bill aims to remove barriers that keep people from getting this preventive medication.

The main changes focus on insurance coverage and costs. The bill requires health insurance plans to cover PrEP without charging patients copayments or deductibles—meaning you wouldn't have to pay anything out of pocket when you pick up the prescription. It also ensures that PrEP is available through Medicaid in all states at no cost to eligible people. Additionally, the bill addresses issues with prior authorization, which is when insurance companies require doctors to get approval before prescribing certain medications. By reducing these approval requirements for PrEP, the bill helps people get the medication faster without unnecessary delays.

Who does this affect? Anyone who could benefit from HIV prevention, particularly people at higher risk of HIV infection, including men who have sex with men, transgender individuals, people who inject drugs, and sex workers. It also affects people with lower incomes who rely on Medicaid or have limited insurance options. By removing financial barriers and making the prescription process smoother, the bill aims to increase the number of people who can actually use this proven prevention tool, which ultimately helps reduce new HIV infections across the country.

PrEP Access and Coverage Act

Smith, Tina

PrEP Access and Coverage Act This bill requires private health insurance plans to cover prescription drugs that prevent HIV, including related screenings, diagnostic procedures, administrative fees, and clinical follow-ups, without any cost-sharing obligation for the plan holder. Further, insurance plans must not impose any preauthorization requirement for this coverage. These coverage requirements also apply to public health insurance programs, including Medicare, Medicaid, and the Children's Health Insurance Program. Additionally, the bill prohibits denying, limiting, or qualifying coverage or increasing premiums for disability insurance, long-term care insurance, or life insurance policies based on an individual taking medication for HIV prevention. The bill further requires the Department of Health and Human Services to award grants to states, or directly to eligible local organizations, to provide uninsured individuals and underinsured individuals access to prescription drugs and related services that prevent HIV. The Centers for Disease Control and Prevention also must develop a public awareness campaign that focuses efforts in communities with a high need for HIV prevention treatment.