U.S. Senator Kamala D. Harris (D-CA) has introduced the “PrEP Access and Coverage Act,” legislation to expand Americans' access to pre-exposure prophylaxis (“PrEP”) medication that, when taken daily, reportedly reduces the risk of HIV infection by up to 92 percent.
“PrEP is a critical advancement in the fight against HIV that can finally provide peace of mind to Americans who live in the shadow of the HIV epidemic. But for too many in our country, lack of insurance coverage and steep costs have put PrEP out of reach – and that needs to change,” Senator Harris said in a statement. “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. Nearly four decades since the beginning of the HIV/AIDS crisis that took so many lives and caused countless others to live in fear, we can and will stop the spread of this disease.”
On June 11, 2019, the U.S. Preventive Services Task Force (“USPSTF”) gave PrEP an “A” rating as a preventive service. This rating means that private insurance companies will have to cover PrEP without cost-sharing for those individuals by 2021. Senator Harris' bill goes further by requiring that all private and public insurance plans – including Medicare and Medicaid – cover without a copay not only the drug itself but also all associated doctors' visits, tests, and monitoring recommended by the U.S. Public Health Service.
The senator's bill would:
- Require all public and private health insurance plans to cover the drug – as well as all required tests and follow-up visits – without a copay, just as the Affordable Care Act requires insurance to cover contraception and other preventive services.
- Fund a grant program to assist states, territories, and tribal communities in facilitating access to PrEP for people who lack insurance and reducing disparities in access to PrEP. The bill authorizes grants to cover the cost of the drug, as well as all associated tests and follow-up visits. The grants will also support outreach to physicians and other providers designed to increase understanding of PrEP and the recommended clinical practices for providing care.
- Prohibit companies selling life insurance, disability insurance, and long-term care insurance from denying coverage to customers who take PrEP or charging them higher premiums.
- Fund a public education campaign to reduce disparities in access to and use of PrEP by educating the public – particularly high-need communities in which PrEP is underutilized – about the safety and efficacy of the drug and to combat stigma associated with using PrEP.
Learn more: Bill text.
Steven A. Meyerowitz
Steven A. Meyerowitz, a Harvard Law School graduate, is the founder and president of Meyerowitz Communications Inc., a law firm marketing communications consulting company. He may be contacted at [email protected].