The California Department of Insurance (“DOI”) has issued a warning to insurers after an investigation uncovered what the DOI said was evidence of discrimination against HIV-negative individuals who used medication to prevent contracting the disease.
In a statement, the DOI said that its investigation of life, disability income, and long-term care insurance companies found that some insurers had denied or limited coverage, restricted products available through accelerated underwriting, placed conditions on coverage, or charged higher rates to users of pre-exposure prophylaxis, or PrEP, medication.
The DOI's notice advised insurers that, under California law, a person's history of PrEP use could not be used as a justification to deny life, disability, or long-term care insurance coverage or charge higher premiums for that coverage. The notice encouraged insurers to review their underwriting guidelines and practices to ensure they are not unlawfully discriminating against applicants.
With an influential medical panel now recommending daily medication to prevent upwards of 40,000 HIV infections annually in the United States, the DOI said that it took the action to protect patients who could face discrimination from life, disability, or long-term care insurers based on a record of taking antiretroviral therapy to prevent HIV.
“PrEP prevents HIV, pure and simple, and I will not tolerate insurers violating California law by discriminating against people taking proactive steps to be healthy,” said California Insurance Commissioner Ricardo Lara. “The Department of Insurance warns insurers to stop discrimination against PrEP users and review their underwriting rules before we take action.” He added that “ending HIV infections is within our reach. But first we have to eliminate prejudice and fear that still stands in the way of a cure.”
The notice applies to all companies that sell life, disability, and long-term care insurance in the nation's largest insurance market. During the DOI's investigation, a number of insurers reported that they had discontinued these practices, the DOI said.
The U.S. Preventive Services Task Force recommended on June 11 that doctors prescribe daily PrEP medication to those at high risk of HIV infection. Studies show only 17 percent of those eligible for daily PrEP actually take it.
Learn more: DOI notice.
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].