Adam Schiff introduces bill to expand access to PrEP

Congressman Adam Schiff (D-Calif.) and Senator Tina Smith (D-Minn.) have introduced legislation that will expand access to lifesaving HIV prevention medications.

The PrEP Access and Coverage Act of 2021 addresses the underutilization of HIV prevention drugs – known as PrEP (Pre-exposure prophylaxis) and PEP (Post-exposure prophylaxis) – in high-risk communities by ensuring these medications and any associated costs are covered by health insurance. The measure also establishes community public health campaigns, and expands access to the drugs for uninsured individuals and underserved communities.

“Preventative medications like PrEP and PEP are one of the easiest and most effective ways to protect individuals against HIV. But what isn’t always easy, especially for those at the highest risk of infection, is obtaining that medication. High out-of-pocket costs, lack of comprehensive coverage, and underfunded public awareness and outreach campaigns still stand between at-risk communities and life-saving medication,” said Schiff. “Our health care system must provide access to these preventative treatments for every patient who needs them – regardless of their race, ethnicity, sexual orientation, gender identity, income level, or health care coverage. The PrEP Access and Coverage Act would help us close those gaps, so that no one has to suffer from a now-preventable disease.”

“Every person deserves access to affordable, high quality health care,” said Smith. “Too many people in Minnesota and across this country are unduly burdened by the high costs of HIV 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.”

“If we are to meet the nation’s goal of ending the HIV/AIDS epidemic by 2025, it is imperative that we expand access to pre-exposure prophylaxis (PrEP), a daily medication to reduce the risk of HIV infection,” said J. Maurice McCants-Pearsall, Director of HIV and Health Equity for the Human Rights Campaign Foundation. “The PrEP Access and Coverage Act removes barriers for individuals seeking to utilize this crucial preventive measure and will address the current disparities among those who can access this effective medication. The Human Rights Campaign thanks Senator Tina Smith and Congressman Adam Schiff for their leadership on this issue.”

“HIV+Hepatitis Policy Institute fully supports this bill and urges Congress to swiftly pass it. It addresses many of the coverage and affordability issues responsible for low uptake of PrEP and will be essential as new PrEP drugs become available. While there are government programs for people living with HIV and other prevention programs, there isn’t a comprehensive nationwide program for PrEP,” said Carl Schmid, Executive Director of the HIV+Hepatitis Policy Institute. “The PrEP Access and Coverage Act would help fill that void by providing grants to states, community-based organizations, community health centers, and others to establish and support PrEP programs. Not only would these programs provide PrEP and associated medical services, but also much-needed community and provider outreach programs.”

“PrEP is still under-utilized by many who would benefit from it, and Post-Exposure Prophylaxis (PEP) is even less understood, even by many health care providers and hospital staff,” said Daniel Bruner, Senior Director of Policy at the Whitman-Walker Institute. “This ground-breaking bill promises to advance a more equitable fight against new HIV infections by making PrEP and PEP more affordable, protecting PrEP and PEP users, and educating providers as well as the general public about these life-changing HIV prevention tools.”

“The PrEP Access and Coverage Act ensures that all people, regardless of what type of healthcare they receive, have access to PrEP without paying anything out of pocket,” said Michael Ruppal, Executive Director of the AIDS Institute. “Since PrEP was approved by the FDA, uptake has skewed towards privileged groups with better insurance and the ability to pay for the medication and associated costs. This bill will help to create more equitable access to this life-saving medication by requiring nearly all public and private insurers cover the medication as well as the labs and doctors visits that are required to start and maintain a PrEP prescription.”

“APLA Health applauds the introduction of Rep. Adam Schiff’s PrEP Access and Coverage Act on World AIDS Day 2021. The PrEP Access and Coverage Act will build on the progress that we have made thus far to ensure that all Americans have access to PrEP at no cost regardless of income, insurance or immigration status,” said Craig E. Thompson, CEO of APLA Health. “When PrEP was first approved nearly a decade ago, it revolutionized HIV prevention and accelerated efforts to end the epidemic. But currently PrEP use remains far below desired levels – particularly among young Black and Latinx gay men and other communities most impacted by HIV in the U.S. Additionally, this legislation will substantially scale up outreach and education efforts to increase awareness and understanding of this highly effective HIV prevention tool and will help us realize the goals of the federal Ending the HIV Epidemic initiative: a 75 percent reduction in new HIV infections by 2025 and 90 percent by 2030.”

The PrEP Access and Coverage Act of 2021 would address the significant disparities among those who are recommended to take HIV prevention drugs, and those who are prescribed the medication by:

• Ensuring comprehensive health insurance coverage of HIV prevention drugs by eliminating out-of-pocket costs for the medication and associated costs for individuals who are enrolled in federally regulated private and public health insurance.
• Prohibiting prior authorization requirements for HIV prevention drugs under private and public health insurance plans.
• Prohibiting denying coverage or increasing premiums for disability insurance, long-term care insurance, or life insurance policies based on a person taking medication for HIV prevention.
• Directing the Department of Health and Human Services (HHS) Secretary to establish public health education campaigns to increase utilization of PEP and PrEP among individuals at risk of contracting HIV.
• Establishing a grant program for States, Territories, Tribes, and health care facilities, such as Federally Qualified Health Centers and family planning centers, to expand access to PrEP and PEP for uninsured individuals and underserved communities.

The PrEP Access and Coverage Act of 2021 is co-sponsored in by Chairman Jerrold Nadler (D-N.Y.) and Representatives Eleanor Holmes Norton (D-D.C.), Bobby Rush (D-Ill.), Nydia M. Velázquez (D-N.Y.), Sheila Jackson Lee (D-Texas), Barbara Lee (D-Calif.), Stephen F. Lynch (D-Mass.), Steve Cohen (D-Tenn.), Peter Welch (D-Vt.), Jackie Speier (D-Calif.), Chellie Pingree (D-Maine), Paul Tonko (D-N.Y.), Mike Quigley (D-Ill.), David N. Cicilline (D-R.I.), Terri Sewell (D-Ala.), Donald M. Payne, Jr. (D-N.J.), Dina Titus (D-Nev.), Mark Pocan (D-Wis.), Eric Swalwell (D-Calif.), Mark Takano (D-Calif.), Seth Moulton (D-Mass.), Bonnie Watson Coleman (D-N.J.), Ro Khanna (D-Calif.), Darren Soto (D-Fla.), Sean Casten (D-Ill.), Katie Porter (D-Calif.), Ayanna Pressley (D-Mass.), Rashida Tlaib (D-Mich.), Mondaire Jones (D-N.Y.), Kathy Manning (D-N.C.), and Ritchie Torres (D-N.Y.) in the House, and by Senator Amy Klobuchar (D-Minn.) in the Senate. The legislation has also been endorsed by the following organizations: National Alliance of State & Territorial AIDS Directors, HIV + Hepatitis Policy Institute, The AIDS Institute, Whitman-Walker Health, Human Rights Campaign (HRC), and APLA Health.