Biden-Harris administration requires insurers to cover long-acting PrEP to prevent HIV

With low uptake of PrEP among the communities most impacted by HIV, this insurance coverage requirement with zero cost-sharing will help jumpstart the use of more effective forms of PrEP and lead to fewer HIV transmissions. We are grateful to the Biden-Harris administration for responding to our request to issue this guidance. Without it, we feel some insurers would continue to only cover daily oral PrEP, and not provide PrEP users with the choice they need. With up to a third of privately insured PrEP users still being charged cost-sharing, we must ensure that both federal and state regulators vigorously enforce PrEP coverage requirements.

Biden-Harris Administration Sides with Insurers & Fails to Take Steps to Lower Patient Costs for Prescription Drugs

Every day these rules are delayed is another day that insurers and PBMs are pocketing billions of dollars meant for patients who are struggling to afford their drugs. Coming from an administration that prides itself on supporting patients and lowering their prescription drug costs, this is a huge disappointment. While they have gone on record that they will issue these rules, the clock is ticking and there isn’t much time left.

Medicare Beneficiaries Can Now Access PrEP Without Cost-Sharing

We commend the Biden-Harris administration for increasing PrEP uptake using all the tools at its disposal. Patient cost-sharing has been a significant barrier for Medicare beneficiaries. With this new NCD, people on Medicare can join those with private insurance who can access PrEP without cost-sharing. Now we have to make sure these policies are properly implemented and enforced.

Senate Appropriators Maintain Funding for Domestic HIV and Hepatitis Programs

We sincerely thank Senate Labor HHS Appropriations Subcommittee Chair Tammy Baldwin and Ranking Member Shelley Moore Capito and their colleagues for demonstrating their continued commitment to ending HIV in the U.S. While working within the confines of an extremely restrictive budget, they crafted a spending bill that prioritizes the domestic response to HIV. However, given that the House version of the bill includes sizeable funding cuts, program eliminations, and divisive policy riders, we realize passage of this spending bill is far from reality. House Republicans must come to the table and support bills, such as this one, that can pass the Congress and be signed by the president.

63 HIV Organizations Urge Biden Administration to Require Insurers to Cover Long-Acting PrEP Without Cost-Sharing

Instead of providing new investments in ending HIV by increasing funding for testing, prevention programs, such as PrEP, and life-saving care and treatment, House Republicans are again choosing to go through a worthless exercise of cutting programs that the American people depend on and will never pass.

House Proposes to Gut Ending HIV Programs—Again

Instead of providing new investments in ending HIV by increasing funding for testing, prevention programs, such as PrEP, and life-saving care and treatment, House Republicans are again choosing to go through a worthless exercise of cutting programs that the American people depend on and will never pass. These were purposeful decisions that are well below the agreed-upon budget caps. While we will vigorously fight these cuts, we look forward to working with the entire Congress in a bipartisan fashion on spending bills that can actually become law.

Who We Are

Monitors policies that impact the prevention and treatment of HIV, viral hepatitis, and other health conditions in the United States.

Communicates with members of the HIV, hepatitis, and other patient group communities on key policy issues that impact their access to healthcare.

Educates policymakers and members of the media about efforts to end both HIV and hepatitis in the United States and to improve access to quality and affordable healthcare for people with or at risk of serious or chronic health conditions.

Key Issues

Causes We Care About, and So Should You!

HIV

Promote necessary funding, programs, and policies to end the HIV epidemic in the United States

HEPATITIS

Promote necessary funding, programs, and policies to end viral hepatitis in the United States

HEALTHCARE ACCESS

Promote necessary funding, programs, and policies to end viral hepatitis in the United States

Facebook posts by @HIV+Hep

The Biden-Harris admin. has announced annual #patient #costsharing limits that will increase over 10% in 2026, up to $10,150 for an individual & $20,300 for a family. All more reason why patients need #copayassistance to help pay for their drugs: bit.ly/4gZO6BM ... See MoreSee Less
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On updated #PrEP coverage guidance: “W/low uptake among the communities most impacted by #HIV, this $0 #costsharing requirement, prohibition on #priorauth & new coding guidelines will help jumpstart the use of more effective forms of PrEP & lead to fewer HIV transmissions. We are grateful to the Biden-Harris admin for responding to our request to issue this guidance”: bit.ly/4eNJUni ... See MoreSee Less
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