HIV+Hep in the News

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Health Insurers Must Cover All PreP

by | Jan 6, 2025

“With low uptake of PrEP among the communities most impacted by HIV, this insurance coverage requirement with zero cost-sharing will help jump-start the use of more effective forms of PrEP and lead to fewer HIV transmissions,” says Carl Schmid, executive director of HIV+Hepatitis Policy Institute. “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.”

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ME insurer to cover HIV drugs after complaint, others still pending

by | Dec 27, 2024

Insurer Harvard Pilgrim will add HIV medication Biktarvy and four other drugs to its formulary for Maine patients after the HIV+Hepatitis Policy Institute filed a discrimination complaint against the company for marketing plans that discriminate against those living with HIV. The organization has filed similar complaints against insurers in several other states, alleging the plans violated Affordable Care Act (ACA) requirements.

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After complaints, health insurer agrees to cover common HIV meds

by | Dec 20, 2024

“While this action is certainly welcome, the fact remains that Harvard Pilgrim removed lifesaving HIV drugs from its coverage formulary, disrupted the treatment of people living with HIV and violated the nondiscrimination protections [of the Affordable Care Act (ACA), or Obamacare],” said Carl Schmid, executive director of the HIV+Hep. “This demonstrates the need for greater oversight of the health insurance industry and enforcement of the safeguards in place to protect patients against the abuse of insurers.”

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How to break down barriers in HIV care

by | Dec 18, 2024

“Over a million people in the United States have HIV,” says Carl Schmid, Executive Director at the HIV+Hepatitis Policy Institute. According to HIV.gov, of those approximately 1.2 million patients, around 13% “don’t know it and need testing. People don’t think about HIV as much as they used to,” continues Schmid. “They think it’s a solved issue, but no—we still have over 30,000 new infections every year.” Testing and timely access to treatments are essential. “To remain healthy, patients must stay on their medication, which is a lifelong commitment,” Schmid says. “While we have great drugs, getting them to the people who need them remains a challenge. Numerous barriers exist—socioeconomic barriers, insurance barriers, and issues with health coverage. Many people can’t access the drugs they need due to cost, formulary restrictions, or lack of coverage.”

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