“While we were predicting the worst, at the moment insurers will still have to cover preventive services, including PrEP, except for the original plaintiffs,” said Carl Schmid, executive director of the HIV+Hep Policy Institute in Washington, D.C. However, if the task force’s authority is ultimately voided, Schmid said, insurers will likely impose cost-sharing for PrEP, or not cover the newer, more expensive forms of it. He projected that such burdens would depress PrEP use among those at greatest risk of HIV.
ObamaCare preventive care mandate to stay in place after court ruling
“While we were predicting the worst, at the moment insurers will still have to cover preventive services, including PrEP, except for the original plaintiffs. That is the good news,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, in a statement. “The bad news is, the court still finds the mandate to cover USPSTF recommended services unconstitutional and now asks the lower court to review both the [Health Resources and Services Administration] and [Advisory Committee on Immunization Practices] preventive services.” Schmid added. “The case is not going to the Supreme Court at this time, but back to the lower court. Coverage of preventive services continues.”
Federal appeals court says some employers can exclude HIV prep from insurance coverage
“While we were predicting the worst, at the moment insurers will still have to cover preventive services, including PrEP, except for the original plaintiffs. That is the good news,” Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, said in an email, referring to a common HIV preventative treatment. But, Schmid lamented that the court found that the coverage requirement for HIV prevention was adopted in violation of the Constitution, and that the case is going back to a lower court for resolution of other issues that could further muddy the coverage issue.
CBO: Expanding hepatitis C treatment could save money
Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, told Inside Health Policy the report is a start, but still incomplete, noting that outreach, implementation and coverage of those outside of Medicaid were left out of the analysis. But he said the report reinforced that it is cost effective to cure people with hepatitis C. “It states the obvious that when you treat people with hepatitis C, it’s definitely cost saving to the health care system,” Schmid said.
R.I. General Assembly passes legislation to help expedite access to HIV prevention meds
A year’s worth of generic, daily PrEP in pill form cost about $360 in 2022. But the new legislation could also save the health care system money by preventing the need for costlier HIV treatments. A 2022 report from the HIV+Hepatitis Policy Institute estimated that, over 10 years, PrEP could prevent enough infections to save $2.27 billion in patient treatment costs.