More people should have an easier time accessing a crucial HIV-prevention medication under federal guidance issued Monday that clarifies that most private health plans must provide pre-exposure prophylaxis, or “PrEP,” without cost-sharing in order to help prevent new infections.
The Biden administration on Monday (July 19) issued long-awaited federal guidance detailing insurers’ ‘requirement to cover pr-exposure prophylaxis (PrEP) and related services without cost-sharing, which gives plans 60 days to comply with the mandate that was effective Jan. 1.
The Biden administration issued guidance Monday directing most insurers to offer pre-exposure prophylaxis (PrEP) to beneficiaries at no cost. The guidance released Monday by the Department of Labor comes after HIV patient advocacy groups have found that insurance plans have been slow to offer preventative drugs without cost-sharing obligations. “We are pleased that the federal government has issued this long-awaited guidance to insurers that will reduce barriers to PrEP and help prevent further HIV infections while advancing efforts to end HIV in the United States,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute in a statement Monday.
Advocacy groups for people with HIV are calling for federal investment in affordable housing, food security, and other social programs as part of the U.S.’s broader fight against the epidemic. The policy push by the U.S. People Living with HIV Caucus highlights how the government should look beyond medication to address disparities, reduce stigma, and ensure better quality of life for those living with HIV.
Clinics that provide vital HIV prevention services to disadvantaged populations are facing a dire — and for some of these nonprofit groups, even existential — financial crisis driven by the vagaries of an arcane federal law governing prescription drug discounts.