ACA

CVS Health’s decision is a clear violation of the ACA’s requirement to cover USPSTF-recommended preventive services, including PrEP. The entire world is excited by this drug and its potential contribution to preventing and eventually ending HIV. However, a drug will only work if people can access it and right now CVS Health, which owns the largest pharmacy benefit manager in the country, is shamefully blocking people from taking it, unlike other payers. We urge CVS, which has been committed to ending HIV in the past, to reconsider their decision immediately. Additionally, we call on federal and state regulators to ensure that plans are in compliance with the federal government’s PrEP coverage guidance and the many state laws that require coverage of all PrEP drugs.

We urge the Court to uphold the preventive services requirement, as supported by the Trump administration. President Trump and Secretary of Health and Human Services Robert Kennedy Jr. are prioritizing prevention as a key component of making our country healthier. Preventing chronic infectious diseases such as HIV and hepatitis through testing and PrEP covered by private insurance is critically vital, especially now that the federal government is seeking to reduce spending. Without the coverage requirement, people at risk of HIV and hepatitis will likely forgo accessing the services or depend more on government programs for their testing and PrEP. However, we are not adequately addressing the needs of the uninsured today, and, given current budget constraints, which are bound to get worse, we will certainly not be able to afford the necessary preventive services for the insured without the coverage requirement. If we are to prevent infectious disease and other health conditions, the Court has no choice but to uphold access to these necessary preventive services.