Cost-sharing

Mississippi insurer adds PrEP coverage after complaint, but gaps remain

Jun 15, 2026

We are pleased that Blue Cross Blue Shield of Mississippi has taken steps to comply with federal preventive coverage requirements by adding these two PrEP drugs. The people of Mississippi deserve the same benefits of innovative HIV prevention tools that other people across the country have access to. But by excluding other long-acting medications, which are recommended in national HIV treatment and prevention guidelines, Mississippians are still not able to access these highly effective drugs that improve patient adherence.

House Appropriations calls on CMS to ensure copay assistance counts toward out-of-pocket limits

Jun 8, 2026

For years patients have seen manufacturer assistance diverted away from their deductibles and out‑of‑pocket maximums, increasing their costs and forcing impossible choices. We thank the subcommittee for urging CMS to act and call on the agency to promptly issue clear, enforceable guidance so patients actually receive the benefit of assistance meant for them.

HIV+Hep asks insurance regulators to investigate concerns Highmark may be diverting copay assistance

May 7, 2026

The HIV+Hepatitis Policy Institute is asking insurance regulators in West Virginia, Pennsylvania, and Delaware to investigate Highmark Blue Cross Blue Shield for what we believe is an effort to profit by diverting copay assistance from drug manufacturers meant to assist patients and splitting the funds between itself a third-party vendor.

Trump administration fails to take steps to lower patient costs for prescription drugs

Feb 9, 2026

In the 2027 Notice of Benefit and Payment Parameters rule proposed today, the administration failed to include promised new regulations on whether copay assistance will count towards patient cost-sharing. “Every day this rule is delayed is another day that insurers and PBMs are pocketing billions of dollars meant for patients who are struggling to afford their drugs,” commented Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “We know that President Trump is squarely focused on drug affordability, and while we are extremely disappointed that this simple step was not yet taken, we urge the administration to act in the very near future.”

TrumpRx Shakes Up Drug Pricing by Bypassing Middlemen

Feb 5, 2026

Today marks a monumental step in transforming drug pricing and making prescription drugs more affordable for the American people, particularly for those without insurance. For those who do have insurance, TrumpRx may not always be the best option. We hope consumers clearly understand this and urge the Trump administration to expand the site and work with insurers so that TrumpRx payments are counted by insurers. Frankly, if people who have health insurance are using TrumpRx, it demonstrates that the insurer is failing to meet the needs of its paying consumers.

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Cost-sharing

Mississippi insurer adds PrEP coverage after complaint, but gaps remain

House Appropriations calls on CMS to ensure copay assistance counts toward out-of-pocket limits

HIV+Hep asks insurance regulators to investigate concerns Highmark may be diverting copay assistance

Trump administration fails to take steps to lower patient costs for prescription drugs

TrumpRx Shakes Up Drug Pricing by Bypassing Middlemen

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