Insurers

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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.”

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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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CVS Health decides to cover new long-acting PrEP drug

Jan 13, 2026

“We are pleased that CVS Health has finally decided to cover this groundbreaking new PrEP medication. Four months ago, 63 HIV organizations joined us in sending a letter to CVS’s president urging them to reconsider their refusal to cover Yeztugo and reminding them of their legal obligation to cover PrEP and describe the important benefits the drug would bring to preventing HIV in the US.  With this coverage decision, CVS joins other leading payers and PBMs in covering the new medication.”

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From the office of Gov. Phil Murphy: Governor Murphy signs legislation bolstering health care affordability and accessibility

Jan 9, 2026

“Patients with HIV, hepatitis, and so many other health conditions rely on copay assistance to afford their drugs. Healthcare is already expensive and when insurers add additional barriers and costs, such as not counting copay assistance towards a patient’s deductible, patients’ costs significantly increase, jeopardizing medication adherence and their health,” said Carl Schmid, Executive Director, HIV+Hepatitis Policy Institute. “We applaud Governor Murphy for signing this bipartisan legislation to put an end to hidden insurer practices that drive up patient costs.”

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Patient groups file amicus brief in imported HIV drug scheme

Jan 2, 2026

“Forcing a person who has employer sponsored health insurance to sign up with an unknown third-party vendor to receive their life-saving drug supplied by a foreign country not only is illegal but jeopardizes the health and safety of patients,” commented Carl Schmid, Executive Director of the HIV+Hepatitis Policy Institute. “In an effort to evade actual coverage of specific prescription drugs that the health insurance plan states it covers, middlemen are profiting by scheming to set up so-called ‘alternative funding programs.’  While federal regulators should be shutting them down, in the meantime, the courts must step in to protect patients.”

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ACA Appropriations Biden administration CDC Congress Copay accumulators Copay assistance Cost-sharing COVID-19 Drug Pricing FDA Gay men healthcare Hepatitis Hepatitis B Hepatitis C hepatits HIV HIV Prevention hous housing insurer Insurers LGBT Medicaid Medicare Part D NAIC NIH PBMs PrEP Prescription Drugs prevention Private Insurance Ryan White Ryan White Program state Syringe services Testing transparency Treatment Trump administration

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