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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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Insurer adds HIV treatments after discrimination complaints

Dec 2, 2025

We are pleased to see the improvements in Medica’s coverage of HIV drugs. While it took a year, with two letters and a great deal of research, we are grateful to the Iowa insurance department for working with Medica on these changes. Though we never received a formal response from the Minnesota insurance department, we assume our c omplaint played a major role in that state as well. Despite the substantial improvements in Medica’s formularies, the issuer still offers substandard coverage and remains an outlier when compared to other issuers on the Iowa and Minnesota Marketplaces, as we have detailed in follow-up letters to regulators in both states.

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Two years after Court victory, patients still saddled with unaffordable drug costs

Sep 22, 2025

Despite a major court victory nearing two years ago for patients’ ability to afford prescription drugs, the federal government has still not enforced the ruling by requiring insurers to count copay assistance towards patient cost-sharing. Although the Court gave the government the alternative to issue a new clarifying rule relating to drug manufacturer copay assistance and patient cost-sharing, no rule has been proposed two years after the government pledged to the Court and the public that it would.

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Insurer agrees to add HIV drugs after discrimination complaint filed

Dec 17, 2024

“While this action is certainly welcome, the fact remains that Harvard Pilgrim removed lifesaving HIV drugs from its coverage formulary, disrupted the treatment of people living with HIV, and violated the ACA’s nondiscrimination protections,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “This demonstrates the need for greater oversight of the health insurance industry and enforcement of the safeguards in place to protect patients against the abuse of insurers.”

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HIV discrimination complaints filed in five states against insurers for substandard drug coverage & high cost-sharing

Nov 15, 2024

“We continue to uncover private insurers that engage in discriminatory plan design by using drug formularies that discourage enrollment of people living with HIV. Putting every HIV drug, including cheap generics, on the highest cost-sharing tier and not covering drugs necessary to treat HIV are blatant examples of discrimination,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “Without proper regulation and enforcement, some insurers will try to get away with whatever they can. We call on the state insurance regulators to act quickly on these complaints and immediately ensure these insurers come into compliance.”

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