PrEP

Comments to Colorado Dept of Health Care Policy & Financing supporting the prohibition of prior authorization for HIV treatment and prevention in Medicaid

We urge Colorado to maintain the prohibition of prior authorization for HIV treatment and prevention in Medicaid. Timely access to guideline-recommended HIV treatment and prevention is critical for both individual and public health. These policies align with rapid scientific advancement. Reinstating prior authorization would disproportionately harm the most vulnerable. 

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Comments to MACPAC urging an exemption for people with HIV to the Medicaid community engagement requirement

As you develop your principles and policy options we urge MACPAC to recommend an explicit exemption for all people living with HIV from the community engagement requirement mandated by Public Law 119-21, also known as the One Big Beautiful Bill Act. People with HIV are living with a lifelong serious and complex medical condition and have special medical needs: they cannot stay healthy without continuous access to their lifesaving HIV treatment. Any gap in treatment risks serious health consequences, including failure of viral suppression and the risk of onward transmission. Longer treatment gaps are potentially disabling, allowing progression to AIDS, after which life expectancy is limited.

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Comments on Oregon PDAB draft 2026 drug review preliminary list

Affordability reviews of HIV medications are unlikely to fully capture the complexity and interdependence of safety net programs, which not only ensure affordability for patients but also sustain the broader HIV care infrastructure. While we recognize the Board’s current position to not seek upper payment limit authority, reviewing medications like Biktarvy, Descovy, and Emtricitabine-Tenofovir based on list price alone (despite their actual affordability for the vast majority of patients) could have significant unintended consequences. Such reviews risk creating systemic uncertainty for manufacturers, healthcare providers, and safety net programs that rely heavily on drug rebates to fund essential wraparound services. Ultimately, this instability could undermine the delicate balance required for continued investment in the transformative advancements our community relies on, including longer-acting treatments, preventive therapies, vaccines, and the pursuit of an eventual cure.

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Arkansas Medicaid community engagement reporting requirement and people with HIV

We write to urge the Arkansas Medicaid program to include an explicit exemption for all people living with HIV from the community engagement reporting required under HR 1. People with HIV are living with a lifelong serious and complex medical condition and have special medical needs: they cannot stay healthy without continuous access to their lifesaving HIV treatment.  Any gap in treatment risks serious health consequences, including failure of viral suppression and the risk of onward transmission.  Longer treatment gaps are potentially disabling, allowing progression to AIDS, after which life expectancy is limited.

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