Letter to MD House Health Committee supporting HB1114 so Marylanders can access all PrEP forms
Maryland House of Delegates Health Committee
90 State Circle
Annapolis, MD 21401
Dear Chair Bagnall and Members of the Health Committee:
The HIV+Hepatitis Policy Institute is a leading national HIV and hepatitis policy organization promoting quality and affordable healthcare for people living with or at risk of HIV, hepatitis, and other serious and chronic health conditions. We write in strong support of HB 1114 that will ensure Marylanders with private health insurance at risk of HIV can access the full range of PrEP options without cost-sharing or prior authorization, including newer long-acting regimens that may better meet patient needs. A recent clinical trial showed that the first long-acting injectable PrEP reduced the risk of HIV acquisition by 66-89 percent compared to daily oral PrEP, in part by addressing adherence challenges associated with daily dosing.[1]
Allowing individuals and their providers to choose the PrEP option that works best for them reflects current best practices in HIV prevention and is consistent with current federal protections. Under the Affordable Care Act, insurers must cover PrEP due to its Grade “A” by the US Preventive Services Task Force, and the federal government has issued guidance to insurers that they must cover PrEP without cost-sharing and prior authorization.[2],[3] Requiring coverage of all PrEP drugs is essential to increasing uptake, supporting adherence, and reducing new HIV cases in Maryland.
A recent study found that Black and Latino individuals show significantly higher interest in long-acting injectable PrEP, with interest levels up to 30 percentage points higher than among White individuals, underscoring the importance of covering all PrEP options to meet patient needs.[4]. This is particularly important in Maryland, where Black and Latino residents make up approximately 42 percent of the population but account for 86 percent of new HIV diagnoses.[5]
This legislation is particularly important at a time when federal preventive health requirements have recently come under attack. By codifying comprehensive PrEP coverage standards in state law, the General Assembly would protect Marylanders from potential federal changes and providing certainty for patients, providers, and public health programs. In doing so, Maryland would join a growing number of states including California, Illinois, Minnesota, and Oregon that require coverage of all FDA-approved PrEP medications without cost-sharing and prior authorization, ensuring patients can access the full range of options without utilization management barriers. A similar bill has passed the DC Council and now pending Mayoral approval.
For these reasons, we strongly urge you to support House Bill 1114. This bill represents a critical step forward in Maryland’s efforts to end the HIV epidemic.
If you have any questions, please reach out to our Government Affairs Manager, Zach Lynkiewicz, at zlynkiewicz@hivhep.org.
Sincerely,
Carl E. Schmid II
cc: Members of the Health Committee
Delegate Ashanti Martinez, Sponsor
[1] HIV Prevention Trials Network (HPTN). HPTN 083 and HPTN 084 Study Results: Long-Acting Injectable Cabotegravir for HIV Prevention.
[2] U.S. Preventive Services Task Force. Prevention of HIV Infection: Preexposure Prophylaxis. Grade A Recommendation (2023).
[3] U.S. Departments of Labor, Health and Human Services, and Treasury. FAQs About Affordable Care Act Implementation Part 47 (July 19, 2021).
[4] Maryland Department of Health. HIV in Maryland Fact Sheet, 2024.
[5] Fraysse J, Anderson S-J, Smith JC, Matthews DD, Sarkar S, de Aragao F, et al. (2025) Achieving the state of Georgia 25% HIV incidence reduction target among men who have sex with men in Atlanta through expanded use of multimodal pre-exposure prophylaxis: