Testimony to Massachusetts Joint Committee on Financial Services on Bills to Address Barriers to HIV Medication
Testimony by Kevin Herwig
Health Policy Manager, HIV+Hepatitis Policy Institute
in support of
H.1245/S.717: An Act to address barriers to HIV prevention medication
Massachusetts Joint Committee on Financial Services
September 17, 2025
On behalf of the HIV+Hepatitis Policy Institute, we respectfully submit this testimony in support of H.1245/S.717: An Act to address barriers to HIV prevention medication.
From 2016-2022, I managed the Massachusetts PrEP Drug Assistance Program, which assists eligible state residents with the cost of PrEP.
PrEP is a key component of both Massachusetts and federal strategies to end the HIV epidemic. But thirteen years after the introduction of PrEP, only a third of those who would benefit from PrEP are on it, with stark racial, ethnic, and gender disparities in uptake.
Long-acting forms of PrEP have been available since early 2022, including a new twice-yearly injectable that was hailed by Science magazine as the 2024 Breakthrough of the Year. Long- acting PrEP offers revolutionary new options for people who find it difficult to adhere to a daily oral regimen, including the unstably housed, and people who are concerned about disclosing their PrEP use. With other long-acting PrEP medications in development, PrEP users and their clinicians will increasingly be able to choose the medication and modality that best suits their needs.
While ACA preventive coverage rules requiring PrEP coverage remain intact, recent litigation has highlighted the importance of state-level coverage protections for HIV prevention to backstop any changes in federal requirements. While eighteen states have passed legislation prohibiting cost-sharing for PrEP, only five states1 provide these protections without relying on the United States Preventive Services Task Force recommendation. We commend the sponsors of this bill for pursuing similar, robust safeguards for Massachusetts.
PrEP includes not just the medication, but the entire suite of ancillary services recommended by CDC PrEP guidelines, including laboratory testing and medical visits. This bill is to be commended for prohibiting both cost-sharing and prior authorization for these services. Studies have shown that even copays under $10 can act as a barrier and lead to prescription abandonment—especially for preventive drugs. Despite federal requirements, studies have shown that a third of commercially insured PrEP users still face impermissible cost-sharing for PrEP medication and ancillary services. This bill will backstop federal requirements and ensure consistent and equitable access across all state-regulated plans.
We need to ensure that everyone is able to benefit from the results of the latest scientific innovations in HIV prevention. We strongly urge the committee to favorably report this important bill to ensure that all Bay Staters using state-regulated commercial insurance plans can access PrEP and PEP without a financial burden or delay, and are insulated from any changes in federal requirements.
Kevin Herwig
kherwig@hivhep.org
(617) 666-6634
1 Illinois, Maine, Minnesota, New Mexico, Oregon