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- Legislation Would Expand Access to and Insurance Coverage of the HIV Prevention Drug & Treatment-Related Services
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"The advent of PrEP, a drug which dramatically reduces the risk of HIV infection, has made the disease more preventable and manageable than ever before. But this life-saving drug is tragically under-utilized by the communities who need it most, in part because health insurance plans aren't required to cover PrEP, or its necessary tests and follow-up visits," said
"We have a tool that can prevent the transmission of HIV, yet it's not reaching, or is too expensive for, the communities who need it most. African Americans represent 14% of the US population but account for 44% of HIV diagnoses, while Latinos represent 18% of the US population and 25% of HIV diagnoses - yet they are often unaware of that heightened risk, are more likely to be uninsured, and are less likely to even know that PrEP could help them," said Rep.
"For too many in our country, lack of insurance coverage and steep costs have put PrEP out of reach. That needs to change," said
Approximately 1.1 million people in
Specifically the bill would:
- Require all public and private health insurance plans to cover the drug--as well as all required tests and follow-up visits--without a copay, just as the Affordable Care Act requires insurance to cover contraception and other preventive services.
- Fund a grant program to assist states, territories, and tribal communities in facilitating access to PrEP for people who lack insurance. The bill authorizes grants to cover the cost of the drug, as well as all associated tests and follow-up visits. The grants will also support outreach to physicians and other providers designed to increase understanding of PrEP and the recommended clinical practices for providing care.
- Prohibit companies selling life insurance, disability insurance, and long-term care insurance from denying coverage or charging higher premiums to people who take PrEP.
- Fund a public education campaign to reduce disparities in access to and use of PrEP by educating the public--particularly high-need communities in which PrEP is underutilized--about the safety and efficacy of the drug and to combat stigma associated with using PrEP.
"The PrEP Access and Coverage Act is a bold step towards ending the HIV epidemic once and for all. It will help to ensure that PrEP - a crucial tool in fighting HIV and AIDS - can be accessed by the communities that need it most. Because of lack of awareness, inability to access culturally competent health care and associated costs, very few people take PrEP, particularly those at highest risk of infection: gay/bi men of color, trans women, youth and women of color," said
"Expanding access to PrEP is central to ending the HIV and AIDS epidemic," said
Background information on the bill is available here (https://schiff.house.gov/imo/media/doc/One%20Pager%20-%20PrEP%20Access%20and%20Coverage%20Act.pdf). The full text of the bill is available here (https://schiff.house.gov/imo/media/doc/SCHIFF_031_xml.pdf).