How The PrEP Access and Coverage Act Could Change HIV Prevention

There is a piece of legislation moving through Congress that could dramatically change how easy it is to get the lifesaving HIV prevention medication, PrEP. In March, U.S. Senators Adam Schiff, Tina Smith, and Representative Mark Takano reintroduced the PrEP Access and Coverage Act. 

Changing the Way Communities Get Covered

The bill would expand the availability of HIV prevention medications and care to communities that either can not afford care or don’t have access to care. It would ensure PrEP, screenings, diagnostic procedures, administrative fees, and clinical follow-ups are covered by patients’ health insurance, without the out-of-pocket costs that deter users from seeking care.

The bill comes on the heels of actions from the Trump administration that have threatened who can get care and how that care can be covered. In April, Trump released a budget that maintains funding for existing domestic HIV care, treatment, and PrEP programs but proposes to cut over $1.5 billion in HIV prevention, substance use, housing, and other programs. Additionally, Trump has cut CDC grants that support HIV prevention programs and several states have limited funding for those receiving federally funded HIV treatment.  The White House is trying to make it harder to access PrEP, this legislation is a response that could offer expanded protections if passed. 

“At a moment when protections for preventive care are being actively undermined, this legislation would safeguard and strengthen a national vision for PrEP access that aligns with our shared goal of ending HIV as an epidemic,” said Jeremiah Johnson, Executive Director, PrEP4All. 

The Potential Impacts

The PrEP Access and Coverage Act would specifically:

• Eliminate out-of-pocket costs for the medications and associated costs for individuals who are enrolled in federally regulated private and public health insurance. 
• Prohibit prior authorization requirements for HIV prevention drugs under private and public health insurance plans. 
• Prohibit denying coverage or increasing premiums for disability insurance, long-term care insurance, or life insurance policies based on a person using medication for HIV prevention. 
• Direct the Department of Health and Human Services to establish public health education campaigns to increase utilization of HIV prevention drugs.
• Establish a grant program for states and health care facilities to expand access to HIV prevention drugs for uninsured individuals and underserved communities. 
• Direct federal agencies to monitor compliance with HIV prevention drugs coverage requirements among private insurers and take appropriate enforcement actions. 

How You Can Get Care Right Now

While the legislation is still moving through the legislature, users can still get care through telehealth platforms that have revolutionized how HIV prevention can reach the people who need it. Mistr handles all of the collaboration needed with insurance companies and patient assistance programs to guarantee that users can get covered by PrEP. With everything happening entirely online, users don’t have to worry about complicated doctor’s visits, especially if they don’t have access to a reliable provider. 

About Mistr

Mistr is a gay-owned and operated online platform that brings together doctors, pharmacists, and industry minds to provide resources and PrEP to folks in need. Instead of relying on insurance providers to approve the purchase of PrEP, Mistr cuts out the middleman to help people get their prescriptions covered.

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