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PrEP Access and Coverage Act of 2023
1/4/2025, 11:17 AM
Summary of Bill HR 4392
The key provisions of the bill include requiring private health insurance plans to cover the cost of PrEP without any out-of-pocket expenses for the insured individual. This would make PrEP more affordable and accessible to those who need it. Additionally, the bill would expand access to PrEP by allowing pharmacists to prescribe the medication without a doctor's prescription in certain circumstances.
Furthermore, the bill includes provisions to increase education and awareness about PrEP, particularly among communities that are disproportionately affected by HIV. This includes funding for outreach programs and campaigns to inform individuals about the benefits of PrEP and how to access it. Overall, the PrEP Access and Coverage Act of 2023 aims to reduce the spread of HIV by making PrEP more accessible and affordable for those who need it. By addressing barriers to access and increasing education about the medication, the bill has the potential to have a significant impact on public health and reduce the number of new HIV infections in the United States.
Congressional Summary of HR 4392
PrEP Access and Coverage Act of 2023
This bill requires private health insurance plans to cover prescription drugs that prevent HIV, including related screenings, diagnostic procedures, administrative fees, and clinical follow-ups, without any cost-sharing obligation for the plan holder. Further, insurance plans must not impose any preauthorization requirement for this coverage. These coverage requirements also apply to public health insurance programs, including Medicare, Medicaid, and the Children's Health Insurance Program.
Additionally, the bill prohibits denying, limiting, or qualifying coverage or increasing premiums for disability insurance, long-term care insurance, or life insurance policies based on an individual taking medication for HIV prevention.
The bill further requires the Department of Health and Human Services (HHS) to award grants to states, or directly to eligible local organizations, to provide uninsured individuals and underinsured individuals access to prescription drugs and related services that prevent HIV. The Centers for Disease Control and Prevention also must develop a public awareness campaign that focuses efforts in communities with a high need for HIV prevention treatment.
HHS, the Department of Labor, and the Department of Treasury must enforce and report on private insurers' compliance with the bill's requirements.
