Bill > S3990

This bill, titled the "PrEP Access and Coverage Act of 2026," aims to significantly increase access to pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), medications used to prevent HIV transmission. It mandates that private health insurance plans, including those offered through employers and individual marketplaces, must cover PrEP and PEP drugs, along with associated administrative fees, laboratory tests, and clinical monitoring, without any cost-sharing for the patient. This coverage requirement also extends to the Federal Employees Health Benefits Program, Medicare (Parts B and D), Medicaid, and the Children's Health Insurance Program (CHIP), ensuring these services are free at the point of service for beneficiaries. The bill also prohibits insurance plans from imposing prior authorization requirements for these HIV prevention services, with a limited exception for therapeutically equivalent drugs. Furthermore, it prevents life, disability, and long-term care insurance policies from denying coverage or increasing premiums based on an individual's use of HIV prevention medication. To support these changes, the bill authorizes public education campaigns to inform people about PrEP and PEP, and provider education campaigns to equip healthcare professionals to offer these services, with a particular focus on reaching underserved communities. It also establishes a grant program to fund PrEP and PEP programs for uninsured and underinsured individuals, and requires the Department of Health and Human Services to update regulations to ensure patient confidentiality regarding the use of these benefits within family health plans. Finally, the bill allows individuals to sue for violations and requires federal agencies to monitor compliance and report to Congress.

Health and Social Services

https://www.congress.gov/bill/119th-congress/senate-bill/3990/all-info