Bill > HR7853

This bill, the PrEP Access and Coverage Act of 2026, aims to significantly increase access to medications and services for preventing HIV transmission, known as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). It mandates that private health insurance plans, federal employee health benefits, Medicare, Medicaid, and the Children's Health Insurance Program (CHIP) must cover these HIV prevention services without any out-of-pocket costs for individuals, including prescription drugs, associated administrative fees, laboratory tests, and clinical follow-up. The bill also prohibits insurance companies from imposing prior authorization requirements for these services, except in limited circumstances where a therapeutically equivalent drug is covered without such requirements. Furthermore, it prevents life, disability, and long-term care insurance policies from denying coverage, limiting benefits, 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 grant programs to fund PrEP and PEP initiatives for uninsured and underinsured individuals and ensures patient confidentiality regarding the use of these benefits within family health plans. Finally, the bill includes provisions for enforcement by federal agencies and allows individuals to sue for violations, with the possibility of recovering legal costs.

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https://www.congress.gov/bill/119th-congress/house-bill/7853/all-info