Sponsors (149)
Official title: To increase access to pre-exposure prophylaxis to reduce the transmission of HIV.
Introduced March 5, 2026 by Mark Takano · Last progress March 5, 2026
The bill greatly expands and enforces no‑cost access to HIV prevention—improving prevention uptake and equity—while increasing federal/state spending, insurer and administrative burdens, and legal/privacy risks that could raise costs or trigger disputes.
People at risk of HIV and those using PrEP/PEP will face little or no out‑of‑pocket cost and fewer administrative barriers because the bill requires coverage (and prohibits most prior authorization) for FDA‑approved HIV prevention drugs, related labs, and follow‑up across private plans, Medicare, Medicaid/CHIP, VA/TRICARE, and federal programs.
Uninsured, underinsured, and underserved communities will gain funded access, outreach, navigators, and adherence supports that increase awareness, uptake, and retention of PrEP/PEP services in populations disproportionately affected by HIV.
People covered as dependents on family health plans (e.g., adolescents, young adults) can obtain confidential preventive services without notice to primary policyholders, protecting privacy and encouraging use of sensitive preventive care.
Taxpayers and state budgets will face significant increased spending because the bill eliminates cost‑sharing across many programs and authorizes ongoing federal funding for outreach and services (including open 'such sums as may be necessary' authorizations).
Health insurers, benefit administrators, and employers will incur substantial administrative and IT costs (reporting, system changes, segregating confidential claims, standardized billing), and plans must collect and submit compliance data for years, creating ongoing implementation expense.
Insurers and taxpayers could face upward pressure on premiums and program costs if drug manufacturers set high prices or plans pass increased drug and administrative costs onto consumers.
Based on analysis of 20 sections of legislative text.
Requires private plans to cover FDA‑approved HIV prevention drugs and related services without cost‑sharing, bans broad prior authorization, funds education and grants, and creates enforcement and a private right of action.
Requires private group and individual health plans to cover FDA‑approved HIV prevention drugs (PrEP and PEP) and related services without cost‑sharing and limits prior authorization. Directs HHS (with CDC, DOL, Treasury, HRSA) to lead compliance guidance, monitoring, and multi‑year reporting; funds public and provider education campaigns and a grant program to expand PrEP/PEP access for uninsured and underinsured people; protects confidentiality for family plan users; bans discrimination by life, disability, and long‑term care insurers based on preventive HIV medication use; and creates a private right of action for enforcement.