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Introduced March 5, 2026 by Mark Takano · Last progress March 5, 2026
Requires broad, no‑cost coverage of FDA‑approved HIV pre‑exposure (PrEP) and post‑exposure (PEP) drugs and related clinical services across federal programs and private group health plans, bans routine preauthorization for those services, and creates federal reporting, enforcement, education campaigns, and a grant program to expand access. Adds privacy protections so someone on a family plan can use these preventive services without the primary policyholder being notified, bars life/disability/long‑term care insurers from penalizing people for taking PrEP, and creates a private right of action for enforcement.
The bill greatly expands access to and equitable coverage of HIV prevention (PrEP/PEP) and funds outreach and provider capacity, improving public‑health protection—at the cost of significant federal spending, new administrative burdens for insurers and providers, potential privacy risks, and increased litigation and implementation complexities.
People at risk of HIV — whether on private insurance, Medicare, Medicaid/CHIP, FEHB, TRICARE, VA, IHS, or uninsured — will gain broadly standardized, no‑cost access to FDA‑approved PrEP/PEP and associated labs/follow‑up, reducing financial barriers to prevention.
Communities disproportionately affected by HIV and uninsured/underinsured people will receive sustained grants, outreach, targeted education, provider training, and funded navigation/adherence services that increase awareness and improve access.
Removal of prior‑authorization requirements in group and individual plans for HIV prevention drugs (with a narrow equivalent‑drug exception) will reduce administrative delays and improve timely access to medications.
The expansions (mandatory coverage, grants, outreach, and IHS support) substantially increase federal spending and could pressure budgets or lead to higher taxes or reallocated priorities.
Higher utilization of prevention drugs and services plus limits on using PrEP use in underwriting may raise insurers' costs and underwriting uncertainty, producing higher premiums or fewer plan options for some enrollees or employers over time.
New annual data collection and public reporting requirements (and related enforcement actions) create administrative costs for plans, insurers, providers, and smaller grant applicants that may be passed on to consumers or divert provider capacity.