Sponsors (30)
Official title: Increase access to pre-exposure prophylaxis to reduce the transmission of HIV.
Introduced March 4, 2026 by Tina Smith · Last progress March 4, 2026
The bill greatly expands no‑cost access to FDA‑approved HIV prevention and funds outreach and provider support—improving prevention for many—but does so at meaningful fiscal and administrative cost while raising privacy, implementation, and litigation risks that will require careful management.
Medicaid/CHIP enrollees, Medicare beneficiaries, federal beneficiaries (FEHB, VA, TRICARE, IHS) and uninsured people will gain substantially expanded no‑cost or grant‑funded access to FDA‑approved HIV prevention drugs and related lab/follow‑up services.
People seeking prevention and their clinicians will face fewer administrative barriers—removal of preauthorization, standard billing/coding materials, technical assistance, and support for PrEP navigators should speed access and reduce claim denials.
People who take HIV‑prevention medication will be protected from being denied or limited life, disability, or long‑term care coverage and from having premiums set solely because they use prevention drugs, with state enforcement and private remedies available.
Taxpayers and insurers face substantial increased costs because of expanded no‑cost coverage, grant programs, and reporting/compliance requirements, which could translate into higher federal spending and insurance premiums.
State governments, insurers, employers, providers, and community groups will incur significant administrative and compliance burdens (systems changes, reporting, application requirements), straining resources especially for smaller organizations and some states.
Collecting, transmitting, and publicly reporting health claims and cost‑sharing data creates privacy and data‑security risks for people using HIV prevention services unless protections and safeguards are robust.
Based on analysis of 20 sections of legislative text.
Requires no‑cost coverage of FDA‑approved HIV prevention drugs and related services, bans insurer discrimination for PrEP use, funds outreach/grants, strengthens privacy, and creates enforcement/reporting duties.
Requires private and federal group health plans to cover FDA-approved HIV prevention drugs (PrEP/PEP) and associated services without cost-sharing and broadly limits prior authorization. Prohibits life, disability, and long‑term care insurers from discriminating against people who take HIV‑prevention medication, creates CDC public and provider education campaigns, funds grants to expand PrEP/PEP access, protects confidential access under HIPAA, establishes enforcement and reporting duties for HHS/Labor/Treasury, and creates a private right of action for violations.