To increase access to pre-exposure prophylaxis to reduce the transmission of HIV.
Analysis under review: This bill has generated analysis that may be too generic or incomplete. Clause-level evidence remains available below.
Summary
What This Bill Does
This bill aims to dramatically increase access to HIV prevention medications (PrEP and PEP) by requiring health insurance plans to cover these treatments without any cost-sharing requirements. It also prohibits insurance discrimination against people taking HIV prevention medication and establishes public education and grant programs.
Who Benefits and How
Individuals at risk of HIV infection benefit by gaining free access to PrEP/PEP medications and associated medical services. LGBTQ+ communities and communities of color, who are disproportionately affected by HIV, benefit from targeted outreach programs. Federally qualified health centers and community health organizations can receive grants to provide PrEP/PEP services. Pharmaceutical companies manufacturing PrEP medications may see increased demand.
Who Bears the Burden and How
Health insurance companies face new coverage mandates and cannot charge cost-sharing for HIV prevention services. Life, disability, and long-term care insurers face new anti-discrimination requirements. Health plans must submit annual compliance reports to HHS. The federal government must fund public education campaigns and grant programs.
Key Provisions
- Mandates coverage of all FDA-approved HIV prevention drugs, lab work, and clinical monitoring with no cost-sharing
- Prohibits life, disability, and long-term care insurers from discriminating against people taking PrEP
- Establishes grant programs for states, tribes, and health centers to expand PrEP access
- Creates private right of action for individuals to sue for violations
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.
At a Glance
What This Bill Does
Increase access to pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) medications to reduce HIV transmission by mandating insurance coverage, eliminating cost-sharing, and funding public health programs.
Key Policy Areas
Healthcare, Public Health, Insurance Regulation, Civil Rights
Primary Purpose
Increase access to pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) medications to reduce HIV transmission by mandating insurance coverage, eliminating cost-sharing, and funding public health programs.
Policy Domains
PrEP Access and Coverage Act of 2023
Identified Gains
- Individuals at risk of HIV
- LGBTQ+ communities
- Communities of color
- Federally qualified health centers
- Pharmaceutical companies manufacturing PrEP
Identified Costs
- Health insurance companies
- Life/disability/long-term care insurers
- Federal government (funding programs)
Sponsors
Legislative Progress
IntroducedMs. Smith introduced the following bill; which was read twice …
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Consumers whose rights are violated, Individuals at risk of HIV infection, Individuals taking PrEP medication
CDC, CDC/HHS, Department of Defense
Positive-direction: Military service members and dependents
Negative-direction: CDC, CDC/HHS, Department of Defense, HHS, Labor, and Treasury Departments, Indian Health Service
Community health organizations, Family planning organizations, Federally Qualified Health Centers
Health insurance companies, Insurers violating coverage requirements, Life, disability, and long-term care insurance companies
Community-based organizations serving HIV-affected populations
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "the_director"
- → Director of the Centers for Disease Control and Prevention
- "the_secretary"
- → Secretary of Health and Human Services
Key Definitions
Terms defined in this bill
A daily antiretroviral medication that helps prevent individuals from acquiring HIV, reducing risk from sex by over 99%
A federally qualified health center or other nonprofit entity engaged in providing PrEP and PEP information and services
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology