Advocates press for state safeguards to ensure access to long‑acting and daily PrEP without prior authorization or cost sharing

Kevin Herwig, health policy manager at the HIV and Hepatitis Policy Institute, and several public‑health providers urged the committee to support House Bill H1245 and Senate Bill S717 to remove insurer barriers to pre‑exposure prophylaxis for HIV (PrEP), including ancillary services such as lab testing and visits.

"PrEP is a key component of both Massachusetts and federal strategies to end the HIV epidemic," Herwig said, describing long‑acting PrEP medications that have become available since early 2022 and arguing state protections are needed to backstop federal requirements.

Witnesses argued that cost sharing, prior authorization and other utilization management practices create real access barriers, particularly for people who are unstably housed, young people of color, and people who use drugs. Several speakers referenced long‑acting injectable PrEP as a transformative option for people who cannot adhere to daily regimens and urged that the bills prohibit both cost sharing and prior authorization for PrEP and recommended ancillary services.

Why it matters: proponents said removing financial and administrative barriers would increase equitable uptake of both daily and long‑acting PrEP, reduce new infections and relieve provider burdens that arise from repeated authorization steps.

Discussion versus action: testimony was advocacy to the committee; no committee vote or formal direction was recorded in the hearing transcript. Witnesses requested favorable reports and emphasized state‑level protections to preserve access if federal policy changes.

Background and clarifications: speakers noted federal Affordable Care Act preventive coverage rules but said gaps and insurer practices mean state mandates provide more consistent access for Massachusetts residents.