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Senator Pinkney urges codifying PrEP and PEP coverage in HS1 to HB200 to preserve prevention access
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Summary
House Substitute 1 for HB200 would require coverage of PrEP and PEP across commercial group plans, the state employee plan and Medicaid; health and HIV‑prevention groups urged the Senate to adopt the substitute, and the Department of Insurance supported codification to protect access amid federal uncertainty.
Senator Pinkney presented House Substitute 1 for House Bill 200, which would require that group health plans, the state employee plan and Medicaid cover two proven HIV prevention medications: preexposure prophylaxis (PrEP) and postexposure prophylaxis (PEP). The sponsor said the measure removes common insurance barriers that delay access to these time‑sensitive medications, particularly for PEP, which must be started within 72 hours of exposure to be effective.
Public health and community organizations testified in support. Kat Caudle of the Delaware Academy of Medicine and Public Health described rising HIV diagnoses and urged passage. Tyler Burrell of the Delaware HIV Consortium said the bill reduces friction such as cost‑sharing, prior authorization and step therapy that prevent people from starting and staying on prevention medications. He also noted clinical follow‑up services—office visits, labs and other supports—remain barriers the state should continue to address.
Natalie DiSabatino Graff of the Delaware Department of Insurance said coverage currently exists in many fully insured commercial markets but argued codifying access is necessary because federal litigation and changing federal guidance have created uncertainty for preventive‑services coverage. She recommended passage to preserve access regardless of future federal decisions.
