Congress·In Committee·S. 3990

Sen. Smith Introduces Bill to Make HIV Prevention Drugs Free for All Americans

PrEP Access and Coverage Act of 2026

15 days ago·View on Congress.gov

Legislative Progress

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Key Points

The bill would require nearly all health insurance plans — private, Medicare, Medicaid, CHIP, FEHB, TRICARE, and VA — to cover HIV prevention drugs (PrEP and PEP) at zero cost to patients, including the medication itself, lab tests, and follow-up visits.
From policy text
“any prescription drug approved by the Food and Drug Administration used for the prevention of HIV (other than a drug subject to preauthorization requirements consistent with section 2729A-11), administrative fees for such drugs, laboratory and other diagnostic procedures associated with the use of such drugs, and clinical follow-up and monitoring”
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Insurance companies would be banned from requiring prior authorization for PrEP drugs, removing a common barrier that delays or blocks access to treatment. Plans can only require prior authorization for a specific brand if they offer a therapeutically equivalent alternative without such requirements.
From policy text
“A group health plan or a health insurance issuer offering group or individual health insurance coverage shall not impose any preauthorization requirements with respect to coverage of the services described in section 2713(a)(5), except that a plan or issuer may impose preauthorization requirements with respect to coverage of a particular drug approved under section 505(c) of the Federal Food, Drug, and Cosmetic Act”
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Life, disability, and long-term care insurance companies would be prohibited from denying coverage, charging higher premiums, or discriminating against anyone for taking HIV prevention medication — a protection that could reduce stigma around PrEP use.
The bill protects patient privacy by ensuring that people on a family insurance plan can access HIV prevention services without the primary policyholder being notified, which is critical for young adults and others who may fear stigma.
From policy text
“ensure that individuals are able to access the benefits described in section 2713(a)(5) under a family plan without any other individual enrolled in such family plan, including a primary subscriber of or policyholder, being informed of such use of such benefits”
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A new grant program would fund PrEP and PEP services for uninsured and underinsured people, with grants going to states, tribes, and community health organizations. A public education campaign would also target high-risk communities and train healthcare providers.
From policy text
“the Secretary shall establish a program that awards grants to States, territories, Indian Tribes, and directly eligible entities for the establishment and support of pre-exposure prophylaxis (referred to in this section as `PrEP') and post-exposure prophylaxis (referred to in this section as `PEP') programs”
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Impact Analysis

Personal Impact

Who is affectedScoreImpactCertaintyScopeDurationSentiment

Scores: 1 = low, 5 = highSentiment: -5 to +5 (net benefit)

Milestones

2 milestones2 actions

Mar 4, 2026Senate

Read twice and referred to the Committee on Health, Education, Labor, and Pensions.

Mar 4, 2026

Introduced in Senate

What Happens Next

Projected impacts based on AI analysis

2027-01-01

Most coverage requirements take effect for plan years beginning on or after January 1, 2027

If enacted, people with private insurance, Medicare, FEHB, TRICARE, VA, and IHS coverage would start getting PrEP and PEP drugs, lab tests, and follow-up care at zero cost starting with their 2027 plan year.

2027-01-01

Medicaid and CHIP HIV prevention coverage requirements take effect

Low-income Americans on Medicaid and children covered by CHIP would gain access to free PrEP and PEP services, with some states potentially getting extra time if they need to change their own laws first.

Within 1 year of enactment

Grant program for uninsured and underinsured PrEP access launches within one year of enactment

Community health centers, rural clinics, and tribal health facilities could apply for federal funding to provide PrEP to people who don't have insurance or whose insurance doesn't fully cover it.

Related News

2 articles

The San Fernando Valley Sun·1 day ago

PFLAG LA Addresses Federal HIV Prevention Funding Cuts

PFLAG Los Angeles expressed concern over federal reductions to HIV prevention funding. The article notes the reintroduction of the PrEP Access and Coverage Act by Senators Schiff and Smith as a critical legislative effort to safeguard access to medications like PrEP and PEP amid budget cuts.

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Erie Gay News·15 days ago

STATEMENT: PrEP Access & Coverage Act Promises to Expand PrEP Access

Senators Adam Schiff and Tina Smith introduced the PrEP Access & Coverage Act to create a comprehensive national program. The bill aims to eliminate financial barriers by requiring public and private insurers to cover PrEP and PEP medications and associated lab work with zero cost-sharing.

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