As part of its pushback against the Republican-led siege on bodily autonomy, the Biden administration has proposed new rules making contraception more accessible. Within the new guidelines is a plan to eliminate cost sharing for injectable PrEP, making the alternative to daily pills broadly affordable under private insurance plans.
According to a White House press release, the proposed rule would represent “the most significant expansion of contraception coverage under the Affordable Care Act since 2012, when contraception was first required to be covered.”
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In terms of injectable PrEP, the rule would require private health insurance companies “to cover every FDA-approved contraceptive drug or drug-led combination product without cost sharing unless the plan also covers a therapeutic equivalent without cost sharing.” The phrase “drug-led combination product” refers to medical products delivered through a device such as a syringe.
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Injectable PrEP is administered via shot every two months as opposed to the pill form of PrEP, which must be taken daily. For this reason, doctors recommend injectable PrEP for patients who have difficulty taking the pill everyday, according to the CDC.
Although the statement from the White House largely refers to women’s contraception, in reference to the overturning of Roe v Wade, the rule concerning injectable PrEP reportedly originated from a “request” from the HIV+ Hepatitis Policy Institute.
“With low uptake of PrEP among the communities most impacted by HIV, this insurance coverage requirement with zero cost-sharing will help jumpstart the use of more effective forms of PrEP and lead to fewer HIV transmissions,” Carl Schmid, executive director of the Institute, told Bay Area Reporter.
“We are grateful to the Biden-Harris administration for responding to our request to issue this guidance,” Schmid added. “Without it, we feel some insurers would continue to only cover daily oral PrEP, and not provide PrEP users with the choice they need. With up to a third of privately insured PrEP users still being charged cost-sharing, we must ensure that both federal and state regulators vigorously enforce PrEP coverage requirements.”
Because the new rule is still under proposal, it is important to note that it may not be adopted, and if it does, it may be subject to changes.
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