The Massachusetts House of Representatives has advanced legislation that will protect Bay State residents from any reversal of federal policies critical to ending the HIV epidemic.
The measure, included in the House Ways and Means Budget under the leadership of Chairman Aaron Michlewitz (D-Boston), codifies into state statute current federal law and policy that requires insurance coverage for all FDA-approved HIV pre-exposure prophylaxis (PrEP) medications without co-pays, deductibles, or prior authorization. The measure was supported by a group of over 60 public health experts, HIV physicians, state and national HIV medical organizations, and LGBTQ+ community groups who warned that a recent Supreme Court decision gave the federal Secretary of Health and Human Services unprecedented power to reverse key scientific recommendations about HIV PrEP medications.
GLBTQ Legal Advocates & Defenders (GLAD Law) and Fenway Health, who — with legislative co-sponsor House Chairman Jack Patrick Lewis (D-Framingham) and members of the Massachusetts LGBTQ+ Legislative Caucus — led the coalition in support of the measure, applauded House leadership for their commitment to ensuring that Massachusetts has the strongest state laws to end the HIV epidemic.
“The Massachusetts House, with leadership from Speaker Mariano, Chair Michlewitz, Leader Moran, and Chairman Lewis, has taken a critical step to protect public health and ensure access to one of the most powerful HIV prevention tools ever developed,” said Kenneth Mayer, MD, medical research director and co-chair of The Fenway Institute.
“PrEP can protect people against HIV infection, yet only about a third of eligible people in Massachusetts have a prescription,” Mayer said. “Cost, prior authorization, and other barriers have long stood in the way, particularly for the communities most impacted by the epidemic. By codifying these protections in state law, Massachusetts is making clear that it prioritizes infectious disease prevention and reducing racial disparities in the HIV epidemic.”
“We are grateful to Speaker Ron Mariano, House Ways and Means Chair Aaron Michlewitz, and Majority Leader Michael Moran for recognizing that we cannot rely on a federal government that has shown hostility to HIV prevention and public health,” said Ben Klein, senior director of litigation and HIV law at GLAD Law. “This legislation will ensure that Massachusetts does not slide backwards in efforts to end the epidemic. We also express our deep appreciation to the sponsor of the House bill, Representative Jack Lewis, for his steadfast dedication to HIV prevention.”
HIV preexposure prophylaxis (“PrEP”) is a powerful medical breakthrough to prevent HIV transmission. More than a decade after the first PrEP medication was approved in 2012, however, only about 35% of the people in Massachusetts who are eligible for PrEP have an active prescription.
Current federal law under the Affordable Care Act (ACA) prohibits cost sharing for all preventive services given an A or B rating by the U.S. Preventive Services Task Force. PrEP has a Grade A rating from the USPSTF and current federal guidelines issued in October 2024 also prohibit prior authorization practices for all FDA-approved PrEP medications. However, these guidelines are now subject to reversal by the current Secretary of Health and Human Services. In a 2025 ruling, the U.S. Supreme Court gave the Secretary of HHS new and unprecedented authority to appoint USPSTF members, remove them at will, and reverse and reject their recommendations.
Just as the Massachusetts Legislature recently acted to decouple vaccine approval provisos from the federal framework, the House budget measure takes the same step with respect to PrEP in order to prevent a decline in utilization and realize the promise of PrEP to eradicate HIV.
— from a GLBTQ Legal Advocates & Defenders (GLAD Law) press release
More: gladlaw.org
