The PrEP Access and Coverage Act of 2026 requires comprehensive HIV prevention coverage across both private insurance and federal health programs, eliminating all cost-sharing for FDA-approved preventive drugs like PrEP, along with associated lab tests, monitoring services, and clinical follow-up care. The law applies to private health insurance plans, federal employee benefits, Medicaid, CHIP, Medicare, Veterans Affairs, TRICARE, and the Indian Health Service, with implementation beginning January 1, 2027. Insurers are prohibited from requiring prior authorization for HIV prevention services, though they may do so only when therapeutically equivalent alternatives exist. The bill directs the Departments of Health and Human Services, Labor, and Treasury to enforce compliance through monitoring, data collection, guidance issuance, and biennial reporting to Congress, while also giving individuals the right to sue for violations and recover attorney fees. The Indian Health Service receives open-ended funding authorization to implement the required coverage.
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