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HB 1301

An Act requiring health insurance policies to provide coverage for pre-exposure prophylaxis and post-exposure prophylaxis HIV medication and associated laboratory tests and patient visits.

2025-2026 Regular Session Introduced by Lisa Borowski and 20 co-sponsors

Pennsylvania bill requires health insurers to cover HIV prevention drugs PrEP and PEP plus related care, removing cost barriers to life-saving preventive medication.

Referred to Health
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Bill Summary · HB 1301

Legislative bill overview

HB 1301 mandates that health insurance policies in Pennsylvania cover pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) medications for HIV prevention, along with associated laboratory tests and patient visits. The bill removes financial barriers to accessing these proven preventive medications by requiring insurance coverage without specifying cost-sharing limits or exclusions.

Why is this important

PrEP and PEP are highly effective at preventing HIV transmission when used as prescribed, yet access is often limited by cost and insurance coverage gaps. This bill could significantly reduce HIV incidence in Pennsylvania by making prevention medications accessible to at-risk populations regardless of income, while also potentially reducing long-term healthcare costs associated with HIV treatment.

Potential points of contention

  • Cost and premium impacts: Insurance companies may argue the mandate increases premiums for all policyholders; supporters counter that prevention is more cost-effective than treatment
  • Scope of coverage: Unclear whether the bill covers all associated costs without copayments/deductibles, or if cost-sharing is permitted, which could still create access barriers
  • Eligibility criteria: The bill doesn't specify whether coverage is limited to high-risk populations or available to anyone, raising questions about medical necessity standards and appropriate prescribing practices

Compiled from official sources — confirm details with the bill’s official record.

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