PrEP Assistance Program Act

Summary#

This Act directs the Secretary of Health and Human Services, working through the Centers for Disease Control and Prevention and in collaboration with the Health Resources and Services Administration, to set up two related programs to expand access to pre-exposure prophylaxis (PrEP) for preventing HIV. First, a grant program will give funds to states, local governments, tribal governments, health centers, clinics, community groups, and university programs to start or support PrEP programs. Grants may be up to $10,000,000 each. The Secretary must give preference to applicants serving communities with high HIV rates (including rural and uninsured populations and high-risk groups) or using innovative delivery methods. Awarded funds can pay for clinic and lab fees, office and telehealth visits, PrEP medication, required blood and urine testing, STD testing per CDC guidance, counseling, outreach and provider education, peer navigation, case management, transportation, mental health services, and similar items. People who receive services from a grant-funded PrEP program cannot be charged for those services. Grantees generally must provide a 10% match to the grant (tribal governments are excepted), and the Secretary may waive the match for certain clinics and community organizations. The Secretary must report to Congress each year for five years, starting one year after enactment, with data broken down by race, gender identity, age, and location and an evaluation of changes in PrEP service disparities and PrEP prevalence. The Act authorizes $400,000,000 per year for fiscal years 2027 through 2031.

In a second program, the Secretary (through the HRSA Administrator) must set up a reimbursement program so registered providers can submit claims and be paid for specified HIV prevention items and services provided to uninsured individuals. The program must also provide a card or other technology called a "PrEP Pass" that uninsured people can use to get covered services at no cost. The Secretary must set payment amounts, review them at least every two years, and pay Medicare-equivalent rates for certain clinical lab tests. Program-registered providers must agree not to bill uninsured individuals for items or services paid under the program. The Secretary must establish both programs within one year after the Act becomes law.

What it means for you#

• If you work at or run an eligible clinic, community organization, or health program, you can apply for grant funding to start or expand PrEP services and related support services.
• If you are uninsured and get services from a program-funded site or a provider registered in the reimbursement program, you should not be charged for covered PrEP medications, tests, or related services when the programs are operating.
• Local areas with high HIV rates, rural communities, and groups at higher risk may get priority for funding and special outreach or delivery models like vending machines, pop-up clinics, or peer-led programs.

Expenses#

• Grants may not exceed $10,000,000 per eligible entity.
• Eligible uses include clinic and laboratory fees, office and telehealth visits, PrEP medication, required blood/urine tests, STD testing per CDC guidelines, adherence counseling, provider outreach and education, peer navigation, case management, transportation, mental health services, and similar items.
• Grantees must generally provide at least a 10% match to the grant amount, except for Indian Tribal governments; the Secretary can waive the match for certain health centers and community organizations.
• The Act authorizes $400,000,000 to be appropriated for each fiscal year 2027 through 2031 to carry out the Act.
• For the reimbursement program, the Secretary sets payment amounts and reviews them no less often than every two years; payment for certain clinical lab tests must match the payment amount under the referenced Medicare provision.

Proponents' View#

No publicly available information.

Opponents' View#

No publicly available information.