The D.C. Council has voted unanimously to advance a bill requiring health insurance companies to cover the cost of HIV prevention drugs, including medications used for pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP).
The vote came after the Council unanimously approved an amendment removing language added in committee that would have required insurers to fully cover only one PrEP drug of their choosing.
The amended bill now states that, for plans issued or renewed after January 1, 2027, an insurer “may not impose cost sharing, require prior authorization, or impose any medically unnecessary restrictions or delays for the coverage of HIV prevention services, PEP, or any formulation of PrEP approved by the FDA.”
Currently, there are two FDA-approved oral medications primarily used as forms of PrEP: Truvada, which is also available in generic form, and Descovy — both manufactured by Gilead Sciences.
Recent scientific advances have led to two long-acting, FDA-approved injectable forms of PrEP: ViiV Healthcare’s Apretude, which requires bimonthly injections, and Gilead’s lenacapavir, marketed under the name Yeztugo, which requires injections every six months.
The bill was introduced by D.C. Councilmember Zachary Parker (D-Ward 5), who sponsored the measure to ensure District residents with health insurance would continue to have access to HIV prevention drugs regardless of decisions made by the Trump administration.
“We are seeing 30-year lows in terms of infection rates, and that progress is in jeopardy because of federal funding being pulled back,” Parker told Metro Weekly. “It’s also really important because it enshrined these protections in local law that are currently afforded via the Affordable Care Act. We know that there have been repeated attempts to curtail the Affordable Care Act. And so it was important for us to put a stake in the ground for these protections locally so that our residents can depend on them, regardless of what happens at the federal level.”
Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, said that while the Supreme Court has upheld the constitutionality of the U.S. Preventive Services Task Force, it remains unclear how the Trump administration will handle the body, which plays a key role in determining which preventive services insurers must cover without additional cost.
“The entire Supreme Court case [around the task force] was brought by conservatives because of objections to PrEP,” Schmid said during a recent phone call. “But it ended up going after all preventive services. And even though the court ruled to uphold it, we don’t know what the Trump administration is going to do with the U.S. Preventive Services Task Force…. Its future is kind of up in the air. They could even roll back the PrEP protections. So that was the basis for having [Parker’s] bill introduced.”
Schmid and other advocates testified in favor of the bill before the Council’s Committee on Health. But after the hearing, the committee approved the measure with language requiring insurers to cover only one PrEP drug, rather than multiple forms of PrEP — a change advocates were not seeking, and that alarmed many HIV prevention experts.
“It basically put people in a situation where their plan may only cover cheaper, once-a-day generic PrEP, which is fine for some people, but others need long-acting PrEP,” Schmid said. “The concern was that insurers would not cover the newer, long-acting forms of PrEP. So we were disappointed when we heard it and said, ‘Wait, what happened? This is terrible.'”
After the bill was shuffled between committees following a leadership change, advocates were left scrambling to warn councilmembers about language that threatened to weaken the measure ahead of the February 3 vote.
On the day of the first vote, Henderson and Parker introduced an amendment requiring insurers to cover all FDA-approved HIV prevention drugs, including those used for post-exposure prophylaxis, as well as any future treatments approved to prevent HIV.
The bill also incorporated provisions of separate legislation introduced by Councilmember Brooke Pinto (D-Ward 2) that prohibit life and disability insurance carriers from discriminating against people for using PrEP — a move advocates welcomed.
“Insurers often think you’re at high risk because you’re on PrEP. But actually, you’re taking responsible steps to protect yourself from HIV,” Schmid said.
Schmid added that he hopes there are no further changes to the bill and that it passes on the required second reading, saying the measure is needed to provide relief to people seeking to proactively protect themselves from HIV.
Parker told Metro Weekly that the original language requiring coverage for only one regimen of PrEP was introduced “at the behest of insurance companies” that were lobbying the Council and providing feedback to the Committee on Health.
“I’m clear that insurance providers were fighting and pushing back on some of this,” he said. “I think that was the reason the change was made. But it also could be because folks just don’t have a depth of knowledge around the various forms of PrEP.”
Parker, the Council’s sole gay member, said his familiarity with HIV prevention as a member of the LGBTQ community underscored the importance of political representation.
“My insight and perspective of having access to PrEP, and the challenges that friends and others have run into trying to get access to PrEP, directly informed the writing of this legislation,” he said.
The Council will take a second vote on the PrEP access bill before sending it to D.C. Mayor Muriel Bowser for her signature. Parker expects Bowser to approve the measure, which would then undergo congressional review, as required for all laws passed by the Council.
“I expect by this spring it will be the law in time for changes to go into effect for fiscal year 2027,” Parker said. “By this summer, people should begin seeing those changes reflected in their insurance coverage.”
A new report finds that acceptance of LGBTQ people is declining across the United States, with nearly three in ten LGBTQ adults saying attitudes toward their community have worsened.
On Thursday, January 15, the Human Rights Campaign Foundation released findings from its Annual LGBTQ+ Community Survey, which drew responses from nearly 15,000 U.S. adults -- roughly two-thirds of whom identified as LGBTQ.
In addition to the survey, HRC last year launched its "American Dreams Tour," traveling to 10 cities and engaging more than 5,000 people through town halls, trainings, and community meetings with local LGBTQ leaders and activists. Those on-the-ground conversations informed the report, which aims to assess the state of LGBTQ life in the United States one year into the second Trump administration.
A recent study of injectable pre-exposure prophylaxis found that twice-yearly injections of lenacapavir -- marketed as Yeztugo by Gilead Sciences -- do not have clinically significant interactions with gender-affirming hormone therapy.
"In the most gender-diverse Phase III PrEP trial conducted to date, lenacapavir had no clinically significant impact on feminizing or masculinizing gender-affirming therapy concentrations," the study’s researchers concluded, as reported by POZ.
The study, led by Dr. Jill Blumenthal of the University of California San Diego, examined whether lenacapavir interacts with gender-affirming hormone therapy, including estradiol (a form of estrogen) and testosterone. Because those hormones are metabolized by enzymes such as CYP3A4 -- which lenacapavir can inhibit -- the researchers analyzed whether the drug altered hormone levels.
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