Delaware passed a law requiring health insurance plans to cover PreP and PEP, which are medications used to help prevent HIV infection.
PreP can be taken regularly by people at risk of exposure to help prevent contraction of HIV. And PEP can be taken up to 72 hours after possible exposure to reduce risk of infection.
The bill's primary sponsor, Rep. Nnamdi Chukwuocha (D-Wilmington) said insurance and cost can delay care and access, especially for PEP, which needs to be accessed quickly after a possible exposure.
Delaware's Department of Insurance gave its support to the measure. It says while the medications are currently covered in Delaware, their availability under the Affordable Care Act, "is under attack."
Without insurance, cost to get a prescription and access to these medications can cost more than one thousand dollars.
Carl Shmid, executive director of the HIV and Hepatitis Policy Institute, said cuts to Medicaid under the One Big Beautiful Bill Act threatens people’s access to treatment, along with added work requirements. Delaware has at least four thousand people living with HIV.
"We're not seeing increases in funding, and we're seeing new cases," Shmid said.
Delaware is one of at least twenty states to cut eligibility to its AIDS Drug Assistance Program, which uses federal funds to offer treatment for low income people living with HIV. Delaware reduced eligibility for this program from 500% of the federal poverty level down to 350% this year. Shmid said it removed approximately 176 people from the state's treatment program.
And it makes preventative medicine like PreP and PEP even more important in preventing spread of HIV.
"If we have more people on PreP, we're not going to see people become HIV positive," he said.
That reduces the number of people who need antiretroviral treatment (ART) in the long term, "which is expensive for the rest of your life. So our goal right now is to limit new infections."
PreP and PEP users still need a prescription from a care provider. But Delaware's law ensures no cost sharing under state and commercial health plans, and people don't need to get prior authorization from their insurance to get the medicine covered.
Shmid said his organization is happy to see Delaware is ahead of the curve to enshrine access to preventative medications. And now it's on the state insurance department to enforce it.
"We'll be watching if more and more people are on PreP," he said.
Work requirements under Medicaid continue to be a concern for his organization. Shmid supports including an exemption for people living and HIV and AIDs.
The number of people newly infected with HIV has generally increased since 2019 in Delaware. That year, the Department of Health and Social Services reported 93 people newly infected, and then 128 in 2022. Last year, it reported 119 new cases.
