Pennsylvania 2025-2026 Regular Session

Pennsylvania Senate Bill SB936

Introduced
7/22/25  

Caption

Requiring health insurance policies to provide coverage for postexposure prophylaxis HIV medication.

Impact

The passage of SB936 would align state health insurance regulations with contemporary medical standards and public health practices concerning HIV prevention. By mandating coverage for PEP, the bill seeks to reduce barriers that might prevent individuals from obtaining this critical medication. This change could significantly impact those at risk of HIV exposure, especially in high-prevalence populations, thereby enhancing overall community health and safety.

Summary

Senate Bill 936, known as the PEP for Pennsylvania Act, mandates that health insurance policies in the Commonwealth of Pennsylvania provide coverage for postexposure prophylaxis (PEP) HIV medication. This legislation aims to enhance access to vital medications that help prevent the transmission of HIV after potential exposure, making it a significant step towards improving public health outcomes. The bill stipulates that any health insurance policy delivered, issued, or renewed after its effective date must include this coverage, thereby ensuring that affected individuals can receive timely and necessary medical intervention without incurring prohibitive costs.

Sentiment

The general sentiment surrounding SB936 appears to be positive, particularly among public health advocates and organizations focused on HIV prevention. Supporters argue that the bill represents a progressive approach to healthcare access, crucially preventing the spread of HIV and demonstrating a commitment to the health and well-being of vulnerable populations. However, there may be dissent from certain insurance providers concerned about the financial implications and potential impact on premiums following the mandate for expanded coverage.

Contention

While the bill marks an important advancement in healthcare policy, it does present points of contention regarding how insurance providers may implement the mandated coverage. Some critics might argue that moving PEP medications to specialty tiers could hinder access despite the mandate, as it may still lead to increased costs for patients. Additionally, regulations regarding counseling requirements before obtaining PEP medication may generate debate about balancing necessary medical oversight with patient autonomy. The discussion around these aspects highlights the complexities of healthcare legislation and the need for careful implementation to ensure the bill's objectives are fully realized.

Companion Bills

No companion bills found.

Previously Filed As

PA SB542

Requiring health insurance policies to provide coverage for postexposure prophylaxis HIV medication.

PA SB541

Requiring health insurance policies to provide coverage for preexposure prophylaxis HIV medication.

PA HB1213

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

PA HB1159

Prohibiting discriminatory practices against applicants and enrollees under certain insurance policies based on claims or prescriptions involving prophylaxis HIV medication.

PA SB100

Providing for patient access to diagnostics and treatments for Lyme disease and related tick-borne illnesses; and requiring health care policies to provide certain coverage.

PA SB440

In casualty insurance, further providing for conditions subject to which policies are to be issued and for health insurance coverage for certain children of insured parents.

PA HB2563

In casualty insurance, further providing for conditions subject to which policies are to be issued and for health insurance coverage for certain children of insured parents.

PA SB954

In casualty insurance, providing for coverage for biomarker testing.

PA HB1754

In casualty insurance, providing for coverage for biomarker testing.

PA HB2385

In casualty insurance, providing for coverage for interprofessional consultation.

Similar Bills

No similar bills found.