Press Release: 7/10/2026

Massachusetts Passes First-in-the-Nation Protections for HIV Prevention

Legislation Ensures No-cost Insurance Coverage for PrEP, Protecting MA Residents Against the Threat of Rollbacks by the Federal Government 

 

Massachusetts lawmakers, with the leadership of House Ways and Means Chairman Aaron Michlewitz, Senate Ways and Means Chair Michael Rodrigues, and House Majority Leader Michael Moran, have passed landmark legislation that will protect access to HIV prevention medication for residents and strengthen state efforts to end the HIV epidemic. Governor Healey signed the legislation on July 9. 

The measure, included in the Fiscal Year 2027 annual budget submitted to Governor Healey on July 1, codifies into state statute current federal law and policy that requires insurance coverage for all FDA-approved HIV pre-exposure prophylaxis (PrEP) medications without co-pays, deductibles, or prior authorization. This legislation sets a national precedent by protecting Massachusetts residents from rollbacks in federal protections for PrEP access and is the first to incorporate these critical insurance protections comprehensively by including all private insurers as well as MassHealth, the state Medicaid plan. 

The law also requires that all persons being released from correctional facilities in the state and who are at risk for HIV be offered PrEP prior to release, including administration of an injectable form of PrEP that provides six months of protection from HIV. 

The legislation was supported by a group of more than 60 public health experts, HIV physicians, state and national HIV medical organizations, and LGBTQ+ community groups who warned that a recent Supreme Court decision gave the federal Secretary of Health and Human Services unprecedented power to reverse key scientific recommendations about HIV PrEP medications. By passing the measure, the State Legislature has ensured the protection of Massachusetts residents from any reversal of federal policies to ensure access to PrEP for HIV prevention 

“We’re so grateful to Chairman Michlewitz and our House and Senate legislative leaders who – with Governor Healey – are boldly protecting access to HIV prevention in Massachusetts. PrEP is our clearest path to ending the HIV epidemic, but only if people can actually get it,” said Ben Klein, GLAD Law Senior Director of Litigation and HIV Law. “We cannot rely on a federal government that has shown hostility to HIV prevention and public health. Massachusetts is stepping up as a national leader to ensure that this lifesaving prevention reaches everyone who needs it.” 

 

GLBTQ Legal Advocates & Defenders (GLAD Law) and Fenway Health, who – with legislative co-sponsors House Chairman Jack Patrick Lewis, Senator Julian Cyr, and members of the Massachusetts LGBTQ+ Legislative Caucus – led the coalition that supported the measure, applauded the State Legislature for its commitment to strengthening Massachusetts’ legal framework to end the HIV epidemic.  

“The Massachusetts Legislature has taken a critical step to protect public health and ensure access to one of the most powerful HIV prevention tools ever developed,” said Kenneth Mayer, MD, Medical Research Director and Co-Chair of The Fenway Institute. “PrEP can protect people against HIV infection, yet only a minority of eligible people in Massachusetts have a prescription. Cost, prior authorization, and other barriers have long stood in the way, particularly for the communities most impacted by the epidemic. By codifying these protections in state law, Massachusetts is making clear that it prioritizes infectious disease prevention and reducing racial disparities in the HIV epidemic.” 

“Expanding access to critical medication like PrEP is essential to HIV prevention and building off the incredible scientific advances that have occurred over the past few years in treating and preventing HIV. By including this critical language in the budget, we once again affirm the Commonwealth’s commitment to science as we focus on public health and health equity,” said Representative Aaron Michlewitz, Chair of the House Committee on Ways & Means. “I want to thank Speaker Mariano for his leadership on this issue, as well as Representative Lewis, and all my other colleagues in the Legislature for their support to advance this critical initiative.” 

“The Legislature’s inclusion of language ensuring greater access to lifesaving medications like PrEP reflects our continued commitment to advancing public health and preventing HIV across the Commonwealth,” said Representative Michael J. Moran, House Majority Leader. “Thank you to Speaker Mariano, Chairman Michlewitz, and Representative Lewis, for their leadership and support of this essential medication.” 

“Access to certain health care treatments and services shouldn’t be based on political decisions. Instead, as a Commonwealth we should support evidence-based and scientifically-sound care that protects our residents and prevents illness and disease,” said Senator Cindy F. Friedman, Senate Chair of the Joint Committee on Health Care Financing. “Ensuring access to PrEP does exactly that. By focusing on prevention and making this highly effective treatment broadly accessible, we can ensure every resident has the means to stay healthy, improve health equity, and reduce long‑term health care costs.”  

“PrEP is a life-saving medication that has transformed HIV prevention, and we must do everything in our power to ensure and further expand access,” said Senator Julian Cyr, Senate sponsor of the legislation. “I’m proud that Massachusetts will codify the Affordable Care Act’s protections, ensuring comprehensive insurance coverage for PrEP without unnecessary utilization barriers. By safeguarding availability to this breakthrough medication, we’re protecting public health and advancing health equity – all while reaffirming Massachusetts’ leadership in the fight against HIV and protecting our most vulnerable.”  

“Scientific breakthroughs have brought us closer than ever to a future with no new HIV transmissions, no HIV-related deaths, and no stigma attached to HIV status. This legislation builds on that progress by expanding access to proven prevention strategies like PrEP, testing, treatment, and wraparound services while ensuring stigma, discrimination, and cost are never barriers to care,” said Chairman Jack Patrick Lewis, House sponsor of the legislation. “I am deeply grateful to the advocates and public health leaders who made this progress possible, including Fenway Health and GLAD Law, as well as Speaker Ron Mariano, House Ways and Means Chair Aaron Michlewitz, and my legislative partners, Senator Julian Cyr and Representative Thomas Moakley, for their steadfast commitment to evidence-based public health.”  

The legislation includes important public health interventions to reduce HIV transmission in Massachusetts, including: prohibiting private insurers, MassHealth, and the Group Insurance Commission from imposing cost sharing or prior authorization on any FDA-approved HIV prevention medications, including long-acting injectable PrEP; requiring state and county correctional facilities to provide PrEP to eligible inmates upon release; and requiring insurers to accept prescriptions for PrEP from any health care practitioner licensed to prescribe medications; and a budget provision passed earlier authorizing pharmacists to prescribe a time-limited supply of PrEP consistent with regulations of the Department of Public Health. 

HIV preexposure prophylaxis (“PrEP”) is a powerful medical breakthrough to prevent HIV transmission. More than a decade after the first PrEP medication was approved in 2012, however, only about 35% of people in Massachusetts who are eligible for PrEP have an active prescription. Financial and insurance barriers, including cost-sharing, deductibles, prior authorization, and step therapy continue to prevent many eligible patients from receiving this nearly 100-percent effective HIV prevention medication. Current federal law under the Affordable Care Act (ACA) prohibits cost-sharing for all preventive services given an A or B rating by the US Preventive Services Task Force. PrEP has a Grade A rating from the USPSTF and current federal guidelines issued in October 2024 also prohibit prior authorization practices for all FDA-approved PrEP medications. However, these guidelines are now subject to reversal by the current Secretary of Health and Human Services. In a 2025 ruling, the US Supreme Court gave the Secretary of HHS new and unprecedented authority to appoint USPSTF members, remove them at will, and reverse and reject their recommendations.  

Just as the Massachusetts Legislature recently acted to decouple vaccine approval provisos from the federal framework, this legislation takes the same step with respect to PrEP to prevent a decline in utilization and realize the promise of PrEP to eradicate HIV. 

Learn more about GLAD Law’s work for PrEP access.