Preventing Discrimination Against Preventive HIV Medication

Other states, including California and Massachusetts, have taken steps to prevent the same type of discrimination.

Other states, including California and Massachusetts, have taken steps to prevent the same type of discrimination. Shutterstock


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A proposal before the Maine Legislature would forbid life insurance companies from denying coverage to people who take medication to prevent HIV.

Life insurance companies in Maine would be banned from denying coverage to people taking preventative HIV medication under the terms of a bill making its way through the state’s legislature.

The bill, introduced by Sen. Heather Sanborn, would update Maine’s insurance code to make it illegal for insurance providers that offer disability, life insurance or long-term care coverage to discriminate against people who opt to take pre-exposure prophylaxis, commonly referred to as PrEP

The drug, marketed under the name Truvada, was approved by the FDA in 2012 for use by people who do not have HIV but are at higher risk of contracting it (including gay and bisexual men, young people, African Americans and Latinos). Taken daily, the pill can reduce the risk of transmission by up to 99 percent, so encouraging its usage should be “a matter of public policy,” Sanborn said.

“Unfortunately, life insurance, disability insurers, and long-term care insurance providers may be discouraging people from taking PrEP drugs by adversely considering their PrEP prescription as part of the underwriting process,” she said in testimony before the Senate Committee on Health Coverage, Insurance and Financial Services. “This stance by insurers creates an adverse incentive that may cause people to discontinue taking PrEP.”

Other states have taken measures to prevent such potential discrimination. Last January, two lawsuits in Massachusetts led Mutual of Omaha to reconsider its policy, which the state attorney general’s office had characterized as discriminatory since 2014. Last summer, California’s insurance commissioner released a statement reminding providers that “a person’s history of PrEP use cannot be used as a justification to deny life, disability or long-term care insurance coverage or charge higher premiums for that coverage.”

In July, U.S. Rep. Adam Schiff, a Democrat from California, filed a bill to outlaw the practice at the federal level, but the legislation stalled in committee.

Sanborn, a Democrat from Portland, first became aware of the issue through a radio report last year. She vowed in a Facebook post that in 2020 lawmakers would “make sure that no one in Maine faces this type of discrimination going forward.”

No one testified in opposition to the bill at a committee hearing on Jan. 8, although a representative from the American Council of Life Insurers suggested tweaks to the language that would still allow “insurers to medically underwrite applicants seeking coverage.”

The legislation is awaiting a committee vote.

Kate Elizabeth Queram is a Staff Correspondent for Route Fifty and is based in Washington, D.C.

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