Massachusetts Governor Maura Healey made history July 9 when she signed first-in-the-nation legislation guaranteeing no-cost health insurance coverage of pre-exposure prophylaxis (PrEP) meds to prevent HIV, reports GLAD Law, the GLBTQ Legal Advocates & Defenders. The law also guarantees people being released from correctional facilities the option of accessing PrEP.
The legislation was included in the state’s fiscal year 2027 budget lawmakers submitted to the governor. House Ways and Means Chairman Aaron Michlewitz, Senate Ways and Means Chair Michael Rodrigues and House Majority Leader Michael Moran spearheaded the legislation.
As GLAD Law notes in its news release:
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.
To date, the Food and Drug Administration (FDA) has approved four forms of PrEP: Truvada and Descovy are daily pills; Apretude is a shot given every two months; and Yeztugo is a twice-yearly injectable that is highly effective in women, gay men and gender-diverse populations. Due to insufficient evidence, Descovy is not yet indicated as PrEP for cisgender women and trans men. Generic (and much cheaper) versions of Truvada are available. To learn more about PrEP, see the POZ Basics on HIV Prevention: Pre-Exposure Prophylaxis (PrEP).
Under the rules of the Affordable Care Act (ACA, or Obamacare), health insurers must cover preventive health services that receive an A or B grade from the U.S. Preventive Services Task Force (USPSTF). In August 2023, USPSTF gave an A grade to all three forms of PrEP that had been approved at that time: Truvada, Descovy and Apretude. (Yeztugo, also known as lenacapavir, was approved in 2025; advocates urge health care insurers to cover it as well.)
In recent years, conservatives have filed lawsuits challenging the ACA’s mandate to cover preventive health services. These include not just PrEP but also cholesterol-lowering statins, vaccines and many screenings for cancer, diabetes and hepatitis.
In June 2025, the Supreme Court upheld the ACA mandate to cover these preventive services but stressed that the task force falls under the leadership of the nation’s health secretary. Currently, that person is Robert F. Kennedy Jr., who is already dismantling federal health programs and services. He recently removed members of the Advisory Committee on Immunization Practices (ACIP), a panel of experts that sets U.S. vaccine policy. As a result, the future of the USPSTF and PrEP insurance coverage remain unclear.
The new Massachusetts law ensures that no matter what transpires at the federal level residents of the Bay State will have no-cost coverage to PrEP.
“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,” Kenneth Mayer, MD, medical research director and cochair of The Fenway Institute, in the GLAD Law news release. “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.”
The legislation was supported by a joint statement signed by more than 60 public health leaders. They wrote that “to realize the promise of PrEP, and moreover to prevent a decline in PrEP utilization, it is critical that the legislature codify existing federal law and policy in state requirements,” adding that current federal “guidelines are also subject to reversal by the Secretary of Health and Human Services.”
In May, advocates with the HIV+Hepatitis Policy Institute also urged Massachusetts lawmakers to support the PrEP legislation.
“We strongly support the House’s inclusion of comprehensive HIV pre-exposure prophylaxis (PrEP) coverage protections across state-regulated insurance markets, MassHealth, the Group Insurance Commission, and correctional settings,” wrote HIV+Hep. “By codifying comprehensive PrEP coverage standards in state law, the General Court would help protect Bay Staters from potential federal changes while providing certainty for patients, providers, insurers, and public health programs. In doing so, Massachusetts would join a growing number of states, including California, Illinois, Minnesota, Oregon, and the District of Columbia that have taken steps to preserve comprehensive PrEP access protections at the state level, including coverage of FDA-approved PrEP medications without cost sharing or prior authorization.”
