One of the newest state laws taking effect Wednesday in Virginia will protect people who take pre-exposure prophylaxis medication to prevent HIV from insurance discrimination.
Gov. Abigail Spanberger approved HB60 earlier this year after similar legislation was vetoed by former Gov. Glenn Youngkin last year. The measure bans insurers from charging higher rates or denying or limiting life or disability coverage for people who take PrEP, a highly effective method of preventing HIV.
Health insurers are currently required to cover PrEP and certain other preventive health measures. But other types of insurance — such as life, disability and long-term care — are generally subject to state laws.
Hampton Del. Jeion Ward, the Democrat who wrote the state legislation, said that barriers to life insurance coverage for people who take PrEP are discriminatory because many other preventive health treatments don't trigger coverage denials.
"People will not have to worry about whether they can get insurance or not, simply because of a medication that they're taking, that's really to prevent them from getting an illness," Ward said.
Life insurance denials due to PrEP disproportionately impact gay men, who are the majority of PrEP users, even though PrEP is recommended to anyone at risk of contracting HIV through sexual activity or injection drug use.
Approved by the FDA since 2012, PrEP lowers the risk of contracting HIV from sex by about 99%, and injection drug use by 74%.
Activists agree, and note that life insurers don't deny people coverage for receiving similar preventive care, such as the Gardasil vaccine that protects against the human papillomavirus (HPV) — which is most commonly spread through sexual activity.
Since 2018, the State Corporation Commission has received a single complaint related to a life insurer's approval processes for applicants who use PrEP, the SCC told VPM News. Further information about the complaint is protected by confidentiality laws.
The new legislation comes after US senators from California and Minnesota drafted a bill that could further protect health insurance coverage for PrEP, and ban life and disability insurance discrimination against people who take PrEP in the U.S.
Ward hopes her legislation will encourage the use of PrEP, particularly in Hampton Roads, a region with some of the highest HIV rates in Virginia. HIV treatment and prevention in Virginia has been dealt a huge blow as HIV clinics continue to weather million-dollar state and federal cuts to healthcare.
"Anytime you want to protect yourself and those around you, and you are being denied that possibility or that right, it does begin to affect your dignity as a human being," Ward said.
During the 2026 legislative session, the House of Delegates voted 89 to 8 in favor of it. The Virginia Senate voted unanimously to pass it.
Last year, voting on the proposal by Ward was more partisan, with a narrower margin. The House voted 53 to 44 in support. Only two Republicans voted in favor.
Ben Klein, an attorney at GLAD Law, an advocacy group for LGBTQ+ issues and people with HIV, said the polarized voting shows that "we are seeing in this country the politicization of basic public health."
"It is sometimes, but not always, the case that Republicans want to attach social, cultural or political factors to what are clear public health issues," Klein said.
"We need to stay focused on the science and the evidence, which is that
PrEP is a low cost prevention for a significant health condition."
Ward agreed, "Some people … believe we [those who voted in favor of HB60] are sanctioning [sexually] risky behavior," she said, "That's just ridiculous."
Life insurers typically favor individuals who choose to take highly effective preventive health measures. But this isn't always the case for people who use PrEP, Klein said.
"When a life insurer or disability insurer excludes a qualified applicant simply because they are taking PrEP, that makes no sense, because the insurer would provide coverage to the same person who was not on PrEP," Klein said. "They're insuring the higher risk and excluding the lower risk."
In 2019, The New York Times reported that some individuals said they ended PrEP regimens to obtain life insurance, despite the health risks.
In a statement on his veto in 2025, Youngkin wrote that the legislation undermines the insurance underwriting process.
"While insurers are rightly prohibited from discrimination based on race, ethnicity, gender, religion, or marital status, they retain the ability to assess risk using relevant health and behavioral factors," Youngkin wrote.
"Singling out one medical treatment for special protection undermines this established process and could set a precedent that invites broader exemptions, potentially destabilizing the insurance market."
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