What's Been Cut
The federal government funds HIV prevention through multiple agencies. Several programs that directly or indirectly support PrEP access have been reduced:
- Ending the HIV Epidemic (EHE) initiative: Launched in 2019 to reduce new HIV infections by 90% by 2030, funding for this initiative has been significantly reduced. EHE funded PrEP navigation, testing, and linkage to care in the 50+ highest-burden jurisdictions.
- CDC HIV prevention funding: Proposed cuts would reduce CDC's Division of HIV Prevention budget, affecting surveillance, testing programs, and technical assistance to states and community organizations.
- HRSA Ryan White Program: Flat or reduced funding affects the network of clinics and service organizations that provide HIV care and PrEP services to underserved populations.
- Ready, Set, PrEP: Already ended July 2025 with no replacement program announced.
- PEPFAR: International HIV funding disrupted, though this primarily affects overseas programs.
What hasn't changed: The ACA preventive services mandate requiring free PrEP coverage is law, upheld by the Supreme Court. Insurance companies must still cover PrEP at $0. Manufacturer assistance programs (Gilead, ViiV) remain operational. Telehealth platforms continue to provide free PrEP.
Your PrEP access doesn't depend on Congress
MISTR provides free PrEP directly — no government program required. Free consultation, labs, medication, and delivery in all 50 states.
ANDR735
Using this code at signup helps us achieve our mission of getting free PrEP out to all who need it.
How Funding Cuts Affect PrEP on the Ground
Community health centers
FQHCs serve over 30 million patients, many of whom rely on these centers for PrEP. Reduced federal funding, combined with Medicaid cuts, could force centers to reduce hours, staff, or services. The January 2025 federal funding freeze (later overturned by courts) already disrupted FQHC operations and created lasting uncertainty.
PrEP navigation services
Many community organizations employ PrEP navigators — trained staff who help people understand their options, complete applications, and start PrEP. These positions are often funded by EHE grants. Reduced funding means fewer navigators at exactly the time people need more help figuring out access.
HIV testing and surveillance
PrEP requires an HIV test before starting and quarterly testing while on it. CDC-funded testing programs at community organizations and health departments provide free testing. Budget cuts could reduce testing availability, creating a bottleneck for PrEP access.
State PrEP Drug Assistance Programs
Some state PrEP DAPs receive partial federal funding. States facing their own budget pressures from Medicaid cuts may struggle to maintain or expand these programs. Currently about 12 states operate dedicated PrEP DAPs.
What Survived and Still Works
- ACA preventive services mandate: PrEP must be covered at $0 by all ACA-compliant insurance plans. This is law, not a program that can be defunded.
- Medicaid PrEP coverage: Medicaid covers PrEP in all expansion states, though Medicaid itself faces cuts (see our Medicaid cuts guide).
- Medicare PrEP coverage: Part B covers PrEP at $0 since September 2024.
- Gilead Advancing Access: Manufacturer program — not government funded — continues providing free and reduced-cost PrEP.
- ViiV copay program: Continues for Apretude (injectable PrEP).
- Telehealth providers: MISTR and others operate as private businesses, not dependent on federal grants.
Government-proof PrEP access
MISTR doesn't depend on federal funding. Free PrEP — consultation, labs, medication, delivery — for everyone in all 50 states, DC, and Puerto Rico.
ANDR735
Using this code at signup helps us achieve our mission of getting free PrEP out to all who need it.
What You Can Do
- Use your insurance: If you have insurance, PrEP is free. Use it.
- Know your alternatives: Bookmark your state's PrEP page and know the local programs available to you.
- Establish care now: If you've been putting off starting PrEP, don't wait. The access landscape is uncertain, and having an active prescription is your best protection.
- Spread the word: Many people still don't know PrEP is free. Share this information with your community.