D.C. Council Eases PrEP and PEP Access, Nonprofits Weather Federal Funding Gaps
We invite you to read this great article from The Washington Informer which features commentary from Kyle Benda, D.O., our Medical Site Director at Whitman-Walker Health’s 1525 (NW) clinic.
“During the latter part of 2025, Whitman-Walker Medical Clinic DC counted among eight organizations that testified before the D.C. Council’s Committee on Health in support of the PrEP DC Amendment Act. As the first quarter of 2026 wraps up, staffers are still calling insurance companies in response to the influx of prior authorization and cost-sharing prompts for prophylaxis.
That’s why Dr. Kyle Benda said that he’s looking forward to seeing Parker’s legislation come into effect.
“I don’t have a reason why more insurances are requiring prior authorization,” said Benda, medical director at Whitman-Walker Health at 1525, located near Logan Circle in Northwest. “But I do know that with the new enactment starting in 2027…they won’t be able to create prior authorization burdens when patients are seeking PEP services, and that is going to be a really, really important factor in just taking some of the pressure off an already stressful situation.”
Whitman-Walker, a provider of inclusive, community-based primary health care predominantly frequented by HIV-positive D.C. residents and members of the LGBTQ community, has nearly 30 staff members who are prepared to provide PrEP and PEP. Amid federal spending cuts, the clinic continues to seek grants while clinical and non-clinical team members collaborate via PrEP navigator programs to help clients maintain their prophylaxis regimen.
Benda, who’s in his fourth year at Whitman-Walker as a staff physician, says that, even as the stigma around HIV wanes, there remains the issue of ensuring that community members can access prophylaxis in a timely fashion.
He told The Informer that insurance matters often complicate that mission.
“We’ve seen an increase in the amount of prior authorizations needed for app services and then some more prior authorizations needed for our long-acting injectables for PrEP,” said. “There’s been some changes to coverage for some folks when it comes to some of the public benefits provided by D.C. that have changed a few ways that….there’s been coverage for certain medications.”
After a budget deliberation cycle that resulted in the narrowing of public health benefits, getting coverage for PrEP and PEP has become an even more confusing endeavor.
“Many patients don’t know what their insurance covers and what they don’t. Also, many providers don’t know what specific insurance plans will cover and what they won’t,” Benda told The Informer. “We often don’t find that out until we try a prescription. Certainly, insurance barriers or needing to navigate the insurance approval process can take a significant amount of time and administrative burden and can delay initiation of PrEP.”
READ MORE:
