Impact of Medicaid Expansion on PrEP Utilization in the US: 2012–2018

We investigated the impact of Medicaid expansions made possible by the 2010 Affordable Care Act on HIV Pre-Exposure Prophylaxis (PrEP) utilization in the US over the period 2012–2018. We used data on PrEP utilization from Symphony Health in a difference-in-differences regression analysis with bootstrapped standard errors. We found that Medicaid Expansion resulted on average in 7.78 additional estimated PrEP users per 100,000 population on a yearly basis (z = 2.72; p = 0.007). When restricting the sample to males, Medicaid Expansion resulted in 14.67 additional PrEP users per 100,000 population each year (z = 2.5; p = 0.012). People in the age group 25–34 were those who benefitted the most from Medicaid Expansion with 16.95 additional PrEP users per 100,000 population per year attributable to Medicaid Expansion (z = 3.2; p < 0.001). States that are considering expanding Medicaid may recognize the benefits in PrEP utilization we document here.