AN ACT TO AMEND TITLE 18, TITLE 29, AND TITLE 31 OF THE DELAWARE CODE RELATING TO INSURANCE COVERAGE FOR TREATMENT TO PREVENT HIV INFECTION.

Removed all 'essential support services' that the Senate had added, including HIV testing, Hepatitis B and C testing, kidney function assessment (creatinine testing), pregnancy testing, STI screening and counseling, and adherence counseling. The bill now only mandates coverage for PrEP and PEP medications themselves.

Added explicit exemptions for accident-only, specified disease, hospital indemnity, Medicare supplement, long-term care, disability income, and other limited health insurance policies from the coverage mandate.

Changed sponsorship from a single-senate bill (Sen. Pinkney) to a multi-chamber bill with four primary sponsors (Rep. Chukwuocha, Sen. Pinkney, Rep. Morrison, Rep. Neal) and nine additional House co-sponsors, reflecting the House's rework of the legislation.

Removed the Senate's detailed 'therapeutic equivalent' definition and rules, which had specified that plans need not cover all FDA-approved equivalent versions of a PrEP or PEP drug, that long-acting versions with different durations are not therapeutically equivalent, and that provider-recommended specific drugs must be covered without cost-sharing.

Changed the applicability date from December 31, 2026 (as set by the Senate) back to December 31, 2027. The synopsis notes this was done so insurance companies can file rates that include the cost of the required coverage.

Added exceptions for catastrophic health plans (under ACA section 1302(e)) and high-deductible health plans (under IRC section 223(c)(2)), allowing cost-sharing where it would cause the plan to lose its federal tax classification. For HSA-qualified HDHPs, the no-cost-sharing rule only applies after the deductible is met.

Changed the definition of 'medically necessary' from a cross-reference to existing code sections (as the Senate had done) to a self-contained definition: 'includes prescribing PrEP and PEP to individuals who are at increased risk of HIV acquisition.' Also removed the Senate's added 'FDA' shorthand definition.