Governor Healey’s signing of the FY27 budget marks an important step forward for LGBTQIA+ health, HIV prevention, and health equity in Massachusetts. At a time when access to affirming care and evidence-based public health are under threat across the country, Massachusetts is choosing to protect care, reduce barriers, and invest in the health and dignity of LGBTQIA+ people.
This year’s budget, together with landmark protections signed into law, advances several priorities central to Fenway Health’s mission:
Gender-affirming care funding. The budget adds $4 million to the state’s Affirming Health Care Trust Fund — the first fund of its kind in the nation, dedicated to protecting access to gender-affirming care. The Fund began with $1 million when it was established last year, grew by $3.5 million this fiscal year, and with this new $4 million now stands at $8.5 million. That is a remarkable trajectory in a short time, and a national model others are watching.
Protecting access to HIV prevention. This session, our advocacy also helped advance a truly seminal and extraordinary step forward on HIV prevention: ensuring that PrEP, the medication that prevents HIV, is covered without out-of-pocket costs, prior authorization, or other delays across state, MassHealth, and private insurance, and that it reaches people in settings where access has historically been hard, including correctional facilities. This is a landmark advance for public health, and one that will save lives and move us closer to ending the HIV epidemic.
Support for an LGBTQ+ Medical and Research Fellowship Program. The budget includes $200,000 for Fenway Health’s Medical Education and Health Research Fellowship Program, helping us train the next generation of clinicians and researchers.
LGBTQIA+ older adults. The budget provides $120,000 to support the Massachusetts Commission on LGBTQ Aging, along with funding for provider training through the LGBTQIA+ Aging Project — so that home care workers, long-term care and nursing home staff, and others are better prepared to care for LGBTQIA+ elders and older people living with HIV.
“The Massachusetts legislature has taken a critical step to protect public health and ensure access to one of the most powerful HIV prevention tools ever developed,” said Kenneth Mayer, MD, Medical Research Director and Co-Chair of The Fenway Institute. “PrEP can protect people against HIV infection, yet only about a minority of eligible people in Massachusetts have a prescription. Cost, prior authorization, and other barriers have long stood in the way, particularly for the communities most impacted by the epidemic. By codifying these protections in state law, Massachusetts is making clear that it prioritizes infectious disease prevention and reducing racial disparities in the HIV epidemic.”
“For the first time in the country, a state built a dedicated fund to protect gender-affirming care, and Massachusetts keeps choosing to grow it,” said Dallas Ducar, Executive Vice President of External Affairs at Fenway Health. “In just a few years, the Affirming Health Care Trust Fund has gone from an idea to $8.5 million, even as other states move to strip this care away. That is what leadership looks like – not only defending access, but investing in it. We are grateful to the Governor and the Legislature for standing with LGBTQIA+ people when it matters most.”
“Removing cost and administrative barriers to prescribing PrEP is one of the most consequential things a state can do to prevent HIV,” said Sean Cahill, PhD, Director of Health Policy Research at the Fenway Institute. “When PrEP is available with no out-of-pocket costs and no prior authorization, including in correctional settings, where the need is often greatest, more people can start it and stay on it. This is critically important given the 34% rise in new HIV diagnoses since 2022 and the striking racial and ethnic disparities that persist here in Massachusetts.”
“Fenway Health is grateful to Governor Healey, legislative leaders, GLAD Law, and coalition partners across the Commonwealth for advancing these historic priorities,” said Jordina Shanks, CEO of Fenway Health. “This progress reflects years of advocacy by patients, providers, advocates, and community organizations who believe health care should be compassionate, evidence-based, and accessible to all. We will continue working with patients, providers, advocates, and policymakers to protect access to care and ensure LGBTQIA+ people across Massachusetts can get the compassionate, evidence-based healthcare they need.”