Thousands of Floridians soon will lose access to HIV/AIDS medications and insurance coverage if changes recently put forward by the Florida Department of Health take effect, the AIDS Healthcare Foundation contends in a petition filed Tuesday.
The AHF, the largest HIV/AIDS nonprofit organization in the world, has filed a petition in Tallahassee with the Division of Administrative Hearings, seeking an expedited hearing against the Department of Health’s changes to the current AIDS Drug Assistance Program and eligibility requirements. The foundation asks that a final order against the department be issued within 14 days.
The federally funded program, referred to as ADAP, provides low-income people living with HIV with access to prescription medications directly or through health insurance that covers the cost of HIV medications.
Beginning earlier this month, the state DOH sent at least two versions of letters to current ADAP recipients explaining that some would lose their insurance coverage by March 1 and in others, that people currently taking the “gold standard,” once-a-day-pill Biktarvy for treatment would no longer have access to the medication, according to the AHF’s petition. Access to Descovy, another prescription medication option, will be available only to people with renal insufficiencies.
A redacted letter from the Department of Health that was received by an ADAP client was included in the AHF’s petition to the Division of Administrative Hearings. (Screenshot of AHF petition)
Both letters noted that clients would only receive benefits if their income is at or below 130 percent of the federal poverty level — a significant drop from the previous threshold of at or below 400 percent of the federal poverty level.
Previously, an individual making up to $62,600 would fall within the income requirements of at or below 400 percent. With the change, an individual making any more than $20,345 would no longer qualify, according to the most recent poverty guidelines.
The changes were “illegally enacted,” the AHF alleges, by not going through the appropriate rule-making process required by law.
Losing or restricting access to Biktarvy and Descovy can lead to a viral rebound for a person who had been prescribed the medication and broader implications of potential increases in HIV transmission, the AHF says in its petition.
“These medications turn HIV/AIDS from a fatal disease into a manageable condition,” the petition says. “Removing or interrupting any part of that system can lead to viral rebound, drug resistance, hospitalization, and death.”
In an update on the state’s AIDS Drug Assistance Program website, the DOH says the recent “adjustments” were caused by rising healthcare premiums across the country and less grant funding under the Ryan White HIV/AIDS Program, which funds the ADAP. The department will cover costs for affected clients for a two-month transition period, according to the update.
“These adjustments will prevent a shortfall of more than $120 million for Florida,” the DOH’s update says.
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