Facing a lawsuit over steep cuts to a state healthcare program that helps HIV patients afford life-saving drugs, Florida Gov. Ron DeSantis is using his emergency powers to end their coverage — a move that advocates say could cost lives and trigger a wave of new HIV/AIDS cases in the state.
Advocates say theThe emergency rule, which removes an estimated 10,000 to 16,000 patients from their state medication funding starting March 1, will create a public health emergency. By standing between HIV patients and their medication, they say, DeSantis risks pushing the state back to the days when the deadly AIDS virus swept unchecked through vulnerable communities.
Governor Blames Federal Budget Cuts
DeSantis blamed federal budget cuts and rising healthcare costs for the decision. But Esteban Wood, director of advocacy and legislative affairs for the nonprofit AIDS Healthcare Foundation, says the government’s reasoning doesn’t hold up under scrutiny.
“Florida is making the deepest cuts to AIDS drug assistance of any state in the country, according to national program data,” Wood says. “And no one has explained to these patients what they are supposed to do on March 2.”
State officials, he says, made these changes without following a requirement that state agencies hear from the community and abide by a 21-day waiting period before making any changes. AHF sued the state and has been granted an expedited hearing.
Florida typically ranks in the top 3–5 states for HIV diagnosis rates and the state’s Black community has been hardest hit. Although Black residents make up just 17% of the state’s population, around 40% of its HIV/AIDS patients are Black.
At issue is the state AIDS Drug Assistance Program, which helps low-income patients pay for HIV and AIDS medications from their state-paid health insurance, which is the program’s primary funding source.
The state first announced in January that it would change the program by lowering the income eligibility threshold from 400% of the federal poverty level to 130%. This means effective March 1, only households earning $20,300 per year or less wouldwill be eligible for coverage; previously, the income cap had been $62,600 per year.
These changes could cause 16,000 Floridians to lose coverage for HIV drugs.
At the same time, Florida also decided to stop covering the cost of Biktarvy, the most popular HIV medication in the country, without giving prior notice. The manufacturer’s price for Biktarvy is roughly $4,200 for a 30-day supply, although retail prices could be much higher.
Ending coverage for the drug endangers patients who have achieved undetectable viral loads because switching medication can trigger irreversible drug resistance.
Decision Made Just Before Legal Action
On Feb. 11 Florida announced it would adhere to the formal rulemaking process, which led the court to pause AHF’s legal challenge. But in a slight-of-hand move just before a hearing on the case, the state’s department of public health used its emergency powers to eliminate health insurance premium assistance entirely and terminate currently enrolled patients effective March 1.
Michael Weinstein, AHF president, says the DeSantis administration issued this emergency order “because they knew we were going to win.”
The state “[has] done every cynical ploy to avoid due process,” Weinstein says. “We still don’t have the documents that actually back up the fact that there is no money, or that this is an emergency. This just represents a reckless disregard for the public health of Florida.
The emergency rule, however, expires in 90 days. Bipartisan majorities in both chambers of the Florida Legislature have proposed bridge funding to maintain ADAP coverage, including a Senate proposal that would preserve the current poverty-level eligibility threshold. But the new law wouldn’t take effect until the start of the state’s next fiscal year on July 1.
However, AHF has also asked the court to reverse the public health department’s action. Weinstein says the court has to act to protect “real people who show up to their appointments, take their medications, and do everything their doctors ask.”
If DeSantis gets his way, “Florida will pay a terrible price,” Weinstein says. ”It will result in more infections. It will result in people becoming ill and presenting at the emergency room. This is not a political battle. This is a battle for humanity.”
*Source: AIDSVu.org