“States that have changed their eligibility programs or don’t have a waiting list, or some states have disenrolled their patients, that’s a kind of silent crisis, I think,” said Jeff Graham, executive director of Georgia Equality, an advocacy group on gay issues. His state holds the second-highest number of patients on a waiting list: 1,520.
In recent weeks:
l Illinois tightened eligibility for the state program that helps HIV patients pay for their medications. On July 1, the cutoff for the program will fall from an annual income of 500 percent of the federal poverty level, or $54,450, to $32,670.
l Georgia cut $100,000 from its program, which serves 4,300 people.
l Florida, which already has the nation’s longest waiting list for HIV prescription drug assistance, held public hearings as officials consider cutting the eligibility threshold in half to $21,780 or less in annual income.
l Utah and Alabama are reopening their waiting lists.
AIDS drug assistance programs, or ADAPs, pay for HIV medications for low-income patients when they cannot afford the drugs and don’t have insurance or have limited coverage that fails to include the cost of the drugs. Nearly 174,000 people are covered by the programs, according to the most recent information from the National Alliance of State and Territorial AIDS Directors (NASTAD).
Murray Penner, deputy executive director of NASTAD, said the average annual cost for ADAP drugs is $11,388 per person, but that is significantly less than individuals trying to buy their own drugs would pay.
The federal government provides the bulk of the ADAP financing through the Ryan White Care Act. This year the budget is $885 million, $25 million more than last year, according to Brandon Macsata, chief executive of the ADAP Advocacy Association. Many states supplement the funding.
But the number of people seeking help is rising after the recession pushed millions of people out of work and cut their insurance coverage. And the downturn in the economy has created budget shortfalls for states and limited their ability to help those patients.
ADAP is not an entitlement program, so even applicants who are qualified can be turned away or put on waiting lists if funding is not available.
Advocacy groups say the pullback by states is shortsighted: HIV patients who get the antiretroviral drugs are generally able to manage their disease, allowing them to continue working and keeping long-term medical costs down for the state. New research even suggests that people put on medication immediately after being diagnosed are less likely to spread the disease.