HIV-positive Floridians are anxiously watching the calendar as a March 1 deadline approaches for major changes to the state's AIDS Drug Assistance Program, known as ADAP.
The proposed cuts would lower the income threshold for qualification from 400% of the federal poverty level to just 130% and end subsidies for Affordable Care Act plans. The AIDS Healthcare Foundation estimates 16,000 people could lose benefits.
Dr. Steven Santiago, chief medical officer at Care Resource Community Health Centers, said the situation has already triggered widespread concern.
"There's a lot of anxiety for the patients because they don't know if, effective March 1st, they're not going to have access to their medication, or if they're going to lose their health insurance, not qualify for ADAP, Ryan White, et cetera," said Santiago. "And also, how are they going to be able to get their medication changed in time?"
The Florida Department of Health cites "rising health care insurance premiums nationwide" and a $120 million budget shortfall as reasons for the changes.
But the AIDS Healthcare Foundation has filed a public records lawsuit seeking documentation of that shortfall, noting Florida is the only state making such cuts.
More than 128,000 Floridians live with HIV, and the state ranks second in the nation for new diagnoses.
Santiago, who has practiced HIV medicine for over 30 years, warned that the cuts could reverse Florida's success in viral suppression among ADAP patients. The viral suppression rate currently stands at 92%, one of the highest in the nation.
"Now we're going to have patients with detectable virus that can transmit, that can become sick, that are going to end up in the emergency room requiring more expensive services," said Santiago, "and in a way transferring some of the cost from the state government for these patients to local governments and hospital systems and clinics."
A ruling from last week's expedited hearing is expected before March 1. A public comment period on the proposed changes is open until March 4.
Meanwhile, the state legislature is working to restore funding, with the Senate proposing $118 million and the House proposing $68 million. The budget won't be finalized until after the deadline, leading some lawmakers to advise patients to stockpile medications.
