Democrats representing Florida in Congress say Florida’s Health Department doesn’t need to nix support for 10,000 AIDS patients. Worse, they say doing so could both cost lives and lead to further spread of the disease.
U.S. Reps. Lois Frankel and Debbie Wasserman Schultz slammed a recent decision by the Department of Health (DOH) to change eligibility requirements for the Ryan White AIDS Drug Assistance Program. That program, named for deceased child AIDS activist Ryan White, provides prescription drugs for more than 50,000 people living with HIV or AIDS in Florida. But financial eligibility changes strip coverage for more than 10,000 people.
“Researchers estimate the average lifetime health care costs associated with HIV infection can get up into the hundreds of thousands,” said Frankel, a West Palm Beach Democrat.
She made the comments on a press call featuring Florida Democrats and medical experts.
Frankel said the decision to kill funding for the program likely means a death sentence for many who will lose access to care, and now she wants the U.S. Department of Health and Human Services to investigate Florida’s administration of the program.
Wasserman Schultz, a Weston Democrat, said ending coverage for many would be a choice, and a wrong one, by Gov. Ron DeSantis’ administration.
“This is a lifeline that provides critical financial assistance to low-income Floridians living with HIV and AIDS. It helps ensure that they can afford their prescriptions and their health insurance, and despite its resounding success now the program is in jeopardy,” she said.
She said the change means most Floridians applying for the program would be denied if they made $120,000 or more, but HIV medication can cost thousands each month.
The subject has already spurred discussions in the Florida Legislature about whether other funding should be diverted.
Florida Surgeon General Joseph Ladapo told the Senate Health and Human Service Appropriations Committee, “It’s a really, really serious issue,” as reported by the Tampa Bay Times.
He notably blamed a budget shortfall on a federal government shutdown in the Fall, one that ultimately failed to lead to any extension in funding for pandemic-era Affordable Care Act tax credits. Ultimately, he said, that left funding for the program $120 million short.
But cutting the AIDS program is the wrong answer, experts on the call said. Michael Rajner, a public health advocate who personally has lived with HIV since 1995, said cutting the eligibility for the program will create an impossible financial burden on many patients.
“We need the Surgeon General and the Governor to give a halt to this and reverse these cuts and find the money, whether it’s through a budget spending authority request to the Legislature and the Governor,” he said.
Moreover, he said he believed money had been misappropriated. DOH has been criticized for spending money on marketing campaigns about marijuana and abortion ballot measures ultimately defeated at the ballot box last year, though Rajner declined to say explicitly which funding he was referring to. But he said some spending mistakes are easily documented.
“This is a problem that they created themselves because of how they administer the program and the fact that they’ve also forced out several staff over the last year,” Rajner said.
Carl Baloney Jr., President and CEO of AIDS United, said the consequences of cutting participation in the program could be far-reaching.
“This is not only morally wrong, it’s financially reckless,” Baloney said. “Consistent HIV treatment saves money, and disrupting care leads to emergency room visits, hospitalizations and higher uncompensated care. Florida is acting without transparency, without following the required regulatory process.”
Wasserman Schultz noted that Biktarvy was the most prescribed once-daily pill used by HIV patients, and forcing people to switch off that drug could cost individuals thousands each year and put their health at risk.
Dr. Elizabeth Sherman of Nova Southeastern University, an HIV clinical pharmacy specialist, said Florida ranks third in the nation right now for new HIV diagnoses. But with the help of public funding, the state has also seen fast incorporation of treatments like Pre-Exposure Prophylaxis, or PrEP, which uses drugs that not only treat HIV, but prevent its transmission.
That suggests that ending programs won’t just shorten lives, but will potentially lead to more infections.
“We have been the envy of many other states for successfully implementing test-and-treat programs where people with HIV are started on treatment on day one of their diagnosis,” she said. “We can continue to make incredible progress, or we can let our guard down now and watch it get worse.”
Frankel dismissed accusations that the problem came from the federal government. The U.S. House Appropriations Committee member said Florida has not requested additional help.
“Florida, I think, last year got about $130 million. And as far as I know, there has not been any request by the federal government to the states to put in their own funds,” she said, “nor do I know of any outreach by Gov. DeSantis to any of us on appropriations for more money.”
She said the impact on eligibility warranted a federal investigation to figure out the true cause of the funding shortfall.