The politics of HIV

Catching HIV is one of the last worries on the mind of the young gay men I meet. The virus that can turn into full-fledged AIDS killed millions of men and made a generation of survivors wary of sexual contact. Now we learn that in Florida patients who need drugs pay higher co-pays:

The Affordable Care Act ended denial of coverage for preexisting conditions and, with the opening of the healthcare marketplace in October 2013, people with HIV/AIDS could enroll in health insurance for the first time under the ACA.

But an analysis by the AIDS Institute of Florida’s silver-level health plans found that the four companies placed HIV and hepatitis drugs in their highest formulary tiers, meaning that people who need those drugs must pay the highest out-of-pocket costs for them. According to the study:

• CoventryOne places all HIV drugs in Tier 5 of its formulary, requiring a 40 percent co-insurance after a $1,000 prescription deductible.

• Cigna also places all HIV and hepatitis drugs in Tier 5 with 40 percent co-insurance after a deductible ranging from $0 to $2,750.

• Humana places all HIV and hepatitis drugs in Tier 5 with a 50 percent co-insurance after a $1,500 deductible.

• Preferred Medical places all HIV drugs and all but two hepatitis drug in a Specialty Tier requiring 40 percent co-insurance.

In each case, most or all of the drugs require prior authorization.

Because these victims are often the poorest, they have no advocates; like the rural victims of the mindless dicta which bans states like mine from receiving the ACA’s Medicaid expansion or who make too much over the poverty line to qualify for federal aid anyway, they’re in limbo.

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