Temporary relief was granted this week for low-income HIV patients, but the push to ensure long-term access to lifesaving medication has just begun.
On Tuesday, Gov. Ron DeSantis signed a bill into law that temporarily suspends an emergency rule by the Florida Department of Health that limited eligibility for the AIDS Drug Assistance Program.
The rule had lowered the income level at which people qualify for medication assistance from 400% of the federal poverty level ($63,000 a year for an individual) to 130% (about $20,000 a year).
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The rule change impacted half the enrollees, more than 15,000 people, according to a report by AIDS United.
Now, advocates are working with lawmakers to make sure the emergency rule doesn't take effect again.
"Our hope is that lawmakers continue to recognize the urgency of this crisis," said John Harris Maurer, the public policy director for Equality Florida.
What happened to the HIV medication assistance?
The legislative session came to an end earlier this month without a budget for the next fiscal year. A special session has been scheduled to start April 20 to pass a state budget.
Earlier this year, the Department of Health announced the emergency rule changing access to ADAP. The rule took effect at the start of March. State health officials cited increasing health insurance premiums and a lack of federal funding.
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"The Department of Health pointed to a $120 million budget shortfall in a program, and on the basis of that accounting, proposed dramatic cuts," Maurer said.
He said legislators saw the need to address a long-term solution, but also saw the writing on the wall that a budget was not in the near future. Thus, bill was proposed as a stopgap to hold off the emergency rule until June 30, the end of this fiscal year.
The bill passed the Senate and House without opposition.
What the bill does and doesn't
The law went into effect immediately, allowing those within 400% of the federal poverty level to access medications worth over $1,000.
However, the law doesn't reset access back to the status quo. There are two key components it does not address, Maurer said.
It does not cover the expense of a medication known as Bektarvy. The medication is a once-a-day pill, considered an "antiretroviral therapy." It impedes the virus's ability to replicate, reduces the viral load in a patient, and can even increase the amount of white blood cells.
Simply put, Bektarvy controls HIV and can even stop a patient from transmitting it, though it is not a cure.
Without insurance, a 30-day supply can cost over $5,000.
About 60% of clients on ADAP were prescribed Bektarvy, said Michael Rajner, who has HIV and has been speaking with legislators to fully restore the program.
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"The advantage of having a one-pill-a-day medication (as opposed to) a two-pill-a-day is for medication adherence. The more pills you have to swallow, the more issues it could present for individuals, depending on their different circumstances," he said.
The other ADAP component that law does not bring back is "premium assistance," which provided monthly payments toward health insurance premiums such as employer-based coverage or Affordable Care Act Marketplace coverage.
"If there is not sufficient funding in the next budget, we will be right back in the same posture," Maurer said.
He and other advocates are working with legislators ahead of the special session to secure funding for the ADAP.
"I do expect that we will see something in the budget," Maurer said. "What it is, obviously, remains to be seen."
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