The Illinois health insurance marketplace open enrollment period ends on Feb. 15, 2015, and it is crucial that people living with HIV and AIDS have complete information to choose a marketplace plan.
Today, the AIDS Foundation of Chicago (AFC) is releasing information on HIV medication coverage for each marketplace plan giving examples of what a person with HIV might pay for HIV medications.
If you qualify for the Illinois Medication Assistance Program (MAP, formerly ADAP) and Premium Assistance Program (PAP, formerly CHIC), and choose a plan that is compatible with MAP/PAP, MAP/PAP will cover premiums and any out-of-pocket costs for HIV medications.
AFC’s drug coverage guide shows that without help from MAP/PAP, many people with HIV would be unable to obtain life-saving medications. While three insurance companies have affordable medication copays, the remaining four companies feature out-of-pocket costs of as much as $2,250 a month for an HIV medication regimen. MAP/PAP can help people with HIV by covering these out-of-pocket costs.
Finding the right plan that’s compatible with MAP/PAP can be complicated, but our in-person counselors can help! You can contact AFC’s health insurance in-person counselors and benefits coordinators at 312-784-9060 for assistance.
With the deadline fast approaching, we encourage you to act fast and seek the help you need to choose the best plan available in the marketplace before the deadline of Sunday, Feb. 15, 2015.
Download the guide on this page.
AFC also provides an assessment on the cost of pre-exposure prophylaxis (PrEP) for those who are HIV-negative.
The AIDS Foundation of Chicago (AFC) is pleased to announce 18 award recipients of its 2014 Challenge Grants — a legacy program that awards financial support to organizations that are making a difference in the HIV epidemic and the lives of people living with the virus in Illinois. A combined total of $220,000 was awarded among the receiving organizations.
This year, funding was determined based on four categories: Community Mobilization, Strengthening Communities & Reducing Health Disparities, Integration of Service Systems, and Improving Outcomes at Every Stage of HIV Care. These categories directly align with the initiatives set forth by AFC’s 2013-2015 Strategic Plan.
“After an in-depth review process by our Grant Making Committee, we are excited to announce this year’s grant recipients and look forward to supporting an array of innovative and strong HIV/AIDS programs,” said Cynthia Tucker, AFC’s director of Prevention and Community Partnerships.
AFC will be providing funding to the following organizations:
- AIDS Legal Council of Chicago
- Alexian Brothers Housing and Health Alliance
- Care2Prevent at the University of Chicago
- Catholic Charities of the Archdiocese of Chicago/Lake County Stands Against Stigma Coalition Enhancement
- Chicago House & Social Service Agency
- FCAN
- Heartland Health Outreach
- Hektoen Institute for Medical Research/City-Wide Adolescent Sexual Health Roundtable
- Howard Brown Health Center
- LAF
- McDermott Center (Haymarket)
- New Age Services Corporation
- Open Door Clinic
- Planned Parenthood of Illinois
- Puerto Rican Cultural Center — Vida/SIDA/MSM Taskforce
- The CORE Foundation/Step Up Get Tested Plus
- The Night Ministry
- TPA Network
The 2014 Challenge Grants prioritize strategies advancing the fight against HIV/AIDS within the following populations identified in the National HIV/AIDS Strategy: gay and bisexual men and other men who have sex with men of all races and ethnicities, African Americans, Latinos/Latinas, transgender people and women of color.
“Given the major changes facing the HIV/AIDS service sector, including implementation of the Affordable Care Act, the National HIV/AIDS Strategy, new prevention strategies and the increasing need for community collaboration, our Challenge Grants give us an opportunity to fund innovative programs that address immediate and long-term priorities in an ever-changing HIV/AIDS landscape,” said John Peller, AFC president/CEO.
Each year, Dec. 1 offers the world an opportunity to ponder the HIV epidemic and remember the millions who have died from HIV-related complications over the last 30 years. On World AIDS Day, people around the globe will take a moment to consider the impact this virus has had on the course of human history — and look ahead to the future and a world without new HIV transmissions.
The AIDS Foundation of Chicago (AFC) is proud to honor this important day through big announcements, speaking engagements, celebratory events, and new ways of learning more about the disease and AFC’s impact on it.
Here is a list of key ways AFC will commemorate World AIDS Day. Will you join us?
A new aidschicago.org. Starting on Dec. 1, AFC will have a brand-new way to assist people living with and vulnerable to HIV in Illinois and around the world. The new aidschicago.org will tell AFC’s 30-year story through the people who serve — and are served by — the organization. A new dynamic search function will help users find the information they seek rapidly; refreshed navigation, content, images, and stories will tell the story of HIV and AFC in a new way.
The Ryan White program, then and now. On Dec. 1, AFC’s Director of Special Projects Roman Buenrostro will be a featured speaker at a luncheon at Erie Family Health Center’s Humboldt Park location. He will describe the current landscape for Ryan White participants and discuss how the program to assist people living with HIV has changed over the last decade. For information about this event, email Erie’s health educator and outreach coordinator, Emeralda Rosales.
Dine out with Francesca’s. On World AIDS Day, Chicago-area Italian restaurant group Francesca’s will donate 15 percent of net bills presented with a special flier to AFC in honor of those living with HIV. To participate, print this flier, dine out on Dec. 1 at one of the four Francesca’s locations listed on the flier, and present the flier with your bill to the server.
World of Chocolate. AFC’s annual winter gala, World of Chocolate, will welcome 1,500 guests to the majestic Chicago Union Station on Thursday, Dec. 4, for a night of food, drinks and dancing. If you are interested in tasting chocolaty treats from 24 of Chicago’s top chefs, enjoying an open bar among fellow HIV/AIDS allies and dancing the night away, purchase tickets at aidschicago.org/chocolate.
Assistance with health insurance enrollment. Several in-person counselors will be on hand at Center on Halsted’s World AIDS Day event on Saturday, Dec. 6 from 10 a.m. to 2 p.m. Stop by to learn more about your health insurance options through the Illinois marketplace, and enroll in a plan onsite. Learn more about Center on Halsted here.
Supporting policies that work for people with HIV. Policy Manager Molly McAndrew will unpack AFC’s key policy initiatives at the center on Halsted event on Dec. 6. Her brief presentation will cover legislation to cap the copay, provide mandatory screening for HIV and more. Learn more about Center on Halsted here.
Celebrating the Holidays with Friends. A benefit concert to raise funds for Step Up. Get Tested., a citywide collaboration to make HIV tests accessible to Chicago’s most vulnerable communities, will take place on Dec. 7 and 8 at Victory Gardens Theatre and include performances by Ledisi, Donald Lawrence, Pauletta Washington and more. Tickets and more information are available here.
The largest and longest running national coalition of community-based HIV/AIDS organizations, AIDS United (AU), is calling for the scale-up of pre-exposure prophylaxis, or PrEP. AIDS Foundation of Chicago (AFC) is a long-standing member of AU’s Public Policy Committee (PPC) and is a local, national and international leader on new HIV prevention technologies, including PrEP.
PrEP, a breakthrough in biomedical HIV prevention, involves a once-daily medication that reduces the risk of HIV infection by upwards of 90%. The PPC and AFC commit to raising awareness of and reducing barriers to a full scale-up of PrEP as a critically important prevention toolfor people at increased vulnerability to HIV infection.
Nov. 23, 2014, marked the four-year anniversary of the iPrEx study — the first randomized, controlled trial that found PrEP effective in reducing HIV infection risk. In July 2012, the Food and Drug Administration (FDA) approved Truvada as PrEP. Earlier this year in May, the Centers for Disease Control (CDC) released clinical guidelines for PrEP. Preliminary findings from two ongoing studies of PrEP in Europe, PROUD and IPERGAY, bolster the growing evidence for the effectiveness of PrEP. While not appropriate for everyone, it is clear that, when taken as directed, PrEP can significantly reduce new HIV infections. The time for debate on the effectiveness of PrEP is over.
“Our scientific knowledge that PrEP works and is a substantial tool to prevent HIV just keeps getting stronger,” said Michael Kaplan, President and CEO of AIDS United, a nonprofit dedicated to ending the AIDS epidemic in the United States through strategic grant-making, capacity building, formative research and policy. “It’s time to move forward on PrEP. Our task must now be to educate people at risk of HIV infection, leaders and policymakers about PrEP and make PrEP accessible and affordable throughout the United States.”
“The AIDS Foundation of Chicago (AFC) is in full support of efforts to scale-up PrEP and is taking decisive action,” says John Peller, president/CEO of AFC, a member of the PPC that serves the Chicago metropolitan area. “45,000 people become infected with HIV in the U.S. each year — 1,000 from our community. PrEP is an opportunity to reverse that trend.”
While the body of science showing PrEP is strong and continues to grow, it remains unknown and underutilized by the very people most likely to benefit from it. An August 2014 study by the Kaiser Family Foundation found that 80% of gay and bisexual men knew “only a little” or “nothing at all” about this important HIV prevention tool. People most at risk for HIV infection need to have full and accurate information to make an informed decision about PrEP, as well as support access and adherence to the daily medication.
“The results of this study clearly demonstrate the work that needs to be done to educate the American people about the reality of HIV/AIDS in 2014,” said Peller of AFC.
AFC has been a strong supporter of PrEP — and has contributed significant efforts to build awareness and access across Illinois. AFC is collaborating with partners in Chicago and other parts of Illinois to train the HIV workforce on PrEP and to educate communities who might benefit from PrEP. With the Chicago Department of Public Health, AFC has convened a working group of PrEP researchers, providers, advocates and educators to improve PrEP awareness and access, including the creation of PrEP centers of excellence.
“And we are delighted that the Illinois Department of Public Health will soon be launching a special project to help individuals in our state cover the cost of the PrEP medications — a bold and visionary move,” said Peller.
AU PPC members are focusing on how to scale up its appropriate use. Efforts going forward include raising awareness among their constituents of the benefits of PrEP, reducing barriers to access by ensuring insurance coverage and helping the medical community understand who stands to benefit most from this proven prevention tool. At the national level, AU will work do the same by researching barriers to access, developing better ways to message and discuss PrEP, and by advocating that the United States Preventive Services Task Force (USPSTF) review the clinical effectiveness of PrEP.
The PPC invites other AIDS-service organizations and HIV advocates to share their experiences, barriers and perspectives about what will be required to fully scale-up PrEP using the social media hashtag #PrEPWorks.
“While science has proven that PrEP works, individuals need all the facts and support to make decisions that are right for them. AIDS United believes PrEP is another critical tool to prevent new infections. Our PPC member organizations are committed to increasing awareness and working to eliminate barriers to access for all people who could benefit from this important prevention tool. PrEP will be part of ending the HIV/AIDS epidemic — but only if we can implement it widely,” said Kaplan.
In-person counselors will focus on connecting HIV-positive, LGBT, homeless Illinoisans to health insurance
For the second year, the AIDS Foundation of Chicago (AFC) has been awarded a grant to fund in-person counselors (IPCs) to help individuals enroll for health insurance through the Get Covered Illinois In-Person Counselor Program.
In collaboration with AIDS Legal Council of Chicago and Howard Brown Health Center, AFC will focus on connecting communities to health insurance plans who often face barriers to medical care — people who are HIV-positive, LGBT, experiencing homelessness, formerly incarcerated, aged 12-24 and/or experiencing severe mental illness.
“It’s crucial that we help our most vulnerable communities connect to health insurance options through the Affordable Care Act (ACA),” said Daliah Mehdi, chief clinical officer at AFC. “If we are able to help communities that see higher rates of HIV infection have access to care, we can make a difference in people’s lives — and the future of the epidemic.”
Last year, the AFC-managed In-Person Counselor Program connected 3,427 individuals to the information and assistance they needed through the trained guidance of 13 IPCs, and AFC aims to match this capacity with six IPCs during the second enrollment period, starting Nov. 15.
AFC will also have four Medical Benefits Coordinators who will assist clients in Chicago and the suburban areas who are living with HIV and need assistance enrolling in the marketplace, Medication Assistance Program and Medicaid.
The In-Person Counselor Program aims to help people complete Marketplace application forms before the enrollment deadline, assist people with applications to Medicaid, educate people about the fact that there is no deadline for Medicaid enrollment, and teach people about special enrollment periods.
Because AFC’s program is specifically designed to reach out to marginalized communities, IPCs will engage in cultural competency training to better understand the unique needs of each of their target populations. Beyond assisting those in need through the insurance enrollment process, IPCs will also be trained to guide clients to other resources that can help remove barriers to health care, such as housing programs, food pantries, domestic violence organizations, language assistance and Medicare.
AFC is one of 37 organizations that received part of a $25.8 million federal grant to support ACA implementation in Illinois.
Enrollment for coverage in 2015 through the Illinois Health Insurance Marketplace will run from Nov. 15, 2014, through Feb. 15, 2015.
Need help applying for insurance coverage? Call AFC’s hotline number to be referred to a Medical Benefits Coordinator or an In-Person Counselor: 312-784-9060.
The AIDS Foundation of Chicago (AFC) congratulates Illinois Governor-Elect Bruce Rauner on his victory last night. We and the community of HIV advocates stand ready to assist the governor-elect’s transition team as they plan for the new administration.
HIV and public health are not partisan issues. Every HIV infection averted through strong prevention programs saves the state over $380,000 in lifetime medical costs. Moreover, iron-clad scientific evidence shows that when people with HIV have access to comprehensive medical treatment, their individual health improves and their risk of transmitting HIV to partners is dramatically reduced. In fact, HIV treatment is one of the most powerful forms of prevention — and social supports like housing, case management, and food support help people with HIV stabilize their lives so they can focus on their health.
Last night, the people of Illinois spoke when they continued to elect state legislators who have worked to meet the needs of people living with and vulnerable to HIV. Illinois House Speaker Mike Madigan (D-Chicago) and Senate President John Cullerton (D-Chicago) still lead veto-proof Democratic majorities in Springfield that will require bipartisan solutions to the state’s problems. We look forward to working with our allies in the Illinois General Assembly to continue the state’s strong public health and HIV programs.
Throughout Illinois, many individuals and organizations have played a vital role in the state’s Medicaid program. AFC calls on Governor-Elect Rauner to approach the Medicaid program without partisan biases and work with these key stakeholders to develop a full understanding of this program and the essential health care services it provides to individuals and families throughout the state, including many thousands living with HIV.
AFC also urges the Rauner administration to continue the state’s efforts to obtain an 1115 Medicaid waiver. The waiver proposal includes an HIV health home, which would improve access to health care for people with HIV. We also ask Governor-Elect Rauner to continue the state’s nearly four-year effort to implement care coordination programs, including managed care. Illinois is too far down the road in implementing these programs to change strategies.
In addition, we call on Governor Pat Quinn and the Illinois General Assembly to act immediately during the fall veto session to end the state’s fiscal cliff. Without legislative action, current income tax rates will drop Jan. 1, putting an immediate $2 billion hole in the state’s $36 billion budget. The impact next fiscal year will be even greater.
Finally, we thank Governor Quinn and the leaders of his administration for their tremendous work. Thanks to Governor Quinn, the Affordable Care Act has fully been implemented in Illinois, HIV prevention and care programs are stronger and the Medicaid program is on a path to better care. We are grateful to Governor Quinn and agency heads — including Illinois Department of Public Health Director LaMar Hasbrouck, Healthcare and Family Services Director Julie Hamos, Human Services Secretary Michelle Saddler, and others — for their leadership and wish them well.
Governor Pat Quinn thanked runners and walkers and reiterated his commitment to HIV/AIDS services in Illinois this morning at the start of the thirteenth annual AIDS Run & Walk Chicago. The event welcomed more than 3,000 runners, walkers and volunteers to raise more than $380,000 for 32 organizations that support people living with HIV/AIDS.
The event took participants in the event’s 10K run and 5K run and walk along Chicago’s Lake Shore Path, starting and finishing in Arvey Field in Grant Park.
Governor Quinn was joined by Congressman Mike Quigley, Representative Greg Harris, Cook County Board President Toni Preckwinkle, and the AIDS Foundation of Chicago’s Interim President & CEO John Peller. The group motivated corporate teams, individual runners and staff and clients of HIV/AIDS service providers across the Chicago metropolitan area before they crossed the start line.
Morning festivities also included a performance by the Chicago Human Rhythm Project in celebration of Global Female Condom Day. Participants Danced4Demand along with the ensemble to warm up and increase awareness and availability of female condoms, and Governor Quinn marked his “demand” for female condoms on a Citywide map where attendees want to see more availability of this prevention device.
The 5K winners were Alyssa Bracy and Jeremy Solomon, and the 10K winners were Thomas Lynch and Lindsay Young. A full list of participant finish times is available at aidsrunwalk.org.
After the race, runners and walkers viewed the stoic AIDS Memorial Quilt panels on display, and many in attendance participated in free HIV screening at testing trucks in Arvey Field.
Through a flash mob performance, AIDS Run & Walk Chicago participant Armando Ramirez proposed to his longtime boyfriend, Joel Guzman. The couple embraced surrounded by friends, dancers and HIV/AIDS advocates.
Funds raised through AIDS Run & Walk Chicago will benefit programs and services for the AIDS Foundation of Chicago and 31 other metropolitan organizations that provide life-saving services to people living with HIV/AIDS. Since it was established in 2001, AIDS Run & Walk Chicago has netted more than $4.5 million to battle the epidemic.
Donations to AIDS Run & Walk Chicago will be accepted through the end of the year. To donate or learn more, visit aidsrunwalk.org or call 312-334-0946.
CHICAGO —HIV/AIDS activists have found a unique way to pressure the U.S. to prioritize and address rising rates of HIV among communities of color. In a report submitted to the United Nations, a national coalition of HIV/AIDS advocacy organizations details the disparate impact of HIV/AIDS on communities of color, and identifies the lack of U.S. action on social drivers of the epidemic in those communities as a human rights violation.
Led by the HIV Prevention Justice Alliance (HIV PJA), a project of the AIDS Foundation of Chicago (AFC), the report calls on the U.S. to make good on its ratification of the Convention on the Elimination of all forms of Racial Discrimination (CERD) in January 2013. In the Convention, the U.S. pledged to “address disparities in HIV prevention and care involving racial and ethnic minorities and other marginalized populations.”
“Unfortunately, U.S. efforts to combat HIV/AIDS in communities of color have fallen far short of their goals,” said Suraj Madoori, manager of HIV PJA, who will deliver the report to the UN in Geneva. “We believe that this failure to uplift the human rights of these historically marginalized people is a direct violation of this country’s pledge to adhere to CERD.”
According to the U.S. Centers for Disease Control and Prevention (CDC), African Americans represent approximately 12 percent of the U.S. population but accounted for an estimated 44 percent of new HIV infections in 2010. New infections among Latinos/Latinas were also significantly higher than their white counterparts in 2010. The report also details the rising epidemic among black gay and bisexual men, as well as transgender women.
“[H]igh infection rates are due in part to a combination of unjust and uneven policies and laws that enforce racism, stigma, criminalization and discrimination,” the HIV advocates’ report asserts. The report cites specific examples such as mass imprisonment, poverty, unemployment and lack of health care access as key contributors to the U.S.’s systemic failure to prevent new HIV infections among socially disenfranchised groups. Read the full report here.
“We believe that an intersectional approach to the epidemic is key to overcome racial inequalities,” explains report co-author Naina Khanna, Executive Director of the Positive Women’s Network of the United States of America (PWN-USA). “We need to address the impact of social drivers such as HIV criminalization laws, unemployment, and lack of access to overall health care, in order to make significant progress.”
Built on input and consensus from partners, with expert assistance constructing legal arguments from the Center for HIV Law and Policy, the report states, “[T]his disparity – in part due to laws, policies and practices – continues to systemically discriminate against communities of color; increases vulnerability to HIV transmission and to stigma and discrimination following HIV diagnosis; and places people of color living with HIV at undue risk for criminalization and human rights violations.”
In its 2013 compliance report to the CERD committee, the U.S. identified the National HIV/AIDS Strategy (NHAS) as its key method for eliminating racial disparities in new HIV infections. The NHAS aimed to take sweeping actions to prevent new HIV infections and support Americans living with HIV/AIDS, but the authors of the CERD report believe it will fall far short of its goals.
“We hope that the HIV advocates’ report to the U.N. will urge the U.S. to more effectively respond to the racial disparities in new HIV infections, reconfigure the NHAS to be more ambitious in its goals and encourage it to be more accountable in its implementation across vulnerable communities,” said co-author Kenyon Farrow, Director of U.S. and Global Policy at Treatment Action Group.
The coalition behind this report includes AFC and HIV PJA, PWN-USA, the Center for HIV Law and Policy, the Counter Narrative Project, National Working Positive Coalition, Sero Project, Treatment Action Group and Women with a Vision.
Human Service Appropriations Chairs Rep. Greg Harris and Sen. Heather Steans champions of HIV/AIDS funding
SPRINGFIELD — Amid partisan turmoil in the statehouse, the Illinois General Assembly voted in its last days of session in May to increase funding for HIV/AIDS services in the 2015 budget by $1 million. This move comes after weeks of uncertainty about the future of HIV/AIDS funding in the state.
The General Assembly passed House Bill 6096 Amendment 1, which not only boosted direct HIV services, but also increased funding for other social services offered in Illinois. The state supportive housing budget, for example, was increased by $2.6 million to assist an additional 896 people in need. Supportive housing helps low-income people who are homeless and living with chronic diseases, including HIV or behavioral health issues, live successfully in the community.
HIV funding cuts over the last several years have resulted in dramatic decreases in the availability of HIV prevention, housing and supportive services across the state, which threaten the lives of people living with HIV. Tireless advocacy by people living with HIV and their allies averted a $4 million cut to total state HIV spending for services such as prevention and care. The state AIDS Drug Assistance Program (ADAP), which provides life-saving medications to low-income people living with HIV, would have seen devastating cuts. Illinois’ ADAP investment enables thousands of people living with HIV to access essential medications that they otherwise could not afford.
“Lifesaving and sustaining programs such as these aren’t debatable. They can’t be cut because of differing politics or priorities in policies,” said Chez Ordoñez, Director of Government Relations at the AIDS Foundation of Chicago (AFC). “This money provides support for those Illinois citizens who are in need of the most help. These drastic cuts should never be political or fiscal priorities — they should always be moral ones.”
“While we applaud the increase in HIV/AIDS funding, the General Assembly passed a broken budget that fails to provide stable revenue for lifesaving state programs,” continued Ordoñez. “AFC will continue to lead community advocacy to urge elected officials to support sustainable revenue, such as continuing tax rates that were enacted in 2011.”
HB 6096 increased HIV funding from $25 million in FY14 to $26 million in FY15. Supportive housing funding increased to $30.4 million and is expected to support services for 12,000 people in the next fiscal year.
“House and Senate Human Services Appropriations Committee chairs Rep. Greg Harris (D-Chicago) and Sen. Heather Steans (D-Chicago) fought to protect the interests of the state’s HIV/AIDS community,” said John Peller, interim president/CEO of AFC. “We would like to greatly thank them for their advocacy and exemplary leadership. We are also grateful for leadership from members of the House Human Services Appropriations Committee, including State Reps. Sara Feigenholtz (D-Chicago), La Shawn Ford (D-Chicago), Robyn Gabel (D-Evanston), Esther Golar (D-Chicago), Elizabeth Hernandez (D-Cicero), Camille Lilly (D-Chicago) and Rita Mayfield (D-Waukegan).”
Media contact: Chez Ordoñez, 312-334-0928, [email protected]
Announcement sets stage for better HIV medication coverage in 2015
CHICAGO — In a statement issued on May 23, Illinois Department of Insurance (DOI) Director Andrew Boron informs insurers that the department will not permit health insurance plans that discriminate against people living with HIV/AIDS to be sold on the Illinois Health Insurance Marketplace in 2015.
According to the statement, “prohibition on discrimination applies equally to all health conditions, including but not limited to individuals with HIV/AIDS.”
“Thanks to Governor Pat Quinn and DOI Director Andrew Boron, Illinois is the first state in the nation to issue an explicit prohibition on discrimination against people with HIV in health insurance marketplace plans,” said John Peller, interim president/CEO for AIDS Foundation of Chicago (AFC). “This move serves as the latest example of the ways Governor Quinn has served as a watchdog for people living with HIV.”
AFC and AIDS Legal Council of Chicago (ALCC) received pro bono assistance from law firm Jenner & Block to illustrate possible gaps in coverage for people living with HIV/AIDS in current health plans available through Illinois’ insurance marketplace, which was established by the Affordable Care Act. AFC released a report in March 2014 that revealed the extremely high cost of HIV medications for marketplace plans and indicated that some plans are not covering certain HIV drugs at all.
“Health plans endanger the lives of people with HIV when they deny medications. The DOI’s statement underscores that this practice is discriminatory,” said Thomas D. Yates, executive director for AIDS Legal Council of Chicago.
“This is a major step toward fulfilling the Affordable Care Act’s promise to end discrimination by health insurers against people with pre-existing conditions, including HIV/AIDS,” said Daniel A. Johnson, a Jenner & Block associate. Johnson, along with colleagues Christopher C. Dickinson and D. Matthew Feldhaus, formulated a comprehensive report for the DOI addressing insurance companies’ positions on HIV/AIDS treatment (available here).
According to Jenner & Block’s report to the DOI, insurance discrimination against people living with HIV/AIDS can come in many forms, including burdensome restrictions on HIV/AIDS drug coverage.
The statement directs insurers to adhere to recommendations by the Department of Health and Human Services on “recommended” and “alternative” drug regimens for HIV/AIDS treatment.
According to the department’s statement, other measures insurance companies can take that might be found to be discriminatory against HIV-positive enrollees include forcing them to use less effective HIV drugs before moving on to more effective drugs (”step therapy”) and requiring an enrollee to seek pre-authorization for every refill of HIV drugs after the insurer has approved the initial filling.
“The Affordable Care Act is built on the concept of equal access to quality medical coverage for all Americans, and that includes people living with HIV/AIDS,” said Peller. “The action by the Department of Insurance is a strong step towards making that concept real. We look forward to working with the department and insurers to make sure people with HIV get the coverage they need to stay healthy on the Illinois Health Insurance Marketplace in 2015.”