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December 13, 2013

HIV Coalition Sees 'Disturbing Trends' in Health Care Reform

A coalition of 31 HIV/AIDS groups wants the Obama administration to investigate if some health insurers are discouraging people with HIV from enrolling in new policies, The Wall Street Journal reports. The Affordable Care Act (a.k.a. the health care reform law, or ACA) forbids discrimination against people who are ill. In a letter to Kathleen Sebelius, the Health and Human Services secretary, the HIV Health Care Access Working Group cited “a number of disturbing trends” in plans that do not cover all HIV drugs. The letter also claims that some insurers seem to be singling out all HIV drugs with high co-pays at the same time that some insurers find a way to charge low co-pays.

To read the article, click here.

Search: health care reform, Affordable Care Act, ACA, HHS, Sebelius

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  comments 1 - 8 (of 8 total)    

thomas, USA, 2014-02-23 19:27:19
My co pay went from $55.00 to $574.91 I have been off my meds for 23 days, I have no alternative, no patient assistance, ADAP was cut last year, the truly sad part is no one cares.

Kyle Fletcher Baker, Maine, 2013-12-19 13:58:03
Here in Maine…none of the plans offered by only two organizations…Anthem and another offer any coverage for specialty medications. Still working through the lines of communication.

Steven, Indianapolis, 2013-12-19 01:23:20
My Atripla is a tier 2 drug for 2013. In 2014 it becomes a tier 5 specialty. Seems criminal to me that after years of being a tier 2 it changes to tier 5. This means that for me my co-pay up to the GAP is 33%. Then, 47% through the GAP. Then once I reach catastrophe it drops to $6.25. Dam greedy insurance company. BTW, my insurance company in Indiana is I.U. Health plans.

Stephen Bradshaw, Portsmouth, 2013-12-18 20:29:53
I am a government retiree on FEHBP and Optima insurance. I recently received a notice that my co-pay for HIV drugs were increasing. Currently I pay a $30 co-pay for Truvada and Kaletra. Starting Jan. 1, 2014, the co-pay will increase to 50% on the market value up to $250 for each prescription. Also these meds now have to be mail ordered rather than local pickup. I was told when I questioned the letter that OPM had directed the change to provide more funds to the ACA.

Anonymous, , 2013-12-18 10:17:46
David - WSJ has copyright to its story. That's why POZ provides summaries. Although you may see bloggers and other sites do it, no credible media source will just pick up the entire text of a story from another media source without compensation.

David Morrow, Santa Rosa, CA, 2013-12-17 22:35:10
It's be nice to be able to read the whole article but it can't be done without logging into WSJ ... and I don't feel like I want to create an account there. Can't POZ just post the whole article???

dbeck, Texas, 2013-12-17 13:38:35
Two plans in TX do not allow combination therapy, you have to use each component separately. I don't know if they are trying to save money or keep PLWHA off of their plans but they are taking many steps backward in the area of adherence by forcing people to take more pills than is necessary. Advocacy groups around the country are working on getting these and other insurers doing the same thing to change the policy. I know at least on insurer in CA has changed theirs because of these efforts.

Matthew Sharp, , 2013-12-17 11:12:06
Despite the fact that I'm a long term survivor that works independently making a modest income, I get no subsidies even though I am a long term survivor at risk of aging co-morbidities. The cheapest plan on the exchange will cost me around $500 per month to the best plan that I need at around $1000 per month. It is not affordable for long term survivors who are thriving and self-employed. Read my story on

comments 1 - 8 (of 8 total)    

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