Nearly 100 Missourians living with HIV and receiving care through federal Ryan White HIV/AIDS funding will lose their health insurance coverage in the New Year, The St. Louis Post-Dispatch reports.
That’s because, according to the state, the available insurance plans are not cost-effective. This does not mean these individuals will have to go without HIV meds. Instead, Missouri will use the federal funds to purchase just their medications and not comprehensive health care.
The change takes effect January 1 and impacts people in 51 counties across the state, notably folks living in rural areas where there is little to no competition among insurance providers. For example, in many counties, Anthem Blue Cross Blue Shield is the only company that offers coverage, and it places HIV meds in its most expensive tier.
“One of the biggest challenges in health care is the rising cost of specialty drugs,” Anthem said in a statement to the Post-Dispatch. “Next year, Anthem will pay more than half of all money spent to cover members’ prescription drugs on high-cost specialty drugs. As a result, many specialty drugs, like HIV drugs, are on higher tiers and require coinsurance.” (The triggering of coinsurance means a patient pays a percentage of the total cost of the drug instead of paying a flat fee like a copay.)
According to the newspaper, Missouri is the first state to say it is now cheaper to scrap comprehensive insurance in favor of covering only HIV meds.