Charles Rex Arbogast/AP
HIV drug Kaletra

Calif. Must Offer Medication to Eligible People With HIV, Court Says

December 24, 2008 04:32 PM
by Emily Coakley
Medication must now be offered to people who have HIV and are eligible for the state’s low-income health care program.

Medi-Cal Must Cover HIV Patients

Advocates in California have successfully sued to have the state’s Medicaid program, called Medi-Cal, cover people with HIV in accordance with a 2002 state law. Previously, the law required Medi-Cal coverage only for people with full-blown AIDS, but a Los Angeles Superior Court judge ruled that medications must be provided to anyone who tests HIV-positive, the AIDS Healthcare Foundation announced this week.

The state Department of Health Care Services had argued that the law didn’t require coverage in certain budget conditions.

“The law was very clear that it should not be implemented if the costs could not be offset by savings,” the department’s spokesman, Anthony Cava, told Bloomberg. He added that DHCS “will continue to work with its partners to implement the law in a cost-neutral manner, just as the legislature intended.”

Other states have different programs to provide medication to people with HIV or AIDS. Maryland uses federal Ryan White Care Act funds, named for a young Indiana boy who died after developing AIDS in the 1980s, to provide low- and moderate-income people with HIV or AIDS drugs, according to the Examiner.

Despite changes to federal law, health insurance options remain limited for people with HIV and AIDS. For those who haven’t had health insurance for work, or aren’t eligible for federal programs such as Medicaid, self-insurance isn’t an option, either, reports the Center for American Progress.

“A handful of states prohibit insurers from discriminating on the basis of health status, but in most places insurers can deny coverage to individuals with pre-existing conditions, exclude coverage for their pre-existing conditions, or charge enrollees higher premiums, wrote Lester Feder and Ellen-Marie Whelan in a brief dated Dec. 23.

They cited a Kaiser Family Foundation study in which 19 insurance companies reviewed profiles of people and families with “less than perfect health” seeking an individual or family policy. No insurance company in the study would offer coverage to the person with HIV, the study reported.

Reference: HIV/AIDS resources on the Web


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