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June 25, 2017

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AIDS patients fear discrimination by US insurance firms

MIAMI--Patient advocates in the U.S. say some insurance companies are making HIV and AIDS drugs unaffordable in plans issued through the country's new health care law by shifting much of the cost to customers.

While the issue applies broadly to all patients with chronic illnesses that require expensive medication, HIV and AIDS advocates say they are the first to file a formal complaint with the government about pricing.

Under U.S. President Obama's Affordable Care Act, the signature legislation of his time in office, insurance companies are forbidden from turning away consumers with pre-existing conditions. But advocacy groups allege insurance companies are discouraging HIV and AIDS patients, who are expensive to cover, by requiring them to pay a percentage of costly medications instead of a flat payment, essentially pricing the medications out of reach.

The new health law has been under immense scrutiny in the U.S., especially by Republicans, who are eager to see it overturned. The law was meant to provide coverage to millions of Americans who normally went uninsured.

The rollout of the law hasn't been easy.

Several insurance companies are impeding access to services by requiring re-authorization for drugs consumers have been taking for years or making the claims process difficult, says Carl Schmid, deputy executive director of The AIDS Institute. The group filed a complaint with U.S. Health and Human Services (HHS) officials this year against four Florida insurance companies, and advocates in other states are considering similar action.

Georgia advocates are planning to file a similar complaint with federal officials, said Dr. Melanie Thompson. Advocacy groups say they are finding similar problems with some exchange plans in Ohio, California and Illinois.

HHS said it's reviewing the complaint in Florida but declined further comment.

Advocates say intervention by the federal government would also benefit patients who take expensive medications for chronic conditions such as blood cancer and rheumatoid arthritis.

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