HIV POLICY UPDATE

July 12, 2018

AAHIVM Submits Public Comments on Administration’s “HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs”

When the Trump administration released the DHHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs last May 16, it allowed the public (as is customary) 60 days in which to submit comments on the document. Anyone — individual or organization — can submit comments online here before 11:59 PM on Monday, July 16 EDT. DHHS specifically seeks public comments “from interested parties to help shape future policy development and agency action.”

Care for people living with HIV is facilitated by the Medicare Protected Classes Policy. Created in 2006, this policy requires that six key classes of critically needed drugs be protected from financial or policy fluctuations to ensure their accessibility when needed. The six classes are antidepressants, antipsychotics, anticonvulsants, antineoplastics, antiretrovirals and immunosuppressants. Unsuccessful efforts were made in 2013 and 2015 to reduce the number of protected classes. The current HHS Blueprint also proposes changes that could that could encroach on these drugs’ protected status.

AAHIVM is submitting Public Comment that focuses primarily on prior authorization issues (from which HIV drugs currently exempt, thanks to the Protected Classes Policy), the importance of Medicare Part D plan formularies offering multiple drugs per category and some other issues. You can read our statement here.

Please note that YOU are also welcome to submit in your own comments here at any time prior to the Monday, July 16 deadline above.

Medicaid Expansion on the Ballot in Two More States

Medicaid expansion is on the ballot in Utah and Nebraska in next November’s elections. In both states, advocates launched statewide signature campaigns to get the issue added as a certified ballot measure.

In Utah, organizers collected 147,280 signatures for Medicaid expansion to appear on the ballot. The Hill quoted Families USA Director Frederick Isasi as observing that, “Thousands of Utahans have added their signatures to the campaign, declaring it’s time that our most vulnerable families have access to high-quality and affordable health care through Medicaid.” The expansion of Medicaid would potentially enable 150,000 Utahans to gain insurance.

In Nebraska, Insure the Good Life’s Medicaid expansion campaign successfully collected 133,000 signatures to add this to the November ballot. NPR reported State Senator Adam Morfeld as declaring that “Now people will speak out and get the job done that should have been done long ago.” According to Forbes.com, Insure the Good Life has noted that Medicaid expansion could “create and sustain 10,000 new jobs, reduce medical bankruptcies, bring $1.1 billion of Nebraskans’ tax dollars back from Washington, DC, and produce significant savings by reducing uncompensated care for those who lack health coverage.” With the expansion of Medicaid, 90,000 could gain access to basic health care.

Idaho, said Forbes, may follow Utah and Nebraska in organizing a Medicaid expansion campaign in time to make it on the November ballot.

Has HIV Money Been Moved to the Office of Refugee Resettlement?

On July 10, Slate magazine published an article saying that the administration was taking funds from the Ryan White Program to pay for child relocation expenses incurred by the Office of Refugee Resettlement. Understandably, this set off alarm bells among providers and recipients of Ryan White Program services.

Leaders in the HIV advocacy community suggest that we all moderate our strong reactions to this news until we know more about exactly what is happening. They have already confirmed that funding for this fiscal year’s Ryan White contracts has already been transferred to recipient organizations. People relying on Ryan White services need not fear that current services will be defunded this year. It appears that the Secretary of DHHS was using his transfer authority to move unused funding left from previous years.

More news on this as it becomes available!

Still More Cuts in Funding for ACA Navigator Services

On July 11, the Centers of Medicare and Medicaid Services (CMS) announced that funding for ACA Navigator services for the upcoming enrollment cycle had been slashed to $10 million, furthering the steep decline imposed on the Program since the last national election. Established in 2015, the Navigator Program was created to provide people enrolling in ACA insurance plans with knowledgeable assistance in determining what plan would best meet their needs. In the 2015-16 enrollment cycle, the government invested $60 million in the program. Due to its success, $63 million was allocated for the 2016-17 to expand the service and help more ACA participants.

In 2017-2018, however, only $36.8 million was allocated to fund the service and this (among other factors) led to some decline in ACA enrollment. Now only $10 million will go into hiring ACA Navigators in 2018-19. According to U.S. News and World Report, “CMS Administrator Seema Verma says the navigators just aren’t cost effective. New Jersey Democratic Rep. Frank Pallone called the cuts more ‘sabotage’ from the administration.”

 

 

 

 

 

 

 

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