Director Robert Redfield’s View from CDC
In a June 25 interview, CDC’s recently appointed Director Robert Redfieldtold the Wall Street Journal that “stigma is the enemy of public health” and that the national suicide rate, the opioid crisis and HIV/AIDS are among his top priorities in his new job. A respected researcher, Redfield’s appointment last March nevertheless stirred up controversy, due in part to his long affiliation with the Children’s AIDS Fund International (CAFI). Formerly known as Americans for Sound AIDS/HIV Policy (ASAP), the organization advocates “for abstinence until marriage as a main tool for HIV prevention.” In the late 1980s, it also actively supported mandatory HIV testing for people enlisting in the military (so that people living with HIV could be excluded).
Redfield not only stepped down from the CAFI board last March to accept this federal appointment, but also took a salary cut in accepting the CDC’s offer of $375,000 annually (the highest compensation ever offered for that position). Some Senators expressed concerns about his appointment but with no effect since the position does not require Senate confirmation.
In the interview, Redfield emphasized the importance of biomedical tools such as PrEP to curtail HIV spread – noting that while “behavioral strategies are important, they’ve always had limitations. And with the advent of PrEP, we know we have a biological mechanism that can prevent infection.” Redfield estimates that the U.S. can end AIDS in “seven years or maybe a little longer.” His optimism does not seem to be affected by the fact that CDC’s budget declined in 2017 and 2018. Its size for 2019 is not yet established.
How Short Term Limited Duration (STLD) Insurance Stacks Up for People Living with HIV
Kaiser Family Foundation has just released the results of a study to assess Short Term Limited Duration (STLD) insurance policies that provide coverage for up to one year, avoid compliance with ACA standards and are promoted by the current administration. For survey purposes, they focused on Florida, Georgia, Illinois, Maryland and Texas – home collectively to one third of the U.S. population living with HIV. KFF tested these insurers by completing online applications through Agile.com and found that:
• All of the STLD insurers surveyed refused insurance to people living with HIV
• All refused to renew policies for people who acquired HIV while enrolled in their plan
• 87% provide no HIV drug coverage for people who seroconvert while enrolled. The remaining 13% offer minimal support, with benefits as low as $3,000 per three-month period. Customer also pay deductibles from $1,000 – $10,000, as well as high co-pays.
Kaiser concluded that STLD enrollees who acquire HIV while on such plans “would not have access to needed services, such as prescription drugs, or face limits and prohibitive costs if the service was covered. Further, since STLD policies are non-renewable, at the end of the coverage period an enrollee diagnosed with HIV would not be able to enroll in a new policy.”
Medicaid Work Requirements Watch : Michigan
On June 22, Michigan became the fifth state to impose work requirements in their state’s Medicaid program. Governor Snyder signed a bill requiring “able-bodied” people insured under the state’s Healthy Michigan (Medicaid) plan to log 80 hours a month working, training or participating in volunteer work, school, or a substance abuse program. Michigan expanded its Medicaid coverage in 2014 and The Detroit News reports that 670,000 uninsured people are currently covered under it, adding that “the new work rules could apply to roughly 540,000 able-bodied adults, according to the nonpartisan House Fiscal Agency, which projects about 5 to 10 percent of recipients will drop out or leave the program as a result.”
Governor Snyder stated on Medium; “This bill was crafted to ensure the program is serving those most in need, by exempting certain populations and requiring those who are fully capable of working to be actively seeking work or participating in other activities such as job training or community service.” Upon federal approval of the waiver, this plan will limit recipients to receiving Medicaid for no more than four years and will require them to pay a 5% premium for their coverage.
View the latest HIV Policy Update here.