ObamaCare Insurers Reject Louisiana AIDS Patients

ObamaCare Insurers Reject Louisiana AIDS Patients

HIV-AIDS advocacy groups say the three insurance companies in Louisiana that offer healthcare plans under ObamaCare are rejecting payments from a federal program that was meant to assist low-income HIV patients.

According to Reuters, the Louisiana Health Cooperative and Vantage Health Plan–two smaller insurers–followed the decision of the state’s largest insurer, Blue Cross and Blue Shield of Louisiana, at the end of last year to reject the payments for the HIV patients.

In response, Lambda Legal, a nonprofit group, filed a civil rights complaint with the Obama administration about the two smaller insurers’ action on Thursday, following their complaint against Louisiana Blue last week, in which they argued that the insurer’s refusal to accept Ryan White payments flouted a key provision of ObamaCare, namely its requirement that insurers must accept customers with pre-existing conditions.

“Additional carriers are jumping on the discrimination bandwagon,” Susan Sommer, director of constitutional litigation for Lambda Legal, said.

The legal nonprofit works to protect the civil rights of lesbians, gay men, and people with HIV.

“The worst nightmare for people with HIV-AIDS is coming true in Louisiana: they’re being turned away in what’s become a race to the bottom by insurers,” Sommer said.

At issue is the federal Ryan White HIV/AIDS program that, for 23 years, has made grants to states, cities, and nonprofit groups to assist low-income people with HIV in the purchase of health insurance.

The advocacy organizations assumed the federal funds could be used to purchase premiums for Ryan White beneficiaries who bought private insurance on the ObamaCare exchanges, in the same way the funds had been used to pay insurance premiums prior to President Obama’s signature healthcare reform law.

Recently, however, both Louisiana Blue and Blue Cross Blue Shield of North Dakota began rejecting Ryan White payments made on behalf of poor HIV-AIDS patients who had enrolled in a plan on the ObamaCare exchanges.

According to Reuters, the insurers told HIV-AIDS advocates that guidance obtained from the Centers for Medicare and Medicaid Services (CMS)–which is the lead ObamaCare agency, prevented them from accepting third-party payments for the new health plans, even when the funding comes from a federal program.

Last week, CMS said the ban on third-party payments “does not apply” to those made on behalf of ObamaCare enrollees by “state and federal government programs or grantees (such as the Ryan White HIV/AIDS Program).”

CMS further said it “is considering amending the rules to require,” and not merely allow, “issuers to accept these (Ryan White) payments.”

Without any definite change in regulations, however, the Louisiana Health Cooperative has said it “will not be accepting third-party insurance premium payments either,” according to Lucy Cordts of the NO/AIDS Task Force.

Cordts’ group, which advocates on behalf of those with AIDS, has about 350 Louisiana residents who chose the Coop plans.

“They’ll all now need to consider another company,” Cordts said.

Some other HIV advocates indicated they had informed Coop officials that CMS now allows Ryan White payments to be used for ObamaCare premiums, but were informed, “they would not change their policy unless required,” said Moriba Karamoko, director of the Louisiana Healthcare Coalition.

Vantage Health Plan has also informed the state that it will not accept Ryan White payments as well.

“What we’re seeing in Louisiana is a crisis for low-income people with AIDS,” said Sommer. “These are exactly the people the Affordable Care Act [ObamaCare] was designed to provide a safety net for.”

Mark, 44, a former high school teacher who asked that his last name not be published, said he is now without insurance. While he was able to obtain HIV medications from the NO/AIDS Task Force, through the Ryan White program, he cannot afford his medications for high cholesterol and high blood pressure.

“My health is in danger at this point,” he said. “If we sit back and let them do this, it goes against everything the Affordable Care Act is about.”

Last October, Breitbart News reported that HIV/AIDS advocates were urging patients with the disease to delay enrolling in ObamaCare exchanges, warning that coverage for them and the price of prescription drugs could be confusing during the early days of enrollment.

An Inside Health Policy report indicated at the time that the Ryan White funds “can’t be used for any administrative costs, and in general Ryan White is a payor of last resort so patients must try to use other funding sources when possible,” said AIDS Institute Deputy Executive Director Carl Schmid.

The report also indicated that, according to HHS’ Health Research and Services Administration (HRSA), “Ryan White funds may only be used to purchase and maintain health insurance that is cost-effective.”


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