The National Health Law Program and the AIDS Institute filed a complaint with federal health officials Thursday asserting that four insurance companies have structured their plans in a way that discourages people living with HIV or AIDS from choosing them. If the accusations are true, those insurance companies would be violating a civil rights section of the Affordable Care Act.
The two health organizations say the insurance companies, which offer plans in Florida through the federal online exchange, require that HIV and AIDS patients pay for a percentage of their drugs instead of a flat $10 co-pay. HIV and AIDS drugs can get expensive, so asking patients to pay 40% to 50% of the wholesale cost of their drug — thousands of dollars — becomes burdensome.
The two groups also allege that the plans require high up-front costs and too many prior authorizations. Federal health officials are reviewing the complaint.