An economic "perfect storm" is hitting state AIDS Drug Assistance Programs across the nation. As of June 24, according to the National Alliance of State & Territorial AIDS Directors, 1,840 people who cannot afford treatment were on ADAP waiting lists. In June, Florida joined 10 other states whose ADAPs have closed enrollment to new patients, NASTAD reported.
Three more states have tightened eligibility criteria - including Arkansas and Utah, which dropped some current ADAP clients. New Jersey plans a similar cut on Aug. 1 that could remove 600 from the subsidized treatment program. Illinois may soon follow Georgia, which on July 1 began deferring enrollment in ADAP.
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Louisiana capped enrollment on July 1, but has decided not to create a waiting list. "It implies you are actually waiting on something. We don't want to give anyone false hope," said DeAnn Gruber, interim director of Louisiana's HIV/AIDS programs.
Nationwide, ADAP enrollment grew 12 percent from June 2008 to June 2009, just as the economic crisis saw many people lose their jobs and insurance coverage.
While federal ADAP assistance was up a scant 2 percent this year, state contributions were down by 34 percent. Expanded testing efforts and earlier initiation of antiretroviral therapy also are factors driving demand, NASTAD reported. Pharmaceutical companies have upped their contribution by half, but this is not enough to close the gap.
Ten states have stopped covering treatments not directly related to HIV/AIDS. By Aug. 1, Florida will slash 53 of 101 drugs on its ADAP formulary - some for common HIV-related conditions.
President Barack Obama opposes the proposal by two Republican senators, Tom Coburn (Okla.) and Richard M. Burr (N.C.), to divert $126 million in economic stimulus funds to support ADAP, said Shin Inouye, a White House spokesperson. Obama is recommending a $20 million increase to ADAP next fiscal year. Recently passed national health care reforms will not go into full effect until 2014.