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September 24, 2010

New ADAP income ceiling leaves 320 Ohioans out

Columbus--While almost $13 million of Medicaid money will fill spending gaps in the Ohio AIDS Drug Assistance Program to prevent further cuts, the influx of money still leaves 320 Ohioans with HIV cut off from the service.

The Ohio Department of Health, trying to stop the financial hemorrhaging, changed the income ceiling for inclusion in ADAP from 500% of the federal poverty line, and below, to 300% and below, which removed those 320 from eligibility. While there is now a waiting list for ADAP, those 320 former clients are not eligible for benefits at all.

The old 500% ceiling for a single-person household meant an income of $54,150, which seems ample. But, without benefits, someone with HIV could easily spend over $40,000 a year on medication for the HIV itself as well as the side effects of the disease and its treatment.

The cuts to ADAP also removed a number of accessory medications, like those to treat kidney problems, heart problems and anti-diarrheals.

The cuts went into effect on July 1, leaving those 320 people scrambling to find help, even after the September 2 announcement of the influx of Medicaid money.

AIDS activist Gil Kudrin is incensed by the changes.

“What happens if you make $35,000 a year, but have to spend $30,000 a year on meds?” he asked, pointing out that the eligibility is based on pre-tax gross income, not after-tax net income. “These are tax-paying people, people who are working. The poorest people can get Medicaid, but people who are working but don’t have that great of a job, they’re the ones who are being cut off.”

“We already had a very limited formulary [list of approved medications] in Ohio, which is why we had a 500% threshold,” he noted. “What they cut out--besides lowering the threshold--is, they cut out the diabetes drugs, they cut out Lipitor for the heart . . . and they cut those 300-plus people. Those people got letters in July saying, ‘You get no more drugs from this point, period.’ You have people who were on regimens for three, four or five years, and they’re not getting medication anymore.”

“We’re actually in a really bad place, because it’s going to take the federal government to put the program back where it was. We need $127 million across the country, and they’re not moving,” he said. “The government gives drug companies millions of dollars for the medications, but we’re not getting enough medications for the money. They have finally sucked the public teat dry.”

“The pharmaceutical industry needs to lower their prices so we can get medication,” he concluded.

“I’ve heard quietly from people in the federal government that there is talk between them and the pharmaceutical industry, but are they finally going to lower prices?” he asked. “When they priced these drugs, they were looking at life expectancies of four or five years, not 20 years, so they priced them out of the ballpark.”

He pointed, however, to the efforts of Sen. Sherrod Brown as well as supporters of the Facebook page for the Ohio AIDS Drug Assistance Program Crisis for helping to make what little progress has been made possible. The Facebook supporters called Gov. Ted Strickland’s office over 400 times in a single day, and Brown sent a “really, really passionate letter to [Secretary of Health and Human Services Kathleen] Sebelius, which got us nothing.”

“HHS released $25 million to get people off waiting lists, but those 320 people aren’t on waiting lists, they just don’t qualify anymore,” Kudrin concluded.            |

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