Ohio’s Medicaid director says roughly 61,000 residents on the federal-state health program are poised to lose their coverage the end of this week.
Slashed Funding For Drugs Translates To “Life and Death” for HIV Patients
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Nearly six months ago more than 250 Ohioans living with HIV were dropped from the state AIDS drug assistance program. Advocates blame the reductions on an increase in clients combined with cuts in state funding. WOSU recently sat down with one those individuals to talk about what the past few months have been like for him.
Richard sits at a small cafe table at a north side Starbucks. His hand lightly grips a 20 ounce coffee. He works in the service industry, and it’s the busy season. Richard was in such a rush on this day he forgot to remove his apron before he got to the coffee shop.
Richard is gay and is HIV positive. WOSU is not using his last name because he fears he could lose his job because of his status.
Ten years ago, Richard was a 28-year-old hair salon owner living in Florida. A routine blood test for group health insurance coverage changed his life.
“I was notified by the insurance company that they couldn’t insure me, and that I needed to get to a doctor immediately,” he said.
Richard had HIV, but medication made the virus all but disappear.
“They immediately got me meds. And I’ve pretty much been undetectable for the most part,” Richard said.
But now, because he’s been dropped from the state’s AIDS drug assistance program, Richard has not taken any of his three HIV medications for four months.
“On my legs and feet and stuff I’ve got this really horrible rash because my T-cells are suppressed. It always comes out in my skin. I’m really tired. That’s the biggest thing. I don’t have any energy. What’s happening is I’m starting to revert back to when I first started to get sick. I’ve got night sweats at night now. It happens really fast that you revert,” he said.
In July, Richard along with 265 others learned they had been dis-enrolled from the Ohio AIDS Drug Assistance Program. In addition, there are close to 400 people on a waiting list.
The Ohio Department of Health said a tremendous increase in clients and a decline in revenue forced it to raise the income eligibility level for those like Richard receiving the life saving drugs for free.
Jay Carey works with HIV Care Services at ODH.
“We really didn’t have any decision other than to make the reductions or the cost-containment measures in a way that affect the least amount of people, but still provide us financial solvency to the program so we can continue to provide the care to those who need it the most,” Carey said.
To qualify for the free AIDS medications, individuals have to make less than $32,500 a year. Richard makes $35,000 a year, too much for the program. But his meds would cost him more than $27,000 a year.
Pharmaceutical companies have stepped up to assist people who have been dropped. Several companies are offering AIDS medications for free or at a reduced cost. Richard stands to benefit, but he had to see a doctor first. And he doesn’t have health insurance.
“I had to have the money to go see the doctor. You have to have lab work done, the whole nine yards. It’s a lot of money. It’s almost $100 just for the office visit, plus all your labs. Once I got all that rolling, I faxed in my applications about a month ago, and I’m finally starting to hear from them. And they say it will take about another month for them to send me the medication,” Richard said.
The Ohio Department of Health said it surveyed people who were dropped from the drug program and those on the waiting list and found – of those who responded – two-thirds were their getting HIV drugs through other sources.
Columbus AIDS Task Force caseworker Adrienne Gavula says many of her clients are getting their medications but not without jumping through hoops first. And Gavula said for her clients who suffer with mental illness it’s quite frustrating.
“If you have more kind of severe mental health issues and you’re on three or four different meds, you have to have three or four different applications at three or four different dates, some six months, some one year, some you pick up at the pharmacy, some you pick up at the doctor’s office, some gets mailed to you – and to try to help clients navigate that system has been difficult. It’s not impossible; it’s just an extra burden, an extra barrier to receive medication,” Gavula said.
ODH is trying to help the sickest who are not getting their meds. A new proposal would have the sickest individuals move to the top of the waiting list. But advocates don’t see the situation getting better. They fear with the state facing a huge deficit, more cuts are on the way possibly dropping even more people from the program.
Meanwhile, Richard waits for his medications from the drug companies to arrive, and he hopes the current issue will promote solidarity.
“That’s what I would like to see. Not only the gay or the HIV, just everybody. It doesn’t only affect my community, everybody needs to take a stand and say ‘look this is enough. This is the year 2011, there is no reason for anybody to die from this disease. Period,’” Richard said.