In North Carolina, an estimated 36,300 people are living with HIV. In 2013 alone, 1,525 people were diagnosed with HIV in our state. And despite tremendous strides in early detection and treatment, all of these North Carolinians live in a region – the American South – with the highest rates of new HIV diagnoses, the largest percentage of people living with the disease and the most people dying from it.
Here are three immediate goals I hope our state and local leaders will address in 2016.
1Maintain and expand the AIDS Drug Assistance Program, which provides HIV medication for over 6,500 low-income North Carolinians. This program is funded by both state and federal appropriations, along with rebates paid by pharmaceutical companies.
In North Carolina, we’re lucky to have an incredibly well-run ADAP program, with over 84 percent of residents on the program virally suppressed. Earlier this year, North Carolina modified its ADAP qualifications to begin covering prescription co-payments for residents who purchase their own health insurance. This modification has saved the program money and increased access to a wider range of health care services for those enrolled.
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Nevertheless, we can and should be doing more to protect and expand ADAP. In the vast majority of states, including our Southern neighbors, ADAP also covers insurance premiums. In North Carolina, it does not.
This puts North Carolina’s ADAP program at serious risk in 2016. Recently, the U.S. government released a draft of a new rule that will prohibit states from receiving rebates if they don’t cover premiums. This will have serious consequences for North Carolina, as our state currently receives millions of dollars in rebates that help keep the program solvent.
There’s a compelling reason to cover these premiums beyond a financial benefit. A recent study in Virginia found that patients enrolled in an Affordable Care Act health plan had higher rates of viral suppression than those who received only medication through their state’s ADAP. Saving a significant source of revenue and increasing the quality of health for our residents make premium assistance a win-win for our state.
2Expand Medicaid to close the coverage gap, which would be one of the most significant public policy wins for those living with HIV in North Carolina. Expanding Medicaid would provide health insurance to over 500,000 North Carolinians, including thousands of people living with HIV. Expanding Medicaid would also save North Carolina money. Our state already lost $2.7 billion in federal funding last year and will lose $3.3 billion this year. A recent study from the Kate B. Reynolds Charitable Trust and Cone Health Foundation found that the state has lost 52,000 jobs over the last two years because of the state’s failure to expand Medicaid.
3Increase access to pre-exposure prophylaxis, which provides a new and important medication to prevent the transmission of HIV. For those at risk, taking PrEP once a day will prevent them from becoming HIV positive. Anyone taking PrEP is required to meet with a doctor for HIV testing and counseling every three months. This consistent level of care helps increase conversations between doctors and patients about reducing factors involved with HIV transmission.
Last year, the Orange County Board of Health voted to approve plans to provide counseling and prescriptions for individuals at high risk for exposure to HIV-infection. In partnership with UNC Healthcare and the UNC Pharmacy Patient Assistance Program, eligible clients can receive a prescription for only $4 a month. This act by the local Board of Health provides a model that other local boards of health can consider.
The time to unite and act on these resolutions is now.
Lee Storrow is executive director for North Carolina AIDS Action Network.