HIV+Hep in the News

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Sens. Merkley, Smith, colleagues sound alarm on unlawful charges for PrEP patients

by | Sep 9, 2022

“We appreciate Senators Merkley and Smith’s leadership and all their colleagues desire to ensure that the preventative service provisions of the Affordable Care Act are properly implemented. Private insurers must provide PrEP drugs and associated services without patient cost-sharing. We are receiving too many complaints from PrEP users that this is not always happening. We trust with this letter insurers will ensure full compliance,” said Carl Schmid, Executive Director of the HIV+Hepatitis Policy Institute.

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Patient groups sue U.S. Health Department over co-pay rules

by | Sep 9, 2022

“This practice is not only illegal but increases the cost of prescription drugs for millions of patients nationwide,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, in the press statement. “Nearly one in four Americans taking prescription drugs struggles to afford them. The growing practice of insurers and PBMs [pharmacy benefit managers] not counting co-pay assistance is one reason why. We trust the court will side with us—and invalidate the ability to implement these punitive practices that impact people with HIV, hepatitis and so many other health conditions that are treated with prescription drugs.”

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Tackling cancer while battling the insurance system

by | Sep 9, 2022

I began hearing similar horror stories from patient advocates, such as Carl Schmid, the executive director of the HIV+Hepatitis Policy Institute. “To me, co-pay accumulators very much seem like extortion,” Schmid told me. “And they lead to a decrease in adherence since people can no longer afford their drugs.” “What’s more,” he said–and this is something I hadn’t realized–“the out-of-pocket obligations patients must pay to meet their deductible and any coinsurance are based on the drug’s undiscounted, pre-rebate list price, not the pharmacy’s actual negotiated price.”

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PrEP mandate violates religious freedom, rules Texas federal judge

by | Sep 8, 2022

A Texas federal judge ruled on Wednesday that requiring employers to provide health coverage that includes HIV prevention drugs is unconstitutional, saying that it violates the religious freedom of a Christian-owned company. The ruling by Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas could jeopardize the ability of the Affordable Care Act (known as Obamacare) to require which preventive health services and drugs must be fully covered by private health insurance. Under the ACA, employers must provide insurance coverage for drugs prescribed for HIV prevention, known as PrEP.

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