Louisiana HIV/AIDS Patients in Obamacare Limbo Facing Discrimination

Some time ago I wrote about how the refusal to expand Medicaid impacts poor people living in southern states. Unfortunatly, a very large number of those individuals are African-Americans.

These are people who are unable to afford health insurance who or qualify for government subsidies under Obamnacare. In these states, residents caught between a rock and a hard place, are expected to rely on the expansion of Medicaid to access health care per the Affordable Care Act.

One such state is Louisiana, and Reuters has an interesting report that details a new development which affects HIV/AIDS patients who have signed up for Obamacare who are now virtually in limbo.

Hundreds of people with HIV/AIDS in Louisiana trying to obtain coverage under President Barack Obama’shealthcare reform are in danger of being thrown out of the insurance plan they selected in a dispute over federal subsidies and the interpretation of federal rules about preventing Obamacare fraud.


Some healthcare advocates see discrimination in the move, but Blue Cross and Blue Shield of Louisiana says it is not trying to keep people with HIV/AIDS from enrolling in one of its policies under the Affordable Care Act, also known as Obamacare.


lOUISIANA-hiv-aids (1)The state’s largest carrier is rejecting checks from a federal program designed to help these patients pay for AIDS drugs and insurance premiums, and has begun notifying customers that their enrollment in its Obamacare plans will be discontinued.


The carrier says it no longer will accept third-party payments, such as those under the 1990 Ryan White Act, which many people with HIV/AIDS use to pay their premiums.


“In no event will coverage be provided to any subscribers, as of March 1, 2014, unless the premiums are paid by the subscriber (or a relative) unless otherwise required by law,” Blue Cross Blue Shield of Louisiana spokesman John Maginnis told Reuters.


[…]  Hundreds of indigent HIV/AIDS patients are dependent on Ryan White payments for Obamacare because they fall into a gap. They are not eligible for Medicaid, the joint federal-state health insurance program for the poor, because Louisiana did not expand the low-income program, and Obamacare federal subsidies don’t kick in until people are at 100 percent of the federal poverty level.


Before Obamacare, the 1990 Ryan White Act offered people with HIV/AIDS federal financial help in paying for AIDS drugs and health insurance premiums, especially in state-run, high-risk pools.


Obamacare, which bans insurers from discriminating against people with preexisting conditions, was designed to replace these high-risk pools.


Starting on October 1, AIDS advocates and others in Louisiana “were enrolling anyone and everyone we could” through the Obamacare exchange, said Lucy Cordts of the New Orleans NO/AIDS Task Force.


Last month, her clients and those of other AIDS groups began to hear from Louisiana Blue that their enrollments were in limbo because the company would not accept the Ryan White checks for premium payments.


[…] Healthcare advocates are worried that the refusal to accept Ryan White payments is an effort by insurers to keep AIDS patients from enrolling in their plans and last month began pressing the issue, including with the office of Democratic Senator Mary Landrieu.


[…] Asked if it were engaging in efforts to avoid adverse selection by refusing to accept Ryan White payments for would-be customers with HIV/AIDS, Louisiana Blue said it was not trying to keep such customers out of its plans. “We welcome all Louisiana residents who chose Blue Cross and Blue Shield of Louisiana,” said Maginnis.

There’s no telling just exacttly how many residents of Louisiana are negatively impacted, by this development. However, here’s a look at some figures on HIV/AIDS in Luoisiana as put together by the folks over at LPHI. One glance and you can see how serious this could be for many.

  • As of December 31, 2010, a cumulative total of 30,876 HIV/AIDS cases have been reported in Louisiana, including 316 pediatric cases.
  • The cumulative number of deaths among persons diagnosed with HIV/AIDS, reported to the Louisiana Office of Public Health through December 31, 2010, is 12,755 including 103 deaths among pediatric cases.
  • A total of 18,308 persons are living with HIV/AIDS in Louisiana; of these individuals, 10,035 persons (55%) have an AIDS diagnosis.
  • Among women living with HIV/AIDS, the predominant known mode of transmission is high-risk heterosexual contact followed by injection drug use. Among men living with HIV/AIDS, the predominant mode of transmission is men who have sex with men followed by high-risk heterosexual contact.
  • Nationally, Louisiana ranked 4th highest in AIDS case rates and 11th in the number of AIDS cases diagnosed in 2008, according to the CDC 2008 HIV/AIDS Surveillance Report (Vol. 20).
  • The Baton Rouge metropolitan area ranked 2nd for AIDS case rates among the largest metropolitan areas in the U.S. in 2008; New Orleans metropolitan area ranked 3rd.
  • In Louisiana, 33% of new HIV cases and 31% of new AIDS cases are among women.
  • HIV continues to disproportionately affect African Americans in Louisiana. In 2009, 76% of newly diagnosed HIV cases and 76% of newly diagnosed AIDS cases were among African Americans.