Posted by: Allison Rice | January 9, 2013

New ADAP/Inclusive Health iniative expands insurance

Starting January 1, 476 uninsured people with HIV/AIDS now have full insurance through a collaboration between the AIDS Drug Assistance Program and Inclusive Health.

Inclusive Health administers the pre-existing condition insurance program (PCIP) that was created as part of health reform.  The PCIP provides comprehensive health insurance coverage for people with pre-existing conditions who have been uninsured for at least 6 months.  This program was designed as a bridge from the 2010 passage of the Affordable Care Act to the full implementation of the law in 2014.  This is a great option for people whose medical history has caused them to be turned down or charged astronomical rates for insurance.  But even though premiums under the PCIP are more affordable than the private market, they are still prohibitively expensive for many low income people.  In 2014, low income people will be eligible to buy subsidized insurance on the Health Benefits Exchange or get Medicaid, if North Carolina opts to expand.

To the rescue – the AIDS Drug Assistance Program and Inclusive Health.  Through a partnership authorized by the legislature last year, up to 10% of ADAP clients are eligible to enroll in Inclusive Health for 2014.  Instead of buying their expensive medications, ADAP will pay the premiums, co-pays, and deductibles so that low income clients aren’t excluded because of cost. This will give clients access to a full range of medical services and prescriptions drugs, and it is expected to save the state money.

I am particularly delighted that this program is underway, as the Duke AIDS Policy Project did the initial research to bring together the state and Inclusive Health.  An email I received the other day from an infectious diseases social worker brought home the full impact of what this program is doing.

From the front lines today, directly from the mouths of newly insured patients through PCIP.

Patient Number One:

“I felt so proud standing in Gurley’s [local pharmacy] with my prescription.”

Patient Number Two:

“Ain’t never had insurance before.  It feels nice, don’t it?”

My social worker friend, always insightful, helped me really understand that this initiative is not just about saving money and expanding care.  It has brought dignity to people who have previously had no way to pay for their drugs and medical care. From my social worker friend:

From the first time you talked to me about this prospect, it was this aspect that interested me as much as the actual access to meds.  Having insurance definitely makes people feel better about themselves, but I could never put it as eloquently as these two patients did today.

There’s going to be a lot more dignity coming in 2014.  Come this time next year, an estimated 1000 people living with HIV/AIDS will be eligible for subsidized insurance through the new Health Benefits Exchange.  If our state leaders can get beyond politics and expand Medicaid, some 5000 uninsured people with HIV/AIDS be newly eligible for coverage through Medicaid.


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