There are some HIV/AIDs patients who are on the bubble, they can’t afford the high premiums for plans through the exchanges, they aren’t poor enough to be eligible for the federal funds. 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. Those pools no longer exist but the Obamacare participant companies won’t take the “Ryan White funds,” and it’s all the federal government’s funds.
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.
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
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.
According to Blue Cross they are complying with statements from
Centers for Medicare and Medicaid Services (CMS).
In September, CMS informed insurers that
Ryan White funds “may be used to cover the cost of private health
insurance premiums, deductibles, and co-payments” for Obamacare plans.
In November, however, it warned “hospitals, other
healthcare providers, and other commercial entities” that it has
“significant concerns” about their supporting premium payments and
helping Obamacare consumers pay deductibles and other costs, citing the
risk of fraud.
The insurers told healthcare
advocates that the November guidance requires them to reject payments
from the Ryan White program in order to combat fraud, said Robert
Greenwald, managing director of the Legal Services Center of Harvard Law
School, a position Louisiana Blue still maintains.
“As an anti-fraud measure, Blue Cross and Blue Shield of Louisiana has
implemented a policy, across our individual health insurance market, of
not accepting premium payments from any third parties who are not
related” to the subscriber, Maginnis said.
Friday, CMS spokeswoman Tasha Bradley told Reuters that, to the
contrary, Ryan White grantees “may use funds to pay for premiums on
behalf of eligible enrollees in Marketplace plans, when it is
cost-effective for the Ryan White program,” meaning that having people
with HIV/AIDS enroll in insurance under Obamacare could save the
“The third-party payer guidance CMS released (in November) does not apply to” Ryan White programs.
Apparently no one told the insurance companies.
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.
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
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.
The only other carrier that
is refusing to accept such payments is Blue Cross Blue Shield of North
Dakota, according to a CMS official.
Blue “restricts premium payment from third parties including employers,
providers, and state agencies,” said spokeswoman Andrea Dinneen, but “is
currently reviewing its eligibility policies with respect to recipients
of Ryan White Program funding.”
Eventually, this problem will be worked out, it’s just another example, like the screwed up website, and the people losing their plans, of how this President’s rush to shove Obamacare down our throats and get it started is hurting various Americans
H/T The Corner