An emergency rule issued by the Florida Department of Health took effect Sunday, sharply restricting eligibility for the state’s AIDS Drug Assistance Program (ADAP) and potentially limiting access to HIV medication for thousands of Floridians.
ADAP, a federal-state partnership, provides free FDA-approved HIV medication to low-income, uninsured and underinsured individuals. Under the new rule, income eligibility has been reduced to at or below 130% of the federal poverty level — about $20,345 annually for a single-person household, according to the U.S. Department of Health and Human Services.
Previously, eligibility extended to individuals earning up to 400% of the federal poverty level, or roughly $62,600 per year for a single-person household.
The emergency rule also limits insurance coverage of Biktarvy, a once-daily HIV treatment pill used by approximately 60% of Floridians enrolled in ADAP.
HIV advocates estimate that as many as 16,000 of the roughly 30,000 Floridians currently enrolled in the program could face restricted access to medication under the new income threshold and coverage changes.
State health officials said the cuts are necessary to address budget shortfalls and prevent a projected $120 million funding gap. In a statement, the department cited rising health insurance premiums nationwide and reduced federal funding as contributing factors.
The emergency rule will remain in effect for 90 days and cannot be renewed unless the state initiates formal administrative rulemaking to make the changes permanent.
In January, Florida Surgeon General Dr. Joseph Ladapo described the issue as “very real and consequential,” pointing to escalating costs tied to changes at the federal level, including Affordable Care Act tax credits.
“With additional resources, it would be possible to fill that gap. But with the resources that we currently have, we’re unable to fill that gap,” Ladapo said at the time.
The AIDS Healthcare Foundation has filed a lawsuit challenging the proposed cuts, arguing that they jeopardize access to life-saving medication.
“We are talking about real people’s lives. This is not theoretical. This is not just a nice thing to do,” the organization said in a statement.
