HIV Medicine Association supports public plan option to ensure patients' needs are met

As Congress drafts health care reform legislation, HIV clinicians urge lawmakers to include a public plan option to ensure affordable access to comprehensive care for HIV patients - nearly 30 percent of whom have no insurance. The HIV Medicine Association (HIVMA) believes that a public plan option can help offer everyone the chance to benefit from early and reliable access to lifesaving HIV care and treatment.

"HIV treatment is one of the most effective medical interventions available today, but it requires ongoing access to high-cost medications and services over the course of a patient's lifetime," said Michael S. Saag, MD, FIDSA, HIVMA chair-elect. "People with chronic conditions like HIV are not attractive to most private insurers."

HIVMA is particularly concerned that private insurers will discourage HIV patients from enrolling in their plans by excluding HIV clinicians and programs from their provider networks. HIV treatment delivered by an experienced HIV provider results in better patient outcomes and more cost-effective care.

Only 17 percent of HIV patients have private insurance coverage, according to the Kaiser Family Foundation. Fifty-four percent rely on Medicaid and/or Medicare, while 29 percent are completely uninsured. Even if potential safeguards were in place requiring private insurance plans to include HIV health care providers, it would be difficult to ensure the adequacy of HIV provider networks in the numerous private plans that likely will be available across the country.

"The availability of a public plan option will ensure a reliable coverage option is available to people with HIV no matter where they live in the U.S.," said Arlene Bardeguez, MD, MPH, HIVMA chair. "A public plan option will better ensure all of our patients have the opportunity to benefit from HIV treatment and live healthy and productive lives."

Today, HIVMA released a position statement, which has also been adopted by the Infectious Diseases Society of America (IDSA), outlining additional reasons a public plan option is so important for people with HIV

• A public plan option would offer greater dependability, consistency and security than private plans, which can close, merge or change benefits at will.
• Even in a well-regulated private insurance market, such as the Medicare Part D prescription drug program, private plans have limited patients' access to drugs by charging high co-payments for HIV medications and imposing burdensome prior authorization requirements on non-HIV medications. The purchasing power of a public plan option would offer greater opportunities to lower the cost of these drugs and other services.
• Traditionally, public programs, such as Medicare, have been leaders in developing and supporting innovative chronic disease management approaches, such as the medical home model. The coordinated, comprehensive approach offered by medical homes is critical to keeping many people with HIV in treatment and addressing their complex health care needs.

HIVMA also released a set of health care reform principles for meeting the needs of people living with HIV. The principles outline the needs any national health care reform plan must meet to ensure HIV patients receive the proper care, stem the spread of the epidemic, improve care quality, and reduce costs.

http://www.idsociety.org and http://www.hivma.org