National
Higher AIDS drug costs under Obamacare?
Sebelius urged to allow drug company subsidies in exchanges
AIDS groups sent a letter to HHS Secretary Kathleen Sebelius urging her to allow drug company discount programs to operate under Obamacare. (Washington Blade file photo by Michael Key).
AIDS advocacy organizations say people with HIV could be forced to pay hundreds of dollars more each month for life-saving prescription drugs through health insurance plans required under the soon-to-be implemented Affordable Care Act known as Obamacare.
Leaders of more than 160 national and local organizations advocating for people with AIDS and other diseases sent a joint letter on Monday to Kathleen Sebelius, the U.S. Secretary of Health and Human Services, urging her to allow drug company discount programs to operate under Obamacare.
“We, the undersigned organizations and individuals, are writing to urge that the HHS issue clear guidance on the allowance of drug industry-provided co-payments, co-insurance, or other out-of-pocket discount cards and coupons in the Affordable Care Act’s Health Insurance Marketplaces,” the letter to Sebelius says.
“As people living with, and organizations serving people with HIV, HCV [Hepatitis C Virus], and other life-threatening and chronic health conditions, we are alarmed by the possibility of the prohibition of these critical financial lifelines,” the letter says.
The signers of the letter were referring to a controversy that erupted last month when Sebelius released a letter she sent to U.S. Rep. Jim McDermott (D-Wash.) saying HHS determined that the Obamacare health insurance exchanges were not “federal health care programs” as defined by a separate federal law aimed at curtailing health care fraud.
By declaring that the exchanges are not federal health care programs HHS, among other things, made the exchanges and the insurance plans sold under them exempt from a provision of the Social Security Act that bans pharmaceutical companies from providing insurance co-payment discounts or subsidies to patients for the purchase of prescription drugs.
Although this initial action by HHS drew strong support from AIDS organizations it surprised and angered many private health insurance companies and federal and state consumer protection regulators, who argued that the exemption would take away an important tool for preventing and prosecuting health care fraud.
Critics, including U.S. Charles Grassley (R-Iowa), noted that the Social Security Act prohibits pharmaceutical companies from providing co-payment assistance to patients under Medicare and Medicaid and that the Affordable Care Act should be considered as a similar federal health program.
Possibly due to the criticism of Sebelius’s initial determination on the issue, a short time later the HHS Center for Consumer Information and Insurance Oversight, which oversees insurance-related matters, issued a memo that appeared to contradict Sebelius’s interpretation of the Social Security Act.
The latter development prompted the AIDS organizations and allied groups to send their Dec. 2 letter to Sebelius urging her to hold firm on her initial determination that the insurance exchanges are exempt from the Social Security Act’s ban on drug company subsidies for prescription drug coverage.
The D.C.-based national group Health HIV participated in efforts to recruit groups to sign the letter.
According to the Wall Street Journal, drug companies spent about $4 billion on co-payment assistance programs for patients with HIV and other illnesses in 2011. The paper cited experts in the pharmaceutical industry that said the assistance programs often lowered a patient’s co-payment from $250 or more per month to just $5 per month for a prescription drug.
Critics of the program say the subsidies often are given for brand-name drugs and encourage patients not to request cheaper generic drugs. This forces insurance companies to pay more for the name-brand drugs, resulting in higher premiums for everyone in the long run, critics have said.
But in their letter to Sebelius, the AIDS organization officials said most AIDS-related drugs needed by people with HIV are not available in generic forms.
“[W]e urge you to consider the unintended consequences of suddenly removing industry-provided out-of-pocket assistance for brand-name drugs without generic equivalents from the patchwork of programs that so many people with serious and chronic conditions rely on,” the joint letter says.
“It could potentially threaten access to lifesaving medications for thousands of people living with HIV; bar millions of people with hepatitis C from benefiting from the new short-course curative treatment combinations; and keep countless people with cancer and other debilitating and life-threatening illnesses from the treatment they need to stay alive,” the letter says.
“We fear this will be a major setback to the goals of the Affordable Care Act,” it says.
HHS spokesperson Mike Robinson said he would make inquiries in response to a request by the Blade for Sebelius’s response to the joint letter by the AIDS organizations, but he did not immediately respond.
“We’re still waiting for a clear determination from HHS,” said Carl Schmid, deputy director of the AIDS Institute, one of the groups that signed on to the letter to Sebelius. “There have been some mixed signals from the department.”
Schmid said the drug company assistance programs seek to help people with HIV who are not eligible for the federal-state AIDS Drug Assistance Program known as ADAP, which provides AIDS drugs to low-income people who don’t have insurance.
Although people being helped by the pharmaceutical company assistance programs often are employed and have moderate incomes, the high cost of prescription drug co-payments could be devastating to them, Schmid and others familiar with the programs said. Some people with HIV need more than one drug for their treatment regimen, and co-payments under their insurance plans often result in co-payments of more than $200 per drug per month.
Dan Mendelson, president of the heath care consulting firm Avalere Health LLC told the Wall Street Journal that the average “silver” health insurance plan under the Obamacare exchanges has a required annual deductible of $2,500. He told the WSJ that the average deductible for the “bronze” plans under the exchanges, which are said to be the cheapest plans, is $5,000.
Schmid said these costs are often prohibitive for patients with modest incomes. The elimination of the drug company assistance programs under the Affordable Care Act’s exchanges would create a serious burden on HIV patients and others who now rely on the assistance programs.
National
Madonna turns Times Square into massive dance floor
Pop icon celebrates Pride month with surprise performance
Pop icon Madonna celebrated Pride month with a pop-up performance in New York City’s Times Square on Thursday to the delight of 50,000 fans.
She performed for about 15 minutes high above street level, including several songs from her new album “Confessions II” due on July 3, along with a trio of songs from the first “Confessions on a Dance Floor.”
In addition to the brand new “Love Sensation,” she performed “I Feel So Free” and “Bring Your Love,” plus “Hung Up,” “Get Together” and “I Love New York.” She wished the crowd a happy Pride season; the event was shared with audiences through Grindr’s first-ever livestream.
National
Gallup finds LGBTQ support among Americans is dropping
Marriage equality support lowest since 2016
Gallup, one of the leading organizations in public opinion polling, has found that LGBTQ support among Americans is dropping.
The poll, whose data was collected using Gallup’s annual Values and Beliefs survey, was conducted in May and was published on Wednesday. The data was collected through telephone interviews from a sample of more than 1,000 adults living in all 50 states and D.C. using random digit dialing.
It highlights declining attitudes surrounding LGBTQ issues in multiple areas — from support for same-sex marriage to views on gender identity and the morality of one’s sexuality.
One of the most striking findings was that support for marriage equality fell six points from its 2022-2023 high.
The survey also found that 62 percent of Americans view gay and lesbian relations as morally acceptable, the lowest level since 2016 just after same-sex marriage was legalized nationwide by the U.S. Supreme Court.
One newer question on the poll found that the perceived morality of changing one’s gender has dropped eight points since 2021, indicating the American public is less supportive of transgender people.
The data attributes much of the decline to shifting Republican views alongside the party itself. Conservative leaders have pushed back against diversity, equity, and inclusion programs that were intended to foster greater acceptance of LGBTQ people and other historically disadvantaged groups.
President Donald Trump has been a guiding force behind waves of anti-LGBTQ sentiment, particularly when it comes to trans rights. The president has enacted multiple executive orders, including Executive Order 14168, “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government,” which mandates that gender be defined by one’s sex assigned at birth. He also signed Executive Order 14183, “Prioritizing Military Excellence and Readiness,” which barred qualified trans applicants from joining the military and led to the removal of trans service members already serving in the armed forces.
Additionally, he signed Executive Order 14201, “Keeping Men Out of Women’s Sports,” which prohibits trans female athletes from participating on women’s and girls’ sports teams.
In February, Gallup found that an estimated 9 percent of Americans identified as part of the LGBTQ community in some form.
The organization also found that 23 percent of adults under age 30 identify as LGBTQ, compared with 10 percent of those ages 30 to 49 and 3 percent or less among those ages 50 and older.
Congress
Ogles faces bipartisan backlash over anti-gay social media post
Tenn. congressman blamed the comment on staffer
U.S. Rep. Andy Ogles (R-Tenn.), who represents Tennessee’s 5th Congressional District, is facing backlash from LGBTQ advocates and fellow Republicans after a social media post declared that “homosexuality has no place in America.”
“Homosexuality has no place in America. Happy Nuclear Family Month,” the congressman wrote in a post on X that was later deleted.
According to the Williams Institute at UCLA School of Law, an estimated 6.3 percent of U.S. adults identify as LGBTQ.
Following widespread criticism, Ogles removed the post and blamed it on a staff member.
“The post was stupid, hurtful and a complete distraction from my America First focus. The employee has been reprimanded,” Ogles said in a statement.
The Washington Blade reached out to Ogles’s office for comment but did not receive a response by press time.
Among those condemning the message was U.S. Rep. Mike Lawler (R-N.Y.), who called it “absolutely idiotic” in a social media post.
“Homosexuality exists. In America,” Lawler wrote on X. “In fact, Andy, you have family, friends, neighbors, colleagues, and constituents who are gay and lesbian. It doesn’t make them less than or somehow unworthy of being an American.”
U.S. Sen. Ted Cruz (R-Texas) also criticized Ogles’s remarks.
“For all of recorded history, homosexuals have been a part of humanity,” Cruz told TMZ DC. “I think the behavior of consenting adults is their business.”
Chris Sanders, the executive director for the Tennessee Equality Project and Tennessee Equality Project Foundation provided a statement to the Blade about Ogles’s comment.
“The Tennessee Nuclear Family Month resolution has really backfired on conservatives by ensnaring Congressman Ogles in scandal. He used the resolution as a pretext to say that our community doesn’t belong in America, resulting in incredible backlash from across the partisan divide,” Sanders said. “It is a good opportunity for him to pause and reflect on whether it’s time for him to resign. Fighting one’s own constituents is not the purpose of serving in Congress.”
Human Rights Campaign Senior Press Secretary Jarred Keller provided a statement to the Blade regarding Ogles’s comments.
“LGBTQ+ people are woven into the fabric of America, and any politician who questions that is severely out of touch with reality. When so many people are worried about whether they can afford gas to get to work or groceries for their families, the last thing we need is right-wing Republicans targeting marginalized communities with hateful attacks,” Keller said. “Representative Ogles should spend less time attacking LGBTQ+ people and start addressing the issues that actually matter, because last I checked, our community isn’t the reason families are struggling to make ends meet.”
The controversy comes as Tennessee continues to advance legislation affecting LGBTQ residents. The state already has several laws on the books that LGBTQ advocates have criticized, including the Adult Entertainment Act, enacted in 2023, which restricts certain “adult cabaret performances.”
Lawmakers have also introduced additional measures this legislative session, including the “No Pride Flag or Month Act,” which would prohibit state employees, volunteers, and agents from displaying Pride flags or participating in Pride observances while acting in an official capacity.
Another proposal, the “Banning Bostock Act” would seek to limit the application of state anti-discrimination protections based on the U.S. Supreme Court’s decision in Bostock v. Clayton County. Tennessee lawmakers have also passed other measures restricting LGBTQ rights and access to gender-affirming health care.
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