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.
Florida
Gay Fla. Democrat Elijah Manley sees opportunity in Trump’s second term
State’s 20th Congressional District’s includes Broward, Palm Beach Counties
Just over two and a half miles from President Donald Trump’s primary residence lies one of Florida’s most reliably Democratic congressional districts. There, a 27-year-old progressive is mounting a campaign centered on resisting what he calls the Trump-Vance administration’s attacks on civil rights, immigrants, and LGBTQ Americans.
Elijah Manley, an openly gay Democrat, sat down with the Washington Blade to discuss why he is running for Florida’s 20th Congressional District, why he believes this moment calls for a new generation of leadership, and what he hopes to accomplish if elected to Congress.
Born and raised in Fort Lauderdale’s historic Sistrunk neighborhood — the city’s oldest African American community — Manley was raised by a single mother who struggled to make ends meet. His family experienced housing insecurity and, at one point, homelessness, experiences he says continue to shape both his politics and his policy priorities.
For Manley, those experiences are precisely what he believes Congress is missing.
“I think now the country is in need of somebody like me, with my story, my lived experience, the struggles I’ve been through in my life. We’re going through a really dark time in the country with the Trump administration coming for our civil rights and an economy that is not working for everybody. In a time where we have MAGA fascism, we need progressive leadership, and we need people who are really going to do the work of fighting back and resisting and obstructing Donald Trump and MAGA Republicans’ agenda in Congress.”
Manley said his campaign is also about ensuring people from marginalized communities — those without wealth, political connections, or institutional backing — have a voice in Congress.
“I think my story sets me aside from everyone else. I’m the only one in this race who has a story to tell voters that lines up with their lived experiences and their struggles. Growing up in poverty and experiencing homelessness was instrumental in developing my worldview and how I fight for people, and I think that’s something that’s absent on Capitol Hill.”
He argues that lived experience offers a perspective often missing on Capitol Hill.
“There are too many lawyers and people coming from professional and political backgrounds. Then you have somebody like me who is rooted in the story of this district. That’s what sets me apart from everyone else in this race.”
According to his campaign website, Manley’s interest in public service dates back to childhood. He cites the election of President Barack Obama as a defining moment that inspired him to pursue politics.
“He was inspired by Barack Obama’s historic election, igniting his passion for public service. He began writing to elected officials, speaking at school board and city council meetings, and advocating for issues affecting his community,” the website states. It goes on to describe his involvement in criminal justice and law magnet programs, Navy JROTC, and hundreds of hours of volunteer service while in high school.
As an openly gay candidate running during Trump’s second administration, Manley said Congress must take a far more aggressive approach to protecting LGBTQ Americans, particularly as Republican-led states continue passing restrictions targeting transgender people.
“I think we need to bring the hammer down on some of these states. I’m not one of these states’ rights people — Congress has the power to preempt laws that states pass through the Supremacy Clause. There’s never been a more important time in our history when we’re seeing fascism, we’re seeing an administration out of control, and we need Congress to act.”
His campaign has also drawn criticism from both Republicans and establishment Democrats for his positions on Gaza, immigration, and his call to abolish U.S. Immigration and Customs Enforcement.
Manley said abolishing ICE does not mean eliminating immigration enforcement altogether.
“I’m not saying there should be no immigration laws. We want laws around immigration, but we want dignity. We don’t need a hypermilitarized, paramilitary group chasing people through the streets, terrorizing communities, churches, schools, and families.”
His personal experiences also inform his healthcare agenda.
“When we talk about healthcare, my experience growing up on Medicaid is seeing the failure of the government to expand Medicaid here in Florida, and now we’re seeing cuts from the Trump administration. I’m not just looking at statistics or numbers on paper — this is based on lived experience. I know how the people in this district are going to be hurt by these policies because I’ve lived it.”
California Democratic Congressman Ro Khanna, who has generated early buzz as a potential 2028 presidential contender for his “progressive capitalist” approach to governing, has endorsed Manley’s campaign, giving the first-time congressional candidate one of his highest-profile endorsements.
Manley faces six other Democrats in the primary, including U.S. Rep. Debbie Wasserman Schultz and former U.S. Rep. Sheila Cherfilus-McCormick, along with four Republican candidates in the general election field. Cherfilus-McCormick resigned from Congress ahead of a potential expulsion and is running again while facing federal criminal charges.
Despite running as the youngest candidate in the field, Manley said he hopes voters leave the race remembering one thing above all else.
“I want people to remember bold and authentic leadership. I want them to know I’m running because I’ve been through what people are going through right now — and it’s not that I’ve been through it, I’m actually still going through it. We need bold people who are going to fight for everybody and stand up for what’s right, and that’s what I hope voters see when they go to the polls.”
Florida
Former Fla. gubernatorial candidate Andrew Gillum arrested on drug charges
Democrat narrowly lost to DeSantis in 2018, later came out as bisexual
Andrew Gillum, the former Democratic nominee for governor of Florida and former mayor of Tallahassee, was arrested on drug possession charges in Alabama last week.
Police in Daphne, Ala., said they pulled Gillum over for erratic driving and found marijuana and methamphetamine in his vehicle. He was charged with possession of marijuana and unlawful possession of a controlled substance, according to the Daphne Police Department. Jail records show he was arrested on July 2 and released on July 3, the Associated Press reports.
Gillum, the first Black nominee of a major political party for governor in Florida, lost the 2018 election to current Republican Gov. Ron DeSantis in a highly contentious race.
Once considered a rising star in national politics, Gillum served in Tallahassee’s local government, first as a city commissioner and then as mayor of Florida’s capital from 2014- 2018.
The Daphne Police Department said officers stopped Gillum’s vehicle around 10:45 p.m. and initiated a probable cause search after one officer noticed a glass pipe on the center console.
During the search, officers found several rolled marijuana cigarettes and three packages containing a substance that tested positive for methamphetamine, police said.
The day after his arrest he was charged with possession of dangerous drugs, use or possession of drug paraphernalia, and possession of marijuana.
In 2020, Gillum was involved in a similar incident when he was found in a Miami Beach, Fla., hotel room with a man identified as an escort who had apparently overdosed on drugs. Police also found three bags of suspected crystal methamphetamine in the room. The man survived, and no one was ever charged with a crime.
Later that year, Gillum came out as bisexual during an appearance on “The Tamron Hall Show,” where he discussed his struggles with drug and alcohol addiction and his decision to seek treatment following the 2020 incident.
In the same interview he shed light onto this, saying his substance use was a byproduct of the emotional struggles he experienced after losing the 2018 gubernatorial race to DeSantis.
This is not the first time Gillum has faced legal scrutiny.
During his 2014 mayoral campaign, he faced allegations of misconduct after hiring private equity investor Adam Corey as his campaign treasurer, raising questions about a potential conflict of interest. However, the FBI ultimately concluded there was no conflict of interest.
Pennsylvania
Philadelphia murder suspect remains at large
Two killed, one injured in attacks motivated by victims’ sexual orientation
Police seek the public’s support in finding a suspect wanted in connection with three Philadelphia shootings, including two murders, who may have targeted his victims because they were gay. All three shootings took place near Hunting Park Recreation Center between May 29 and June 26.
The suspect is 21-year-old Jahylin Melchur, who has not been located by police and is not in police custody as of July 7. Police seek the public’s support in tracking down the suspect, whose image was captured on surveillance cameras. Previous reporting underlined that Melchur should be considered armed and dangerous.
Each of the victims was found partially clothed between 10 and 11 p.m.
On May 29, a 55-year-old in Juniata Park was found two miles from the rec center. The victim, who survived the encounter with critical injuries, said a man approached him and announced his intention to rob him, before shooting him in the elbow and torso.
Martin Higgins, 45, was pronounced dead on the bleachers of the rec center’s baseball field on June 20, suffering from a gunshot wound to the abdomen. Sharef Holman, 29, was found near the basketball courts on June 26, suffering from multiple gunshot wounds. He was transported to Temple University Hospital but died shortly thereafter.
Deputy Police Commissioner Frank Vanore declined to answer the Philadelphia Inquirer’s question regarding whether the victims may have met Melchur on a dating app, citing the ongoing investigation. Sources told the Philadelphia Inquirer that investigators are exploring this possibility
Although robbery may be at least part of the motive in the first shooting, other movies are unclear.
NBC10 reported that law enforcement sources told the station all three victims were targeted because they were gay, but the Philadelphia Police Department did not confirm this.
The Philadelphia Police Department replied to PGN’s questions with an email stating, “This remains a very active investigation, and investigators are looking at all aspects of the case, including underlying motivations for committing these crimes.
“At this point, we can confirm that Melchur is wanted for two homicides by shooting and one non-fatal shooting, all of which occurred in the Hunting Park area.
“The investigation has not established that the victims were specifically targeted because of their sexual orientation.”
The Philadelphia Police Department is urging anyone with information to contact the Homicide Unit at 215-686-3334 or submit an anonymous tip by calling the PPD Tip Line at 215-686-TIPS (8477).
(This story is republished with permission of the Philadelphia Gay News.)
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