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Higher AIDS drug costs under Obamacare?

Sebelius urged to allow drug company subsidies in exchanges

Published

13 years ago

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Kathleen Sebelius, AIDS, HHS, gay news, Washington Blade

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.

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National

Lou Chibbaro Jr. documentary wins award from NLGJA

‘Lou’s Legacy’ produced by D.C.’s Mattachine Society

Published

23 hours ago

on

September 2, 2026

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“Lou’s Legacy: a Reporter’s Life at the Washington Blade,” a documentary produced by The Mattachine Society of Washington, D.C., will receive an Excellence in Journalism Award from NLGJA, the Association of LGBTQ+ Journalists. 

The film premiered on WETA PBS in D.C. and Maryland Public Television (MPT) in June of 2025. The documentary’s Emmy-nominated director and producer Patrick Sammon will accept the award for Excellence in Local Television on Sept. 11 at NLGJA’s National Convention in San Francisco. 

“Lou’s Legacy” was produced in association with the Mattachine Society of Washington, D.C., a non-profit LGBTQ history society dedicated to conducting original archival research. Aside from Sammon, the NLGJA is recognizing other members of the film’s production team including Producer Julianne Donofrio, Editor Amir Jaffer, Executive Producer Charles Francis, and Executive Producer Pate Felts.  

“Lou’s Legacy” tells the story of two D.C. icons — legendary Washington Blade reporter Lou Chibbaro Jr. and beloved drag performer Donnell Robinson, known to generations of Washington audiences as “Ella Fitzgerald.” Through Lou’s nearly five-decade career at the Blade and Ella’s return to the stage after a three-year hiatus following COVID, the 29-minute documentary explores the history of Washington’s LGBTQ community and today’s rising backlash against LGBTQ rights, including laws targeting drag performers. 

“All students of journalism can learn a lot from the story of Lou Chibbaro, Jr. Lou has chronicled nearly five decades of LGBTQ+ life and the community’s struggle for equality in Washington, D.C. Lou’s work and the role of the queer press has been essential in covering stories the mainstream media would often ignore or erase,” said Ryan Levi, president of the D.C. chapter of the NLGJA.  

“We are thrilled to receive this award from the NLGJA,” said the film’s director Patrick Sammon. “Lou Chibbaro’s nearly five decade career at the Washington Blade demonstrates the essential role LGBTQ journalism plays in telling our community’s stories and documenting its history. This recognition from journalists who follow in Lou’s footsteps is particularly meaningful to me and the rest of our production team.”

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Arizona

Shooting outside gay bar in Ariz. leaves three dead

Tucson police investigating double murder-suicide as a hate crime

Published

2 days ago

on

September 1, 2026

By

The shooting happened outside Venture-N bar in Tucson, Ariz. (Washington Blade photo by Michael K. Lavers)

Three people were fatally shot outside a gay bar in Tucson, Ariz., early Monday morning, about a mile from the city’s nightlife district.

Police have said the shooting, which took place in the parking lot of Venture-N bar at 1239 N. 6th Ave., was likely a hate crime and a double murder-suicide following a verbal altercation.

The suspect, Ousman Ceesay, allegedly shot Vincent Anthony Siqueiros and Cameron Davis Capara while they were outside the club around 12:30 a.m. Monday.

Reports show Capara and Siqueiros were pronounced dead at the scene. Ceesay died after being taken to a local hospital with gunshot wounds.

Police have also said that Ceesay was carrying a list of LGBTQ businesses at the time of the shooting.

Arizona Public Media has said police are investigating the case as a hate crime because the suspect was carrying a note containing the names of multiple LGBTQ-associated businesses.

“I am deeply saddened that another senseless loss of life has happened in our community,” Tucson Police Chief Monica Prieto said in a statement. “Bias-based crimes are especially heinous and have no place in our community.”

According to Prieto, there is no imminent threat to the community, and the Tucson Police Department is working to provide extra protection to various LGBTQ businesses across town.

Congresswoman Adelita Grijalva, who represents the area, issued a statement condemning the act of violence, which appears to have been at least in part motivated by homophobia.

“I am disgusted and deeply saddened to learn of a targeted act of hate and the cold-blooded murder of two members of our LGBTQIA+ community, Vincent Siqueiros and Cameron Capara, at the Venture-N bar in Tucson last night. This horrific attack is a painful reminder that even in welcoming communities like Tucson, hate and violence against the LGBTQIA+ community still exist.”

“When that hate is combined with easy access to firearms, the consequences can be deadly. I am sick and tired of Congress refusing to lift a finger to protect our communities while, every day, dozens of people are shot and killed across the country. It does not have to be this way. The House of Representatives is returning to session this week, and our first action should be passing common-sense gun safety reforms that we know can save lives.”

Other federal lawmakers also condemned the shooting.

The Congressional Equality Caucus, which is made up of federal legislators advancing LGBTQ interests, issued a statement after news broke.

“Our hearts are with the friends and loved ones of the victims of this devastating attack outside a Tucson gay bar and with the Tucson LGBTQI+ community,” it said on X. “No one should fear violence because of who they are — and we’re going to continue fighting to build a world where no one does.”

The Human Rights Campaign, the largest LGBTQ organization in the country, released a statement following the shooting.

“We are heartbroken by the loss of Vincent Anthony Siqueiros and Cameron Davis Capara and our hearts are with their families, loved ones, and the entire Tucson LGBTQ+ community. Once again, we are reminded that gun violence robs people of their lives, destroys families, and devastates communities.”

A candlelight vigil honoring the victims is planned for Sept. 2 at 6:30 p.m. at Catalina Park in North Tucson.

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Congress

HRC president campaigns for Chris Pappas in NH

Gay congressman running to succeed retiring U.S. Sen. Jeanne Shaheen

Published

3 days ago

on

August 31, 2026

By

Human Rights Campaign President Kelley Robinson, left, campaigns with U.S. Rep. Chris Pappas (D-N.H.) in Manchester, N.H., on Aug. 30, 2026. (Photo courtesy of the Human Rights Campaign)

Human Rights Campaign President Kelley Robinson on Sunday campaigned for U.S. Rep. Chris Pappas (D-N.H.) in New Hampshire.

Robinson traveled to Manchester, the state’s largest city, nine days before the Sept. 8 primary that will determine who will vie for retiring U.S. Sen. Jeanne Shaheen (D-N.H.)’s seat.

Former U.S. Sen. John E. Sununu, who represented New Hampshire in the U.S. Senate from 2003-2009, will face off against former U.S. Sen. Scott Brown, who represented Massachusetts in the U.S. Senate from 2010-2013, in the Republican primary.

Karishma Manzur is among the Democrats challenging Pappas.

A poll the University of New Hampshire Survey Center released on Aug. 26 shows Sununu is ahead of Brown. The same survey shows Pappas ahead of Manzur and his other Democratic challengers.

The UNH Survey Center poll shows Sununu ahead of Pappas by a 45-43 percent margin if they were to face off in the general election. The margin of error is +/-2.1 percent.

Pappas would become the first openly gay man elected to the U.S. Senate if he were to win in November.

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