Following the slashing of hundreds of thousands of dollars from Florida’s AIDS Drug Assistance Program, AIDS Healthcare Foundation filed a lawsuit against the Florida Department of Health over what it says was an illegal change to income eligibility thresholds for the lifesaving program.

The Florida Department of Health announced two weeks ago that it would make sweeping cuts to ADAP, dramatically changing how many Floridians qualify for the state-funded medical coverage — without using the formal process required to change eligibility rules. As a result, AHF filed a petition Tuesday in Tallahassee with the state’s Division of Administrative Hearings, seeking to prevent more than 16,000 Floridians from losing coverage.

The medications covered by ADAP work by suppressing HIV-positive people’s viral load — making the virus undetectable in blood tests and unable to be transmitted to others.

Prior to the eligibility change, the Florida Department of Health covered Floridians earning up to 400 percent of the federal poverty level — or $62,600 annually for an individual. Under the new policy, eligibility would be limited to those making no more than 130 percent of the federal poverty level, or $20,345 per year.

The National Alliance of State and Territorial AIDS Directors estimates that more than 16,000 patients in Florida will lose coverage under the state’s ADAP because of this illegal change in department policy. Florida’s eligibility changes would also eliminate access to biktarvy, a widely used once-daily medication for people living with HIV/AIDS.

Under Florida law, when a state agency seeks to make a major policy change, it must either follow a formal rule-making process under the Florida Administrative Procedure Act or obtain direct legislative authorization.

AHF alleges the Florida Department of Health did neither.

Typically, altering eligibility for a statewide program requires either legislative action or adherence to a multistep rule-making process, including: publishing a Notice of Proposed Rule; providing a statement of estimated regulatory costs; allowing public comment; holding hearings if requested; responding to challenges; and formally adopting the rule. According to AHF, none of these steps occurred.

“Rule-making is not a matter of agency discretion. Each statement that an agency like the Department of Health issues that meets the statutory definition of a rule must be adopted through legally mandated rule-making procedures. Florida has simply not done so here,” said Tom Myers, AHF’s chief of public affairs and general counsel. “The whole point of having to follow procedures and rules is to make sure any decisions made are deliberate, thought through, and minimize harm. Floridians living with HIV and the general public’s health are at stake here and jeopardized by these arbitrary and unlawful DOH rule changes.”

AHF has multiple Ryan White CARE Act contracts in Florida, including four under Part B, which covers ADAP. More than 50 percent of people diagnosed with HIV receive assistance from Ryan White programs annually.

According to an AHF advocacy leader who spoke with the Washington Blade, the move appears to have originated at the state level rather than being driven by the federal government — a claim that has circulated among some Democratic officials.

“As far as we can tell, Congress flat-funded the Ryan White and ADAP programs, and the proposed federal cuts were ignored,” the advocacy leader told the Blade on the condition of anonymity. “None of this appears to be coming from Washington — this was initiated in Florida. What we’re trying to understand is why the state is claiming a $120 million shortfall when the program already receives significant federal funding. That lack of transparency is deeply concerning.”

Florida had the third-highest rate of new HIV infections in the nation in 2022, accounting for 11 percent of new diagnoses nationwide, according to KFF, a nonprofit health policy research organization.

During a press conference on Wednesday, multiple AHF officials commented on the situation, and emphasized the need to use proper methods to change something as important as HIV/AIDS coverage availability in the sunshine state. 

“We are receiving dozens, hundreds of calls from patients who are terrified, who are confused, who are full of anxiety and fear,” said Esteban Wood, director of advocacy, legislative affairs, and community engagement at AHF. “These are working Floridians — 16,000 people — receiving letters saying they have weeks left of medication that keeps them alive and costs upwards of $45,000 a year. Patients are asking us, ‘What are we supposed to do? How are we supposed to survive?’ And right now, we don’t have a good answer.”

“This decision was not done in the correct manner. County health programs, community-based organizations, providers across the state — none of them were consulted,” Wood added. “Today is Jan. 28, and we have just 32 days until these proposed changes take effect. Nearly half of the 36,000 people currently on ADAP could be disenrolled in just over a month.”

“Without this medication, people with HIV get sicker,” Myers said during the conference. “They end up in emergency rooms, they lose time at work, and they’re unable to take care of their families. Treatment adherence is also the best way to prevent new HIV infections — people who are consistently on these medications are non-infectious. If these cuts go through, you will have sicker people, more HIV infections, and ultimately much higher costs for the state.”

“Patients receiving care through Ryan White and ADAP have a 91 percent viral suppression rate, compared to about 60 percent nationally,” the advocacy leader added. “That’s as close to a functional cure as we can get, and it allows people to live healthy lives, work, and contribute to their communities. Blowing a hole in a program this successful puts lives at risk and sets a dangerous precedent. If Florida gets away with this, other states facing budget pressure could follow.”

The lawsuit comes days after the Save HIV Funding campaign pressed Congress to build bipartisan support for critical funding for people living with or vulnerable to HIV. In May of last year, President Donald Trump appeared to walk back his 2019 pledge to end HIV as an epidemic, instead proposing the elimination of HIV prevention programs at the Centers for Disease Control and Prevention and housing services in his budget request to Congress.

House appropriators, led by the Republican majority, went further, calling for an additional $2 billion in cuts — including $525 million for medical care and support services for people living with HIV. 

While Senate appropriators ultimately chose to maintain level funding in their version of the spending bills, advocates feared final negotiations could result in steep cuts that would reduce services, increase new HIV infections, and lead to more AIDS-related deaths. The final spending package reflected a best-case outcome, with funding levels largely mirroring the Senate’s proposed FY26 allocations.

“What the state has done in unilaterally announcing these changes is not following its own rules,” Myers added. “There is a required process — rule-making, notice and comment, taking evidence — and none of that happened here. Before you cut 16,000 people off from lifesaving medication, you have to study the harms, ask whether you even have the authority to do it, and explore other solutions. That’s what this lawsuit is about.”

The Trump-Vance administration and congressional Republicans’ “Big Beautiful Bill” could strip more than 10,000 Floridians of life-saving HIV medication.

The Florida Department of Health announced there would be large cuts to the AIDS Drug Assistance Program in the Sunshine State. The program switched from covering those making up to 400 percent of the Federal Poverty Level, which was anyone making $62,600 or less, in 2025, to only covering those making up to 130 percent of the FPL, or $20,345 a year in 2026. 

Cuts to the AIDS Drug Assistance Program, which provides medication to low-income people living with HIV/AIDS, will prevent a dramatic $120 million funding shortfall as a result of the Big Beautiful Bill according to the Florida Department of Health. 

The International Association of Providers of AIDS Care and Florida Surgeon General Joseph Ladapo warned that the situation could easily become a “crisis” without changing the current funding setup.

“It is a serious issue,” Ladapo told the Tampa Bay Times. “It’s a really, really serious issue.”

The Florida Department of Health currently has a “UPDATES TO ADAP” warning on the state’s AIDS Drug Assistance Program webpage, recommending Floridians who once relied on tax credits and subsidies to pay for their costly HIV/AIDS medication to find other avenues to get the crucial medications — including through linking addresses of Florida Association of Community Health Centers and listing Florida Non-Profit HIV/AIDS Organizations rather than have the government pay for it. 

HIV disproportionately impacts low income people, people of color, and LGBTQ people

The Tampa Bay Times first published this story on Thursday, which began gaining attention in the Sunshine State, eventually leading the Democratic Party to, once again, condemn the Big Beautiful Bill pushed by congressional republicans.

“Cruelty is a feature and not a bug of the Trump administration. In the latest attack on the LGBTQ+ community, Donald Trump and Florida Republicans are ripping away life-saving HIV medication from over 10,000 Floridians because they refuse to extend enhanced ACA tax credits,” Democratic National Committee spokesperson Albert Fujii told the Washington Blade. “While Donald Trump and his allies continue to make clear that they don’t give a damn about millions of Americans and our community, Democrats will keep fighting to protect health care for LGBTQ+ Americans across the country.”

More than 4.7 million people in Florida receive health insurance through the federal marketplace, according to KKF, an independent source for health policy research and polling. That is the largest amount of people in any state to be receiving federal health care — despite it only being the third most populous state.

Florida also has one of the largest shares of people who use the AIDS Drug Assistance Program who are on the federal marketplace: about 31 percent as of 2023, according to the Tampa Bay Times.

“I can’t understand why there’s been no transparency,” David Poole also told the Times, who oversaw Florida’s AIDS program from 1993 to 2005. “There is something seriously wrong.”

The National Alliance of State and Territorial AIDS Directors estimates that more than 16,000 people will lose coverage

El próximo 5 de septiembre, el arte del transformismo en Miami celebra a una de sus figuras más queridas: Alexis Fernández, conocido en el escenario como Marytriny, la emperatriz del transformismo. Su cumpleaños no es solo una fecha en el calendario: es un recordatorio de que la vida, cuando se vive con entrega y disciplina, se convierte en celebración colectiva. Su historia es testimonio, es lucha y es inspiración.

Marytriny nunca actuó en Cuba en sus inicios, pues su personaje nació en Miami, tierra de libertad. No fue hasta el 2014 cuando, por primera vez, tuvo la oportunidad de presentarse en la isla, como si el destino hubiera conspirado a su favor. Alexis viajó entonces a Cuba en medio de un momento político marcado por el acercamiento entre Barack Obama y La Habana. Su madre estaba enferma y aquel viaje coincidió con una invitación del maestro Raúl de la Rosa al Teatro América.

Al finalizar el espectáculo, en el que Marytriny dio vida a la Guarachera de Cuba, la queridísima Celia Cruz, uno de los directivos del teatro se le acercó y le comentó que su interpretación se sintió como si la misma Celia se hubiera presentado en ese escenario. Vale recordar que, desde su salida en 1960, Celia Cruz nunca volvió a Cuba, salvo durante la crisis de los balseros, cuando cantó a los cubanos que permanecían en la Base Naval de Guantánamo.

En esa ocasión única, Marytriny encarnó a Celia como un acto de rebeldía y de búsqueda personal. Fue la primera y única vez que subió a un escenario en la isla, llevando consigo la fuerza de un arte que en Cuba había sido prohibido y silenciado.

Desde sus primeros pasos en Azúcar Night Club en Miami, Marytriny se convirtió en referencia cultural, ícono de comunidad y símbolo de resistencia. Y aquí surge la primera pregunta: ¿Cómo recuerdas esos primeros pasos en Miami, cuando Marytriny empezaba a nacer bajo las luces de la libertad?

La respuesta de Marytriny refleja la autenticidad de su camino.

“Los primeros momentos fueron duros… era todo desconocido para mí, encontrando un espacio para conectar con un público nuevo. Pero entregué toda mi cubanía, alegría y nostalgia de llegar a un país multicultural como esta ciudad de Miami. Fui yo, auténtico, y de pronto la magia de las risas y el aplauso. Fue como un amor a primera vista entre el público y yo. Ya son 26 años y ese amor a lo que hago sigue igual… la gente lo necesita y agradece. Surge el amor incondicional de este arte”.

La disciplina y la entrega lo llevaron más allá del cabaret.

En Telemundo protagonizó la serie “Decisiones”. En América TV formó parte de la novela de larga duración “La Flor de Hialeah”. También trabajó en el cine y en documentales, entre ellos producciones que narraron la vida de Celia Cruz, confirmando que su talento no conoce fronteras. Y entonces aparece la segunda pregunta: ¿Qué significó para ti abrirte paso en la televisión y el cine, y cómo lograste llevar el espíritu de Marytriny más allá de los escenarios nocturnos?

Su voz, firme y reveladora, responde:

“A medida que fue creciendo mi personaje de Marytriny, su voz fue más fuerte, auténtica y llena de verdades silenciadas. Es la voz de muchos que no saben cuál es el camino para encontrar sus libertades y, sobre todo, a quererse y a liberarse de los prejuicios para recuperar esa libertad que nos arrancaron. Difícil hacerlo desde mi personaje… a pesar del tiempo sigue siendo difícil, sobre todo por muchos conservadores que nos siguen atacando. Pero aquí estamos”.

En 2023, la vida lo enfrentó con un reto inesperado: un diagnóstico de cáncer de próstata. Con la transparencia que lo caracteriza, Alexis lo compartió públicamente. Su comunidad respondió con amor y solidaridad, acompañándolo en cada paso. Tras la cirugía, una rosa blanca en su casa se convirtió en símbolo de fe y renacimiento.

En 2024, dio un paso determinante al participar en “Ser Trans”, una producción de TV Martí que expuso la transfobia en Cuba y recuperó las voces que por décadas habían sido silenciadas. Ese mismo año, la obra fue reconocida con un Suncoast Regional Emmy, un galardón que se convirtió en algo más que un premio: fue la constatación de que esas historias tenían un valor innegable y que ya no podían ser relegadas al silencio.

Y entonces llega la tercera pregunta: ¿Qué aprendiste de ti mismo durante la enfermedad y qué mensaje de esperanza quieres dejar a quienes luchan con sus propias batallas?

Marytriny responde con la fuerza de quien ha vencido la tormenta:

“La vida te pone pruebas duras, pero Dios escoge sus guerreros. Esta enfermedad me sirvió para cambiar mi vida y mi forma de pensar, y para ayudar a otros a tomar conciencia, encontrar la fe y dejar un legado de amor. Tolerancia y disciplina son el camino para lograrlo todo… Por eso digo ¡gracias!, y amor con amor se paga”.

Aunque aún faltan algunos días para la celebración de su cumpleaños, desde ya queremos comenzar a celebrar la vida de Alexis Fernández, un artista con más de dos décadas de trayectoria, mentor, voz y presencia de comunidad. Cada vez que Marytriny aparece en escena, no vemos solo a un personaje: vemos a un hombre que convirtió su arte en un canto de libertad, en una afirmación de identidad y en un motivo de orgullo para quienes lo rodean.

El próximo 5 de septiembre, cuando sople las velas, su cumpleaños no pertenecerá solo a él, sino también a todos los que alguna vez rieron, lloraron o se reconocieron en Marytriny. Porque su vida no es solo espectáculo: es un acto de amor y de resistencia. Y cuando caiga el telón, quedará claro que hemos sido testigos de algo más grande que un show: la vida misma de una emperatriz que brilla más que las estrellas.