Florida
AIDS Healthcare Foundation sues Fla. over ‘illegal’ HIV drug program cuts
Tens of thousands could lose access to medications
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.”
Florida
Key West Pride’s state funding pulled
Republican Fla. Gov. Ron DeSantis signed anti-DEI bill
Following the passage of anti-DEI legislation in Florida, Key West will no longer receive any state funding for its future Pride events.
In a letter provided to the Key West Business Guild, the LGBTQ visitor and tourism center for the string of islands, a senior assistant county attorney for Monroe County officially said that the organization would no longer receive funding for its ongoing projects as a result of Senate Bill 1134 and House Bill 1001, starting in 2027.
The popular Key West Pride, gay men–leaning Tropical Heat weekend, and Womenfest will no longer receive any state money. This is something that Gay Key West Visitor Center Executive Director Rob Dougherty highlighted will shift how all the largest LGBTQ events in the Keys will be held after this year.
He said that the explanation is solely a result of SB 1134 and HB 1001, which limits the official actions of local governments by “prohibiting counties and municipalities, respectively, from funding or promoting or taking official action as it relates to diversity, equity, and inclusion …”
The legislation is being used to impose restrictions on funding events that exclude — whereas the events’ true purpose is to uplift already marginalized groups.
“Womenfest lost it [funding] because it’s a women’s-only event. Tropical Heat lost it because it’s a men’s-only event … that’s how this is being applied.”
This will not impact anything this year, Dougherty assured the Washington Blade; however, the future is not as certain.
“The law that (Republican Florida) Gov. DeSantis signed does not go into effect until Jan. 1, so for 2026 we’re okay,” Dougherty told the Blade. “But it impacts Key West Pride 2027, it impacts Tropical Heat 2027 and Womenfest — so we have lost all funding for those three events.”
He said that this will amount to a large chunk of the expected funding for the LGBTQ celebrations, which the Key West tourism board says is “internationally known as a gay mecca.”
“We’re due to lose about $200,000. Not all of that is direct, but the way that the Tourist Development Council (TDC) distributes their money, about $75,000 of it is for Key West Pride, and that helps to pay for things like marketing, swag, and other things that promote the event.”
He went on to explain that marketing to many major metropolitan areas with large LGBTQ populations may not see the same Key West advertisements and push as in years past — and that is the point.
“Our digital marketing, our print marketing, our SEO marketing — all of that is paid for through there, and it targets places with direct flights like Washington, D.C., New York, Philly, Atlanta, Dallas. So it’s definitely going to impact that.”
The money that will stop coming is not just to run events and celebrations, he explained. Money that goes back directly into the community is going to be hardest hit.
“An estimated 250,000 LGBTQ+ travelers make it to Key West on an annual basis, and on a very conservative basis, for every LGBTQ+ person there are two to four allies traveling with the same values.”
“The TDC also estimates that $1,500+ is spent per person per visit … so if you take those figures and multiply those all together, it comes up to about $1.2 billion … that is potentially going to be lost.”
He says that this will intrinsically change how Key West’s tourism — especially the large LGBTQ side of it — will run, especially since gay vacations need a foundation and expectation of safety and support to blossom.
“We travel based upon where we feel most welcome,” Dougherty said. “Key West has always been its own little place … the LGBTQ+ history of Key West and everything about Key West has always been a little bit weird for people, and that’s why they come here.”
The Guild was formed in 1978 to encourage summer tourism and support Key West’s gay community — becoming the nation’s first LGBTQ destination marketing organization. It has grown tremendously from its original membership to now include more than 475 enterprises representing virtually every facet of the island’s business community.
He also went on to say that this should be eye-opening for anywhere considered an LGBTQ destination, regardless of whether it is in a blue state or a red one.
“I think it can be a wake-up call across the country, because if it can happen here, it can happen anywhere.”
Florida
DeSantis signs emergency bill that restores Fla. ADAP funding
Temporary funds to last through June 30
After the Florida Department of Health made huge cuts to the AIDS Drug Assistance Program in January, Republican Gov. Ron DeSantis has signed emergency legislation restoring HIV access to more than 12,000 Floridians.
Two months ago, as the Washington Blade reported, the Sunshine State cut the vast majority of those in ADAP by shifting the income levels required for eligibility — without following standard procedure when changing government policy outside of legislative or executive action.
The bill, signed by DeSantis on Tuesday, passed both chambers of the Florida Legislature unanimously and appropriates $30.9 million in emergency bridge funding through June 30, 2026. It restores Florida’s ADAP income eligibility to 400 percent of the Federal Poverty Level — the level it was prior to the January cuts. The legislation also requires the FDOH to submit detailed monthly financial reports to legislative leadership beginning April 1.
Under the old policy, eligibility would have been limited to those making no more than 130 percent of the federal poverty level, or $20,345 per year.
“For 10 weeks, 12,000 Floridians living with HIV did not know if they could fill their next prescription. Today, they can,” Esteban Wood, director of advocacy and legislative affairs at AIDS Healthcare Foundation, said in a statement.
The detailed reports now required to be sent to legislative leadership must include all federal revenues and expenditures, including manufacturer rebates; enrollment figures by county and insurance status; prescription utilization by drug class; and any projected funding shortfalls. This is the first time the Legislature has required this level of financial transparency from the program.
DeSantis signed the legislation one day after a Leon County Circuit Court judge denied AIDS Healthcare Foundation’s request for an injunction to block the significant changes the DeSantis administration is making to the program, which it claims faces a $120 million shortfall for calendar year 2026.
AIDS Healthcare Foundation, a national organization focused on protecting and expanding HIV healthcare access and prevention methods, filed a lawsuit over the change in eligibility, arguing the Florida Department of Health did not follow the laid out path for formally changing policy and was acting outside established procedures.
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 AIDS Healthcare Foundation, none of these steps occurred.
The long-term structure of ADAP will be determined by the 2026–2027 fiscal year state budget, something that lawmakers have until June 30 to finish.
Florida
Fla. House passes ‘Anti-Diversity’ bill
Measure could open door to overturning local LGBTQ rights protections
The Florida House of Representatives on March 10 voted 77-37 to approve an “Anti-Diversity in Local Government” bill that opponents have called an extreme and sweeping measure that, among other things, could overturn local LGBTQ rights protections.
The House vote came six days after the Florida Senate voted 25-11 to pass the same bill, opening the way to send it to Republican Gov. Ron DeSantis, who supports the bill and has said he would sign it into law.
Equality Florida, a statewide LGBTQ advocacy organization that opposed the legislation, issued a statement saying the bill “would ban, repeal, and defund any local government programming, policy, or activity that provides ‘preferential treatment or special benefits’ or is designed or implemented with respect to race, color, sex, ethnicity, sexual orientation, or gender identity.”
The statement added that the bill would also threaten city and county officials with removal from office “for activities vaguely labeled as DEI,” with only limited exceptions.
“Written in broad and ambiguous language, the bill is the most extreme of its kind in the country, creating confusion and fear for local governments that recognize LGBTQ residents and other communities that contribute to strength and vibrancy of Florida cities,” the group said in a separate statement released on March 10.
The Miami Herald reports that state Sen. Clay Yarborough (R-Jacksonville), the lead sponsor of the bill in the Senate, said he added language to the bill that would allow the city of Orlando to continue to support the Pulse nightclub memorial, a site honoring 49 mostly LGBTQ people killed in the 2016 mass shooting at the LGBTQ nightclub.
But the Equality Florida statement expresses concern that the bill can be used to target LGBTQ programs and protections.
“Debate over the bill made expressly clear that LGBTQ people were a central target of the legislation,” the group’s statement says. “The public record, the bill sponsors’ own statements, and hours of legislative debate revealed the animus driving the effort to pressure local governments into pulling back from recognizing or resourcing programs targeting LGBTQ residents and other historically marginalized communities,” the statement says.
But the statement also notes that following outspoken requests by local officials, sponsors of the bill agreed to several amendments “ensuring local governments can continue to permit Pride festivals, even while navigating new restrictions on supporting or promoting them.”
The statement adds, “Florida’s LGBTQ community knows all too well how to fight back against unjust laws. Just as we did, following the passage of Florida’s notorious ‘Don’t Say Gay or Trans’ law, we will fight every step of the way to limit the impact of this legislation, including in the courts.”
