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Broward County Florida puts income cap on Ryan White services
  Local AIDS activist says change penalizes people with HIV who work
Saturday, September 23, 2006
Broward County has made it more difficult for HIV patients to qualify for free care and medications through the federal Ryan White program, and that has at least one local activist concerned that some people with HIV will not be able to afford health care.
The Broward County HIV Health Services Planning Council recently voted to restrict access to the program based on a patient's income, the coordinator of the planning council confirmed this week. The income cap affects patients applying for Ryan White Title 1 services, which include primary medical care such as doctor's visits, lab work, medications, dental care and substance abuse treatment.
The new cap limits access to the program to individuals with an annual income of $29,400 or less, which is 300 percent of the federal poverty level, the official said. The cap will be $39,600 per year or less for a family of two. The policy change goes into effect in March 2007.
Previously, there was no income restriction on the Ryan White program in Broward County. The services were available to any patient without private insurance who did not qualify for other programs.
Michael Rajner, a local activist and national secretary for the Campaign to End AIDS, worried that the eligibility change will result in more HIV patients falling through the cracks and losing access to health care.
"People are falling through the cracks now," Rajner said.
But Terri Suddon, coordinator for the county's HIV Planning Council, said the council had found that the cap would affect only 44 patients out of 7,000 receiving Ryan White care from the county. Those whose income exceeds the cap could still qualify for Ryan White help on a case-by-case basis, Suddon said.
Rajner, however, said the cap penalizes HIV patients who try to remain active and continue to work while rewarding those who do nothing and live off of the government.
Creating social-welfare addicts?
"We're making people addicted to social-welfare programs," Rajner said. Rajner added that the poorest HIV patients "must be taken care of."
Suddon said patients who make more than $29,400 per year could still receive care from Ryan White but there would be co-pays. She said the council hadn't decided how much patients would have to pay out of their own pockets. The services would be provided on a sliding-scale basis, she said.
But Rajner described several scenarios in which he believed the cap could cause people to lose their health care for good, or at least temporarily while they sift through applications for other HIV government programs.
"A person who's making $28,000 would be kicked out of the [Ryan White] program if they get a $1,500 pay raise," Rajner said.
In addition, he said a person who starts a job earning $40,000 with health insurance benefits might not be covered for HIV treatments for a year because so many private insurance policies do not cover new employees' care for "pre-existing conditions" for the first year of employment.
"That person is probably not going to go to the doctor and will not receive care if they can't qualify for Ryan White," Rajner said.
Suddon, however, pointed out that the county also has other programs in place for people who are working but can't afford health insurance.
Rajner also noted that Broward County has one of the highest rates of new HIV cases in the country. He maintained that a "case-by-case" approach "means there's no established criteria or guarantee that a person would receive care."
Mike DeLucca, executive director of the Broward Regional Health Planning council, which administers the HIV planning council, did not return a phone call seeking comment.
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