Advocates Continue Push to Require Insurers to Accept Ryan White Payments

By Amy Killelea, Associate Director, Health Care Access, NASTAD

CMS ACA Ryan White Payment Guidance

Insurers in two states – Blue Cross and Blue Shield in Louisiana and North Dakota – have prohibited the acceptance of premium payments from the Ryan White Program/AIDS Drug Assistance Program (ADAP) on behalf of eligible low-income clients. These policies risk leaving hundreds of low-income people living with HIV unable to access Qualified Health Plan coverage through the Affordable Care Act (ACA) and have prompted a swift federal and state advocacy response.

On Friday, the Centers for Medicare and Medicaid Services (CMS) issued updated guidance clarifying that Qualified Health Plans are allowed to accept premium payments from the Ryan White Program/ADAP, and encouraging them to do so. However, we remain concerned that without a federal requirement, insurers will continue to set discriminatory payment policies. NASTAD is working with our federal coalition partners to urge CMS to issue an explicit requirement that issuers accept premium payments from Ryan White Program/ADAP, and we will keep you posted on this effort.

In addition, Lambda Legal has filed an administrative complaint with the federal Office of Civil Rights challenging the policy in Louisiana.

We have been monitoring this issue nationwide and have not yet heard of any other instances of premium payments from the Ryan White Program/ADAP being refused.

We want to hear from you! Are you aware of premium payments from the Ryan White Program/ADAP being refused? Please let us know by leaving a comment below or contacting Amy Killelea.