A new policy from Blue Cross Blue Shield of North Dakota threatens access to treatment and health care for people living with HIV and AIDS.
Several months ago, the Centers for Medicare and Medicaid Services (CMS) encouraged health plans to stop accepting "third-party payments," but in early February, CMS stated unequivocally that "federal rules do not prevent the use of Ryan White funds to pay for health care plans."
The Ryan White Act of 1990 is the largest federally funded program in the United States, created to help people living with HIV to pay for HIV care and HIV medicine. Many Ryan White programs pay insurance premiums for HIV patients, as this opens up care across the board, not just for HIV-related care.
The Ryan White program is known as a “payer of last resort”, meaning it funds treatment and care when NO OTHER RESOURCES ARE AVAILABLE.
For people with HIV, especially those also living in or near poverty, Ryan White is literally the last option available to them -- the literal difference between life and death. People who have HIV but do not receive care die an average of 5-8 years after they contract HIV. That means someone whose insurance policies are dropped because they are on Ryan White can be dead within a few years.
According to reports, Blue Cross Blue Shield of North Dakota (BCBSND) has joined another affiliate of the Blue Cross Blue Shield Association (BCBS Louisiana) in refusing to accept Ryan White payments from the federal government to cover premiums on accounts from the Affordable Care Act for HIV and AIDS patients.
When I reached out to BCBSND, they told me under no uncertain terms that they “have not revised our policy at this time….Regarding the Ryan White Program, our current policy is based on North Dakota state century code and does not allow us to accept payment of member premiums by third parties, including employers, providers and state agencies” -- even though CMS has clearly stated insurers SHOULD accept these funds.
In effect, BCBSND has decided to not provide coverage to people with HIV, of their insurance premiums are paid for by the Ryan White program. One of the great benefits of the Affordable Care Act is that it makes it illegal for insurers to deny coverage based upon a pre-existing condition, and that insurers can not pick and choose who they will cover.
Please join me in calling on Blue Cross Blue Shield of North Dakota to reverse this policy and accept Ryan White funds for eligible patients. I'm also encouraging Governor Jack Dalrymple to throughly review the guidelines and CMS to do more to ensure that companies like BCBSND comply with their recommendations.