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Regence BlueCross BlueShield of Utah: Stop classifying anti-HIV drugs as unaffordable "specialty" drugs.

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Routine brand-name anti-HIV and other expensive chronic-condition drugs are now falsely classified by Regence BCBS of Utah as 'specialty' drugs in order to discriminate against HIV-positive and other chronic-condition patients by requiring them to pay huge and unaffordable co-pays which, for me, ended up being over $150 per drug per month -- even though I have Medicare Part D insurance coverage, get 'extra help' from Medicare to pay for my prescriptions because I'm poor, and for 1.5 years elected to pay a higher monthly premium specifically so my drug co-pays would be even lower. (Regence then simply pocketed that extra monthly premium amount without providing any additional drug coverage.)

[My co-pay on my anti-HIV meds was a lower 15% because of Medicare 'extra help' because I'm poor. Without that 'extra help', the co-pay would have been 33% and therefore much higher. Even at 15%, they are still unaffordable.]

Without additional federally-funded, state-run ADAP programs to pay these huge co-pays, poor patients like me can't afford these essential medications. ADAP programs are no longer a reliable funding source and it seems likely that funding for these programs will be cut drastically and maybe even completely soon. Routine brand-name anti-HIV drugs should be classified by Regence BCBS as lower-tier, regular brand-name drugs with affordable co-pays.

Please sign my petition at the link above.

Thank you!
Stuart McDonald


It's clear that the University of Utah and Regence conspired to drive out retired and disabled employees who are poor and with expensive, chronic conditions from the University's group health insurance plans by making them unaffordable either through out-of-reach premiums and/or out-of-pocket co-pays. This makes these group plans no more affordable than the alternative of an individual insurance plan. Under either, we can't afford the medical care we need.

I want to thank Michelle Bonner, Appeals and Grievance Department of Regence BCBS of Utah, for now confirming to me that the University of Utah health insurance plan drug coverage for it's retired and disabled employees through Regence doesn't just discriminate against those with HIV. It arbitrarily lists drugs used to treat many chronic conditions as 'specialty' drugs only because they're expensive, even though they're routine brand-name drugs for treating these conditions. I'll quote her big lie:

"Specialty drugs are prescription medications that require special handling, administration, or monitoring. These drugs are used to treat complex, chronic and often costly conditions, including: Asthma, Cancer, Chronic kidney failure, Hepatitis C, HIV/AIDS, Infertility, Multiple sclerosis, Organ transplants, Osteoporosis, Psoriasis, Rheumatoid arthritis. [Note: that's probably just a partial list.] As you can see from this list, there are many other conditions besides HIV that require specialty drugs, and due to the level of direct physician involvement required, the cost for these drugs can be enormous."

Her explanation doesn't apply at all to anti-HIV and many other routine, brand-name chronic-condition drugs. They've made co-pays for these expensive drugs so high in order to make them unaffordable in order to discourage or even prevent the insured from getting them; if the insured can't get them, the insurance company and Medicare don't have to pay anything for them. In addition, it makes no legitimate sense that the insured's drug copay amounts should be increased by factoring in any other medical costs associated with treating that person's chronic condition(s).

Even worse, she admits here that it's not just drug co-pays, but in fact all co-pays associated with treating expensive chronic conditions, that are set so high because of the overall high costs of treating these chronic conditions. Regence here is admitting to routinely inflating co-pays for all treatments and medications needed for expensive chronic conditions so as to discourage or even prevent the insured from getting them. Once again, if the patient can't get them because they're unaffordable, Regence and Medicare don't have to pay anything.

These big-corporate, insurance-company welfare queens suck up huge amounts of taxpayer monies to provide care for the poor. Yet they still don't provide adequate and affordable health care, and instead soak whatever additional sources they can. Even then, they still don't provide adequate and affordable care for poor patients. When the poor simply have no more available resources to pay for their care, they must go into enormous dept they can't repay or can't get the medical care they need. As US House Rep. Alan Grayson (D-FL) says about the Republican goal for health care for all but the very rich: "Don't get sick. But if you do get sick, die quickly."

In Utah, paying a full 10% tithing to the Mormon Church (one of the country's biggest corporate-welfare queens -- because it pays no taxes on huge amounts of income despite it's continuing, pervasive and barely-hidden political activities) is a health and other safety-net insurance premium for Mormons. The goal of Utah Republicans (like Republicans everywhere) is to ensure that the only non-rich people in the US provided adequate and affordable health care (i.e. full tithe-paying Mormon Church members) will be completely at the whim of the filthy-rich (i.e. the Mormon Church) and under any conditions they demand.

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