Two HIV organizations are accusing Blue Cross Blue Shield of North Carolina of discriminating against people who use drugs to treat or prevent the virus.
The HIV+Hepatitis Policy Institute and the North Carolina AIDS Action Network filed discrimination complaints Thursday against the insurer for placing nearly all HIV medications on its highest-cost drug tiers.
According to the complaints, most HIV antiretroviral medications were categorized as the “highest-cost prescription medications” on health plans for 2022 and 2023. Meanwhile, the only generic drug used to prevent HIV was placed on the second-lowest of six tiers. Antiretroviral drugs are used to keep a person’s viral load at undetectable levels.
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“We believe the formulary design violates the Affordable Care Act’s (ACA) prohibitions against discriminatory plan design, jeopardizing access to medications for HIV prevention and treatment in the state,” stated the complaint filed with the North Carolina Department of Insurance.
ACA is popularly known as Obamacare, which overhauled the health insurance sector.
According to ACA’s non-discrimination provisions, “placing all drugs for a particular condition on a high-cost tier discourages enrollment and is presumptively discriminatory,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute.
His group and the North Carolina AIDS Action Network asked state and federal health officials to not only enforce the ACA requirements, but also “work proactively with all issuers in the state to ensure that people living with and vulnerable to HIV have access to the drugs and services they need.”
Blue Cross Blue Shield of North Carolina didn’t immediately respond to a request for comment Thursday afternoon.
