Until recently, state based ADAPs have been the primary means for low-income PLWH to access lifesaving ART. Through direct ADAP, individual states pay for low-income patients’ HIV medications, which they receive along with HIV-related medical care and related support services (such as social work and nutrition counseling) at Ryan White-funded clinics. However, the advent of the ACA has created another possible route for ADAPs to improve access to care and medications for PLWH.
In some states, such as Virginia, the ADAP has begun to use some of its funds to purchase for patients, not just HIV drugs, but full insurance coverage through the ACA’s insurance marketplaces. As a result, Virginia’s low-income PLWH now have two options: traditional or “direct” ADAP in which the state pays for medications that patients receive care through Ryan White clinics; or enrollment in an ACA health plan using funds provided by Virginia’s ADAP to cover insurance premiums, deductibles, and medication copays.
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