The Center for Health Law and Policy Innovation (CHLPI) has monitored trends in state Marketplaces for the past three years of open enrollment. CHLPI has been concerned by lower rates of coverage and higher cost-sharing for necessary HIV and HCV treatment regimens, particularly in the Silver Qualified Health Plans (QHPs) offered across the nation. This is alarming because Silver QHP are meant to be the most cost-effective plan for low- and moderate-income individuals. These failures to meet the needs of people living with HIV/HCV means that these individuals cannot fully realize the promises of the Affordable Care Act.
CHLPI is continuing this effort today with the start of open enrollment with a dual purpose. First, CHLPI, alongside sixteen state partners conducting plan assessments, hope that the information gathered can be useful as people living with HIV, Hepatitis C, and other chronic illnesses seek to enroll or renew their plans during the shortened Open Enrollment and select the plans that offer the best coverage and lowest cost-sharing for them. Second, CHLPI will hold insurers accountable for any discriminatory practices discovered, including inadequate coverage of HIV/HCV medications as well as disproportionately high cost-sharing imposed on HIV/HCV treatment regimens. CHLPI will work with its state partners to spur both state and federal regulators to action and hold insurers accountable for their discriminatory practices.