Home Insurance Houston-based health insurance agency discriminates against people with HIV, complaint alleges – Houston Public Media

Houston-based health insurance agency discriminates against people with HIV, complaint alleges – Houston Public Media

by Cedric Guzman

A complaint has been filed against Houston-based health insurance agency, Community Health Choice, accusing the organization of discrimination against individuals with HIV. The non-profit organization, HIV+Hep Policy Institute, based in Washington D.C., filed the complaint with the Centers for Medicare and Medicaid Services on September 26th. The complaint alleges that Community Health Choice has been charging large out-of-pocket costs for HIV medications, making them unaffordable for many individuals.

Community Health Choice is a non-profit organization that has been providing Medicaid coverage to low-income families in Houston since 1997. However, the complaint argues that the organization has placed almost all HIV medications in its most expensive health insurance plan, resulting in significant financial burden for individuals who require these medications to manage their condition.

The HIV+Hep Policy Institute is calling on the Centers for Medicare and Medicaid Services to take action against Community Health Choice for offering health insurance plans that violate the Affordable Care Act and its regulations. The institute also urges the federal agency to review health insurance plans that discriminate against individuals.

According to Carl Schmid, the executive director of the HIV+Hep Policy Institute, this discriminatory treatment of individuals with HIV is akin to a step back into the dark ages of HIV treatment. The complaint highlights that Community Health Choice’s premier and select health insurance plans limit access to necessary HIV treatment medications, with a significant number of drugs not covered or placed in the highest cost-sharing tiers.

Furthermore, the institute argues that the drugs that are covered by Community Health Choice are outdated and discontinued formulations. This lack of access to modern and effective HIV medications is a significant concern for individuals living with HIV.

This is not the first time that the HIV+Hep Policy Institute has filed a complaint regarding discrimination against individuals with HIV. In December, a complaint was filed against North Carolina Blue Cross/Blue Shield for similar discriminatory practices. Additionally, a discrimination complaint was filed against Community Health Choice in 2016, demanding an end to their discriminatory practices.

Both complaints reference the Affordable Care Act, which prohibits the exclusion, denial of benefits, or discrimination under any health program or activity that has a contract of insurance with the federal government. These complaints highlight the ongoing issues faced by individuals with HIV when it comes to accessing affordable and comprehensive healthcare.

According to the Texas Department of State Health Services, there has been a 13% increase in the number of diagnosed HIV cases in Texas over the past five years, with over 100,000 Texans diagnosed with HIV by the end of 2020. This emphasizes the importance of ensuring equal access to HIV treatment and healthcare for all individuals, regardless of their financial situation or health insurance coverage.

Community Health Choice has not yet responded to requests for comment regarding the complaint. It remains to be seen how the Centers for Medicare and Medicaid Services will respond to the allegations of discrimination and violation of the Affordable Care Act. The outcome of this complaint could potentially have a significant impact on the access to and affordability of HIV medications for individuals in Houston and beyond.

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