emory AIDS care
Emory University nurse Marda Holstad hugs a patient who came to receive care at Grady Health System's AIDS clinic, Credit;: emoryhealthmagazine.emory.edu

By David Pendered

Two insurance companies in Georgia are among a national group that imposes hardships on consumers who are prescribed costly medicines to extend their life as they live with HIV/AIDS, according to civil rights complaints filed Tuesday with the U.S. Department of Health and Human Services.

The complaints in Georgia cite Cigna and Humana for implementing a number of measures the complaints contend are intended to keep Georgians living with HIV/AIDS from seeking to enroll.

emory AIDS care
Emory University nurse Marda Holstad hugs a patient who came to receive care at Grady Health System’s AIDS clinic. Credit: emoryhealthmagazine.emory.edu
Emory University nurse Marda Holstad hugs a patient who came to receive care at Grady Health System’s AIDS clinic. Credit: emoryhealthmagazine.emory.edu

These measures violate the Patient Protection and Affordable Care Act (ACA) Marketplace in Georgia, according to a statement.

Requests for information delivered late Monday did not elicit response from the two insurers. Cigna’s website offers a 24-hour email monitor and Humana’s offers a 24-hour telephone contact for the media.

The accusation may have enormous consequences in Atlanta, once an epicenter of HIV/AIDS cases.

Grady Health System has offered HIV/AIDS care since the early 1990s, staffed mostly by Emory University doctors and clinicians. The Grady AIDS clinic on Ponce de Leon Avenue serves about 5,200 individuals, according to a 2013 report by Emory.

Most of these patients need the provisions of the ACA, sometimes called ObamaCare. According to the report, patients tend to be:

  • [P]oor, and mostly minorities, working low-wage jobs and living in unstable housing situations with little access to medical care … Many already have progressed to late-stage AIDS by the time they make it to the Ponce Clinic, having lived with the disease for many years while it went undiagnosed and untreated.”

The complaints in Georgia were filed by the AIDS Research Consortium of Atlanta and Harvard Law School’s Center for Health Law and Policy Intervention, according to the complaints.

In particular, the complaints were filed with HHS’s Office of Civil Rights.

Howard-Pat-Ron-photo
A collection of images about the AIDS epidemic in the late 1980s by Atlanta photographer Billy Howard has opened at Emory University. File/Credit: emory.edu

The OCR complaints in the Georgia situations allege, according to the statement:

  • “The OCR Is charged with adjudicating complaints of discrimination pertaining to health plans under the [Affordable Care Act]. Although the ACA provides that no person can be denied health insurance on the basis of preexisting conditions, some insurers have devised restrictive plans with high consumer cost sharing to discourage participation by people with expensive chronic conditions including HIV.”

The statement addresses the situation with some powerful language:

  • “In particular, these plans obstruct the ability of people with HIV to access affordable life-saving medications to fight HIV, in violation of anti-discrimination provisions of the ACA. “

The complaints contend Cigna, Humana and five other insurers have a widespread practice of dissuading HIV/AIDS patients from seeking to enroll. Complaints were filed against the following companies in the following states:

  • Humana – Georgia, Alabama, Illinois, Louisiana and Texas;
  • Cigna – Georgia and Texas;
  • Highmark – Pennsylvania;
  • Independence Blue Cross – Pennsylvania;
  • UPMC Health Plan – Pennsylvania;
  • Community Health Choice – Texas;
  • Anthem Blue Cross Blue Shield – Wisconsin.

In related news, just last month a collection of intimate photos of HIV/AIDS patients opened at Emory University’s Stuart A. Rose Manuscript, Archives, and Rare Book Library.

The pictures are part of photographer Billy Howard’s photography project of AIDS in 1987, as the epidemic was reaching its zenith. Howard created a series, Epitaphs for the Living: Words and Images in the Time of AIDS. Southern Methodist University Press published a book in 1989 based on the photographs.

David Pendered, Managing Editor, is an Atlanta journalist with more than 30 years experience reporting on the region’s urban affairs, from Atlanta City Hall to the state Capitol. Since 2008, he has written...

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