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The South Florida AIDS Network (SFAN) functions as the networking/advisory body for the Ryan White Care (RWC), Part B grant in Broward County. Its monthly meetings are open to the public.

The meeting discussed four topics:

1. Transitioning RWC clients into the Affordable Care Act (ACA) marketplaces

2. ACA enrollment in Florida

3. Florida HIV/LGBT legislative issues

4. A new Jansen one-pill a day anti-retroviral.

Transitioning RWC clients into the Affordable Care Act (ACA) marketplaces

Cliff Eserman raised the issue of potential tax liabilities in tax year 2015 for people transitioning from RWC to the ACA marketplace health plans. These potential tax liabilities result from differences in eligibility calculations between ADAP and ACA plans. In order to calculate eligibility, ADAP uses individual income. The ACA uses household income.

At tax time in 2016, the IRS will compare actual income, reported income, and recalculate the ACA subsidies. It will then reconcile the recalculated subsidy with the paid subsidy. At present RWC legally cannot resolve any subsidy overpayments, leaving the client potentially liable for any overpayment.

Joey Wynn, SFAN Chair, responded that the Centers for Medicare and Medicaid (CMS) are considering allowing RWC to pay for certain liabilities. According to Wynn, “these rules are being rewritten as we speak.” Wynn promised to hold a public forum to discuss this and other issues.

ACA enrollment in Florida

Gursimran Reen of the Broward Regional Health Planning Council reported on ACA enrollment in the Federal Marketplace. As of early February this year, 1,393,068 Floridians and, 661,917 residents of Miami, Broward, and Palm Beach County had signed up for ACA plans.

Florida HIV/LGBT legislative issues

Jason King and David Poole, both from AIDS Healthcare Foundation reported on relevant Florida legislative issues. House and Senate members have introduced two HIV bills and two LGBT bills. Each bill in the legislature has one name for the House with the prefix “HB” and another one for the Senate, with the prefix “SB.”

HB 0321/SB 521 would allow spoken consent to HIV testing in clinical settings to routinize HIV testing with the goal of earlier detection. HB 0475/SB 1040 would allow the University of Miami to establish a privately funded needle exchange program. It would also remove legal barriers to that needle exchange program. HB 33/SB56 would add the categories of sexual orientation and gender identity to Florida anti-discrimination law. HB83/SB204 would prohibit therapists and counselors from attempting to “cure” homosexuality in minors. These bills first have to go through a series of committees before a full vote by either the House or the Senate.

New Jansen one-pill a day anti-retroviral

Donna Sabatino and Yvonne Wind-Vasquez reported on a new Janssen once-a-day anti-retroviral (ARV) drug, Prezcobix, a combination of two other ARVs, Prezista ® (Darunavir) and Tybost ® (Cobicistat). Janssen now has a zero-dollar copay and covers the deductible up to $7,500 per year for Prezcobix. As of press time, ADAP has not yet added Prezcobix to its approved drugs, but its approval process has begun.

Other AICP News: On February 13, Loraine Wells, ADAP State Program Director, announced that the Health Council of South Florida would no longer administer the AIDS Insurance Continuation Program (AICP) as of March 31, 2015.

Next SFAN Meeting: Thursday, March 5 at 6:00 p.m., at the Holy Cross Healthplex, 1000 NE 56th Street, Ft. Lauderdale, FL 33334. Newcomers are encouraged to attend.

Miami-Dade, Broward and Palm Beach Counties and the ACA Enrollment

These three south Florida counties have almost as many ACA enrollees as the rest of Florida. South Florida enrollees represent 8.5 percent of all enrollees in the entire Federal ACA Marketplace. According to the Miami Herald, about 6.5 percent of all Floridians have signed up for an ACA plan. Prior to the ACA, Florida ranked third among states in the number of uninsured residents (3.8 million).

In 2013, about 13 percent of the U.S. population lacked health insurance. Prior to the ACA, about 32 percent of the population of Miami lacked health insurance, as did 26 percent of the population of Broward. Zip Code 33012 in Hialeah and Zip Code 33313 in Fort Lauderdale have, respectively, the highest and third highest ACA enrollment of any zip code in the Federal ACA Marketplace

And yet Florida has been among the most ACA resistant states.