The AIDS Healthcare Foundation filed an administrative complaint against the Florida Department of Health, headed by state Surgeon General Joseph Ladapo, alleging the state didn’t follow the law when making changes to the Aids Drug Assistance Program. (March 7, 2022, screenshot via DeSantis Rumble page)
A state administrative court is being asked to put the brakes on a move by the DeSantis administration to shore up an alleged $120 million funding deficit in an HIV/AIDS program by paring back program eligibility and restricting access to the medications it covers.
Attorneys for the AIDS Healthcare Foundation maintain in their complaint that the Florida Department of Health, which helps administer The Ryan White HIV/AIDS Program, is violating state law because it didn’t pass the requisite rules needed to make the changes to the program.
The National Alliance of State and Territorial AIDS Directors estimates that more than 16,000 patients in Florida will lose coverage because of this change in department policy. The foundation is asking that the state Division of Administrative Hearings expeditiously schedule and hear the case and that a judge issue a recommended order before March 1, when the changes are slated to take place.
“If these cuts go through, you’re going to have sicker people and you are going to have more HIV infections, which is ultimately going to cost the state a lot more money,” Esteban Wood, the organization’s director for advocacy, legislative affairs, and community engagement said Wednesday during a press availability announcing the administrative complaint.
The organization has been “inundated” with hundreds of calls from patients who want to know what the changes mean and how they will impacted them, Wood said.
“What we are seeing right now is a lot of fear and anxiety from patients across the state,” he said. “These patients are terrified. These are working Floridians who did everything right. And we expect to see these interruptions in their regiment and with their medication as soon as March 1.”
From here to there
Since 1990, the Ryan White HIV/AIDS program has provided grants to states to help people living with HIV and AIDS access to medications through the AIDS Drug Assistance Program, or ADAP.
The grants can also be used for insurance premium assistance, plus cost-sharing support to low-income, uninsured, or underinsured individuals.
Since 2007, the program in Florida has been open to people who earn up to 400% of the federal poverty level, which for 2026 translates to an annual salary of $62,600 for a single person. For a family of four it’s $128,600 annually.
The DOH in January began issuing letters to some ADAP patients advising of them changes.
One letter, according to the underlying complaint, advised patients that as of Feb. 28 they no longer would be able to take advantage of the premium assistance and medication support through ADAP. The letter advises that the state changed the income eligibility, paring it back from 400% of the poverty level to no more than 130%, which is $20,345 annually for an individual or $41,795 for a family of four.
The second letter the DOH sent informs patients that while they remain eligible for services through ADAP they could no longer take Biktarvy, a daily pill used to treat HIV in adults and children weighing at least 31 lbs.
The DOH also posted the changes on its website.
The letters and the website maintain the changes are being driven by “rising health care insurance premiums nationwide and lack of additional Ryan White Grant funding.”
The website maintains the “adjustments” were made to “ensure resources” for “the greatest number of individuals within our funding constraints,” and that they will help prevent a $120 million shortfall in the program.
Follow the rules
The administrative rule-making process can be slow and burdensome. But it’s a process through which the public can discuss with bureaucrats proposed policy changes and provide input.
Tom Myers, the foundation’s chief of public affairs and general counsel, said in regards to the ADAP changes that the rule-making process also would have provided the public with some transparency, including information about the the projected $120 million deficit the DOH says it faces if no changes are made.
“There’s a process that the department has to follow in trying to make these cuts. And with a very good reason, because of the known harmful impact of these cuts,” he said.
Wood said the foundation hopes an administrative law judge will require the DOH to go through rule-making if it wants to push ahead with the changes.
“What we are hoping is the administrative courts in Florida will say, ‘Wait a second. If you’re going to make these changes or if you want to make these changes, you gotta follow the rules, which you clearly haven’t followed. Give it time, give it the proper process. Hear from people. Study the issue, study the problem before you make these cuts, which are definitely going to harm people,’” Myers said. “And that’s really what this lawsuit is all about.”
Attorneys for the foundation in their complaint asked that they be given the right to amend their administrative complaint because of outstanding public records requests with the DOH. Moreover, they asked that the complaint be expedited given the looming deadline.
“Because approximately 16,000 individuals in Florida stand to lose their life-saving ADAP benefits and will be left without viable alternatives to live healthy lives and prevent additional spread of HIV as of March 1, 2026, the standard timeframe of 30 days for the hearing to commence and 30 days to render a Final Order provided (in statute) is direly inadequate. The Department has brought this emergency to patients on itself, and AHF respectfully requests an expedited scheduling order for discovery, final hearing, and Final Order be considered. AHF recommends five days for discovery, 14 days for a hearing, and 14 days for a Final Order,” the complaint says.
Advocating before the Legislature
While the foundation filed an administrative complaint to try to stop the changes, other advocates are looking to the Legislature for help, including Ft. Lauderdale resident Michael Rajner, who relies on the ADAP program for co-payments to help lower the cost of his medications.
Rajner said he isn’t one of the 16,000 people who will lose eligibility for the program in March — because he doesn’t take Biktarvy, that change won’t affect him, at least not now. “But if my doctor every wanted to put me on the medication I wouldn’t be able to go on it,” he said.
The 2026 Session began Jan. 13. In that time, Rajner has twice testified in the Senate about the DOH’s proposed changes, making appearances in the Appropriations and Health and Human Services committees.
He attended the foundation-supported Fight For Our Lives rally at the DOH’s Tallahassee headquarters on Jan. 21 and, later that day, met with Florida Surgeon General Joseph Ladapo for about 30 minutes. It was the second meeting he had with the DOH — the first was on Jan. 16.
“The crux of the message was they’re out of money and the Legislature needs to give them $120 million to close this gap that they continue to blame on federal changes,” Rajner told the Florida Phoenix.
But, Rajner claims, the DOH has not asked the Legislature for money and when he pressed them as to whether they would they “just sat there with their mouths open.”
“They said they weren’t going to ask the Legislature and that the Legislature just needs to kind of do it,” Rajner told the Phoenix. “And so they are not acting as good stewards of the program.”
Rajner said he wasn’t comforted by what he heard from DOH officials at either of the two meetings he had with them.
The Ft. Lauderdale resident, who was making the long drive from Tallahassee to South Florida on Wednesday, said he was feeling more optimistic after meeting with Senate President Ben Albritton’s staff Tuesday.
“I left that meeting hopeful. Because not only in that meeting, but in other meetings with other senators, I keep hearing how Senate leadership is engaging the Florida Department of Health to bring forward more information so they can continue to study this issue and understand what possible solutions to be considered. It felt reassuring also knowing that these [senators] were very aware of my remarks in [the committees.]
“So, they are listening. I feel some comfort in knowing that dialogue is ongoing and I hope that solutions come forward before it’s too late, when on March 1 people will lose access to their insurance coverage and be in a worse situation.”
Although it wasn’t a scheduled meeting, Rajner had a chance encounter with House Speaker Daniel Perez, R-Miami. Rajner was walking his dog, Baby Blue, around the Capitol complex when he bumped into the speaker. Rajner took advantage of his luck and talked to Perez about the ADAP program while he could.
“I felt good about his level of understanding of it and that the crisis actually exists,” Rajner said.