ADAP: State-by-State

The AIDS Drug Assistance Program (ADAP) is a national program that was started by the U.S. government in 1987 to provide free or low-cost drugs to people with HIV who have limited financial resources. Generally, these are people who have an income that is too high for Medicaid, but who don't have private health insurance because their employer doesn't offer it or because they can't afford it.

ADAPs vary from state to state in terms of what drugs are available, what the income requirements are, and what measures each state has taken to support the program. Most states add money to the funding they receive from the federal government, but some do not. As a result, most states offer drugs to anyone who qualifies, while some have waiting lists. ADAPs act as the payer of last resort, a "safety net" that catches people with HIV who fall through the cracks in the U.S. health care system. With more than 134,000 enrollees, ADAP reaches about a quarter of all people with HIV who are currently in care. Almost 2/3 of ADAP clients are people of color, and half have incomes at or below the Federal Poverty Level ($9,800 a year for an individual).

The steps taken by some states to control the costs of ADAPs include waiting lists, limiting the number of drugs available (formularies) and lowering the income eligibility criteria. As of November 15, 2006, 340 people were on waiting lists. 12 states had some kind of waiting list at some point during 2006, and several others had limited access in other ways.