South Carolina's HIV/AIDS Budget Slashed; ADAP Waiting Lists Get Even Longer

Continuing a trend over the past several months, another U.S. state is having serious funding issues with its AIDS Drug Assistance Program (ADAP). This time the focus is on South Carolina, which has been making headlines because the state's legislators have proposed chopping its entire HIV/AIDS budget, including the $5.9 million it spends annually on ADAP. ADAP helps low-income HIVers, many of whom are who are unemployed or uninsured, pay for their medications; South Carolina's program serves 2,600 people monthly.

The development is an alarming one. However, a second look at the situation makes it clear that South Carolina's entire ADAP will not be chopped, according to Thom Berry of South Carolina's Department of Health and Environmental Control (DHEC), the agency that runs ADAP. In previous years, South Carolina's ADAP was funded by a combination of state and federal money, Berry said. This year, while the proposed budget provides no state-based funds, ADAP will continue to run on $2.2 million from the federal government, provided through Medicaid, he said.

Regardless, this is still a serious reduction in the program's budget, which has already caused South Carolina to close ADAP to new enrollees, and is likely to lead to the creation of an ADAP waiting list. (If that happens, Berry says that DHEC plans to work with wait-listed people to help them enroll in pharmaceutical company assistance programs so they won't be left without any recourse.)

According to the most recent ADAP Watch report, as of March 1, 662 people are on waiting lists across 10 states -- up from 346 in nine states in November. However, those numbers do not include everyone who was receiving ADAP coverage but had their assistance cut. Some people are not on waiting lists because, due to ADAP changes in their states, they are no longer even eligible for assistance. For example, Arkansas dropped its financial eligibility level from 500% of the federal poverty line down to 200%, and then as low as 150%, which removed more than 80 people from the rolls. Other states have reduced their formularies of available medications and are considering lowering eligibility or capping enrollment.