Georgia lawmakers kill bill expanding access to HIV meds

A bill making it easier for HIV-positive Medicaid recipients to receive the most effective medications is now dead, thanks in part to its $12 million cost to the state of Georgia.

House Bill 158 passed unanimously in the state House on Feb. 19 and received a hearing before the Senate Health & Human Services committee on Feb. 25. The measure was scheduled for a vote on Monday but was pulled from the committee agenda.

Rep. Deborah Silcox, a Republican from Sandy Springs who sponsored the legislation, said that Gov. Brian Kemp’s office requested a fiscal note to determine the expected cost of the measure.

“It came back at approximately $39 million, with the state on the hook for about $12 million,” Silcox said.

The bill would cost the state $12.9 million, and the total cost would be $39.5 million, according to documents obtained by Project Q. An increase in drug costs would total about $26 million and a $13.4 million rebate provided by drug manufacturers would be lost if the bill became law, according to the document.

Silcox (top photo) said she met on Monday with Frank Berry, the commissioner of the Georgia Department of Community Health. That department is the state’s lead agency for Medicaid. 

Berry told Silcox there was not enough money in the budget to cover the $12 million.

“I reminded him that I was certain the costs would go down if we could slow down the epidemic of new cases of HIV,” Silcox said.

Berry promised to work with Silcox on a compromise bill to introduce in the 2020 session. 

“It is my intent to work out the differences and bring this bill back for full passage next year,” she said. “I am disappointed but hopeful we can get it done in 2020.”

House Bill 158 would ensure that the formulary used to determine which HIV medications Medicaid recipients get is the same formulary established under the Georgia AIDS Drug Assistance Program (ADAP). Silcox said the law is needed to address the difference in medication eligibility between ADAP and Medicaid.

HB 158 would also ensure that new antiretroviral regimens – including single-tablet regimens – be added to the Medicaid HIV drug list no later than 30 days after being added to the ADAP drug list.

Silcox said evidence shows that people on a single-tablet regimen have “much, much better” compliance than if they have to take multiple pills.

Two other bills addressing the state’s HIV epidemic fared better during the legislative session.

A bill that would create a needle exchange program to help reduce HIV rates in Georgia passed in both chambers of the legislature and is now in Kemp's hands. He can either sign the legislation into law, veto it, or leave it unsigned and it becomes law. 

A bill that would create a three-year pilot program to provide free PrEP medication to those at high risk of contracting HIV passed in the House and in the Senate HHS committee. It awaits a vote before the full Senate. 

The final day of this year’s legislative session is April 2.