Op-Ed | New York must protect safety net services to end the HIV/AIDS crisis

HIV positive blood sample
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The HIV/AIDS crisis is not over in New York City, and efforts to eradicate new infections – already delayed by the coronavirus pandemic – are imperiled by an outdated plan to rob community-based providers that care for vulnerable patients of a critical funding stream. 

At the start of the pandemic, disgraced former Governor Andrew Cuomo advanced a plan to carve prescription drug coverage out of the Medicaid pharmacy benefit program. If this plan is implemented, the social safety-net facilities supporting 2.3 million New Yorkers, 71% of whom are people of color and 89% are low income, will be forced to curtail services and possibly shutter completely.

This will have a devastating impact on people living with HIV/AIDS – a virus that disproportionately impacts people of color. According to New York City Department of Health and Mental Hygiene data, rates of new HIV diagnoses among Black and Latino individuals were 8.1 and 3.9 times higher, respectively, than the rate for whites.

For 30 years, the Medicaid Pharmacy Program, known as 340B, has allowed safety-net providers to buy discounted drugs and use the savings to finance other programs for vulnerable patients, like providing food, housing aid and transportation, to name just a few. The 340B program enables safety net providers to give vital support to patients, the majority of whom are low-income and people of color, at no cost to taxpayers. 

If the Cuomo carve-out goes into effect, safety-net clinics would lose access to more than $100 million in funding annually, nearly 80% of health centers would dismiss or lay off staff and at least 32 community clinics would be forced to close entirely, according to a survey by the Community Health Care Association of New York.

The recently enacted state budget was a missed opportunity to permanently repeal the Cuomo carve-out. But there’s still time to right this wrong by passing and signing into law legislation we have introduced in our respective houses to protect the safety-net providers’ funding.  

We both know that these changes would be devastating to many individuals in the communities we represent as well as thousands of others across the state, including health clinics that are essential to reducing new HIV cases. Governor Kathy Hochul has committed to ending the HIV epidemic by 2024 – the 2020 deadline already delayed by two years due to challenges created by the COVID-19 crisis. She will certainly not be able to realize this goal if she allows the Cuomo carve-out to go forward. 

One of the first rules of good government and good health care policy is that when you find something that works, you leave it alone. The Cuomo carve-out is a good example of bad policy that should not see the light of day. Governor Hochul must work with state lawmakers to end this repeal before the legislative session ends next month. 

Assemblymember Linda B. Rosenthal is the Chair of the Committee on Social Services. She represents the 67th Assembly district, which includes the Upper West Side and Hell’s Kitchen. State Senator Cordell Cleare represents District 30, which includes Harlem, Morningside Heights and Washington Heights.