House Bill 526a proposal tabled for next session that would require standard state health benefit plans to cover diagnoses of HIV infection, will likely face an uphill battle.
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That’s according to the bill’s sponsor, Rep. Gene Wu (D-Houston), who pushed a similar bill measure to prevent the spread of HIV last session to see him die in committee.
“In terms of public support from other public officials, it’s rare,” Wu told State of Reform of the bill’s prospects of passing a Republican-dominated legislature next year. “It’s really a shame that this is so but especially for the Republicans, [HIV] isn’t seen as something important to them because they see it as, ‘Well, nobody in my community has this problem, so why should we care?’
When the reality is “No, there are actually a lot of people in your community who are HIV positive” and they are very quiet about it because they know there is no supportive environment around of them that will make them feel free to share this information.
According to the proposal, HIV testing would be part of routine medical screening where blood is tested. Providers would give patients the option of having the test done by written consent or opting out. The proposal aims to use the higher detection rates to better treat and prevent the spread of the virus.
“With our current technology [and] progress in medical science, we have HIV on the ropes,” Wu told State of Reform. “We have HIV stuck and we are able to not only have accurate detection, we fully understand transmission rates, we fully understand transmission routes, we fully understand how to treat people who have been infected, and we we even now have drugs that can prevent the transmission of HIV.
We are in a state where we have all the necessary weapons to finally put an end to this scourge. The final missing piece is intelligence. If you are going to war, you need good intelligence, you need to know where to fight the enemy. Simply stated, [much] of our transmission is still by people unknowingly transmitting it…if you know you are positive there are many things you can do to mitigate transmission and even prevent transmission altogether.
The CDC estimates that approximately 1.2 million people in the United States are HIV-positive, more than 10% of whom are unaware of their status. Almost 40% of new HIV infections are transmitted by undiagnosed people. The CDC says test is the first step for these people in maintaining a healthy life and preventing transmission. It recommends at least one HIV test as part of routine health care for everyone between the ages of 13 and 65.
Concerns about access to preventive HIV care were raised after a Texas federal court decision in September, claimed that employers were not required to cover treatments that mitigated HIV infection and transmission.
The ACA mandates free coverage of many preventive services, including HIV tests and preventive treatment drugs. The American Medical Association estimates that in 2020 alone, more than 151 million people received free preventive care because of this ACA mandate. If upheld, the decision could jeopardize these types of preventive services and treatments covered by market plans.
“There are challenges in implementing routine opt-out HIV testing in all kinds of outpatient or physician visits that happen across our state, one of which is getting paid to be able to do the testing,” said Christopher Hamilton, chief executive of Texas Health. Stock. “With insurance, it opens up a multitude of access for people to access health services in general, but not everything is always paid for by an insurance company.
Requiring an insurance company to pay for HIV testing in an opt-out setting is really going to help our state move forward and move forward in detecting new HIV infections and transmission to breast of [Texas]. This is an important element as part of an overall picture of the fight against HIV transmission in our state.
While Medicaid and most private insurers cover “medically necessary” HIV testing, opt-out testing protocols according to CDC guidelines are not a requirement. Wu said the cost to insurance companies of covering the cost of HIV testing during routine checkups where blood is analyzed would save them more money in the long run, as unchecked HIV status can result in expensive AIDS treatment.
“A lot of people just pass it on because they don’t know they’re HIV-positive,” Wu said. “Because unlike many other illnesses, you wouldn’t know you were positive until the symptoms appear, perhaps even several years later. And meanwhile, these are passed on to maybe different people, even family members and relatives. So the easy solution to this is now that we have very easy, simple and cost effective ways to detect HIV, so why not make it a normal blood test? »
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