In a dysfunctional session that has been underscored by what one senator called an “inexcusable amount of animosity,” the Senate on Tuesday offered to pump nearly $31 million into a program that provides people access to high-cost HIV drugs.
The money was amended onto a House health care bill, HB 697, that changes the state’s laws regulating pharmacy benefit managers.
Adding the $31 million appropriation and directions on how to spend it was the only change the Senate made to HB 697 before voting unanimously to pass it.
The bill was sent to the House for a final vote.
Specifically, the amendment redirects the money away from a Department of Health trust fund toward the state’s AIDS Drug Assistance Program through June 30. The amendment would direct the health department to maintain income eligibility for the program through that date at 400% of the federal poverty level.
The amendment would direct the state to directly distribute the medications to enrollees. That’s a change from the existing approach in which the state helps people with HIV purchase costly drugs through insurance assistance.
While the amendment would maintain existing program eligibility it would not allow continued access to Biktarvy, a daily pill taken by some HIV and AIDS patients.
Sen. Jason Brodeur, who explained the amendment, said the chambers had been in communication and that the House knows about the Senate’s plan.
READ MORE: HIV assistance cuts: Is the DeSantis administration ‘kneecapping’ Legislature?
“I believe we are probably in a good place on the House side. They are definitely aware that it is coming,” he said.
Nevertheless, Speaker Daniel Perez, R-Miami, was tightlipped Tuesday night about his chamber’s plans for the bill.
“I have to make sure that I feel comfortable with that and that it’s in the best interest of the state. I haven’t seen all the details yet. I’m going to get briefed on it,” Perez told reporters Tuesday night.
The Senate’s proposal would put an end to the DeSantis administration’s plans to drastically reduce program eligibility and pare back access to drugs to shore up what the Department of Health says is a $120 million shortfall.
The administration initially moved on the changes in January without any public input or without passing any of the rules needed to implement the cuts.
The National Alliance of State and Territorial AIDS Directors estimates that more than 16,000 patients in Florida will lose coverage because of this change in department policy.
The AIDS Healthcare Foundation sued in state administrative court and Leon County circuit court. The legal wrangling continues and the DeSantis administration has started implementing the cuts.
ADAP is funded with Ryan White HIV/AIDS Program grants. The national safety-net program supports more than 600,000 lower-income people living with HIV across the nation. States receive federal grants and drug rebate money — the latter making up the bulk of state program budgets — to, among other things, help pay for medications and support community groups and specific populations, such as women and children.
Congress has kept key drug assistance funding at $900.3 million annually since 2014. New enrollments for state programs jumped 30% from 2022 to 2024, in part because states cut off pandemic-era Medicaid assistance. But Congress has kept the funding levels the same, which has caused the deficit.
As of January, at least 18 states have pulled back their ADAPs, in some way, according to a March 2 analysis by health research group KFF and a report by the National Alliance of State and Territorial AIDS Directors, which offers consultation for states.
The DOH did not tell lawmakers about the projected shortfall or share any of its plans for shoring up the deficit with lawmakers. The first they heard about the shortfall and the state’s plan to abate it was from Fort Lauderdale activist Michael Emanuel Rajner.
Community activist and Fort Lauderdale resident Michael Emanuel Rajner brought the ADAP deficit to the Legislature’s attention in January. He had to choke back tears following the Senate vote Tuesday night. (Photo Christine Sexton/Florida Phoenix) Rajner has been walking the halls of the Capitol since January meeting with legislators and planning protests. He choked back tears Tuesday night following the Senate vote.
Rajner said Speaker Perez has twice told him he’s aware of the situation and that the House is on it.
“So, I will trust that the speaker understands this is an important issue in areas like Miami, especially, and other places throughout the state,” Rajner said. “And I trust the speaker will do everything to move this through the House and get it to the governor as soon as possible, so that people who right now are finding themselves so vulnerable and giving up on their HIV treatment” don’t lose hope.
One bill for the otherPerez should be familiar with HB 697, the underlying measure the Senate used to continue funding for the program.
Sponsored by Lakeland Republican Rep. Jennifer Kincart Jonsson, the legislation modifies the rules that govern pharmacy benefit managers (PBMs), which serve as the go-between in the prescription drug supply chain, negotiating benefits on behalf of employers and others that pay for health benefits, including Medicaid.
Brodeur sacrificed his own health care bill, SB 1760, to make the potential deal that would prevent 18,000 people from being eliminated from the program.
SB 1760 was similar to the House bill because it also addressed PBM regulations. But SB 1760 was much broader and would have required a legislative joint oversight committee for Medicaid.
Brodeur agreed to switch bills and have the Senate consider HB 697 instead of SB 1760.
Brodeur, who filed legislation similar to SB 1760 in the 2025 session, predicted some of the tenets of SB 1760 would be refiled for consideration in the 2027 session.
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