A circuit court judge has ruled that the administration of Gov. Ron DeSantis can push ahead with reductions to a program that helps people with HIV and AIDS purchase life-saving drugs.
Circuit Judge Jonathan Sjostrom in Leon County denied the AIDS Healthcare Foundation’s request for an emergency injunction to stop emergency rules from taking effect that no longer make available Biktarvy, a daily pill used to suppress HIV viral loads and prevent people from spreading the virus that causes AIDS. Approximately 32,000 people obtain the drug through the program.
To obtain an emergency injunction, the AHF had to show it would likely succeed on the merits of its case — that its clients would face irreparable harm and that the balance of hardship is in their favor.
“It’s not hard to make an argument that the public interest favors granting relief — same thing with irreparable harm absent injunctive relief,” Sjostrom said, ruling from the bench. “The problem is element Number One, substantial likelihood of success on the merits, and that fails in my view on separation of powers and justiciability, also on the deference to be afforded by the declaration of an emergency.”
The judge acknowledged there’s “a pretty good argument to be made” to the Department of Health’s contention that Florida statutes require challenges to emergency rules to be filed in an appellate court and not circuit court.
Sjostrom said that, based on the pleadings filed by the AHF attorneys, he was inclined to dismiss the case. But he’d agreed to the two–day hearing and lengthy testimony because of the importance of the issue.
”To the people who are going to be affected, there is absolutely no doubt that this is an emergency situation. … It’s a judicial emergency, regardless of the analysis of the surgeon general’s statement of an emergency and that’s why we’re here,” he said.
The AHF’s emergency injunction, had it been granted, would have returned eligibility for the ADAP program to 400% of the federal poverty level, or $63,840 annually, and would have allowed patients to continue to access Biktarvy.
Alleging a $120 million deficit in the program, the DeSantis administration reduced eligibility for ADAP participation to 130% of the federal poverty level, or about $20,748 annually. It also eliminated access to Biktarvy.
The AHF did not have an immediate comment Monday on Sjostrom’s ruling.
But in her closing arguments, AHF attorney Louise Wilhite-St Laurent said there are statutory requirements for emergency rules and that the emergency rules issued by the department for ADAP doesn’t meet those standards.
She also argued the rules were vague. The department says it doesn’t have necessary funds to keep the program afloat for calendar year 2026 and that it could have to terminate services to everyone in the program if the changes weren’t made.
“It is not definitive. It is not specific. And that is what’s required to justify an emergency in addition to having a sudden or unforeseen event,” she said — adding that the DOH has provided no evidence of “what the actual emergency is or that there is actually no funding.”
Wilhite-St Laurent specifically was referencing testimony Monday from Lacandria Churchill, a DOH employee in the ADAP program. She said the department had received $42 million in drug rebates for the program in the past two and a half weeks. During cross examination from DOH outside counsel Ed Lombard, she said the department wasn’t “flush” and that the money is being used to pay outstanding bills for the program.
It’s the latest legal setback for the AIDS Healthcare Foundation, as two separate legal challenges to the DeSantis administration’s efforts to scale back the program have been stalled by the DOH.
A third legal challenge, filed to a pair of emergency rules drafted last week, is scheduled for state administrative court on March 30.
The latest emergency rules, which took effect immediately, return the eligibility program back to 400% of the FPL through June 30. Additionally, the emergency rules make clear the state cannot assist ADAP clients with premium assistance and the life-saving drugs the patients require must be directly distributed to the clients by the state. But the rules make clear those changes don’t take effect until April 1.
Those changes track legislative direction contained in HB 697. The legislation, which includes an additional near $31 million for ADAP funding, was sent to Gov. Ron DeSantis last week. He has until April 2 to sign it, veto it, or allow it to become law without his signature.
“I regret that there’s nothing else that I have any authority to do to help these people who are in such desperate need of help,” Sjostrom said. “Take what is probably cold comfort in speculating that the $31 million suggests that you’re in the right place now, and I am hopeful that more relief is coming.”
“I’m praying that I don’t die”
Sjostrom’s from-the-bench ruling wrapped up two days of testimony in the hearing.
In that time AHF called a number of witnesses, including 37-year-old Lorenzo Davis, who testified that he’s worried for his life.
Davis testified that he has been an ADAP client since being diagnosed with HIV when he was 16 years old. He has been taking Biktarvy, which he has accessed through both premium assistance when he was insured and through direct dispensing.
Davis testified Friday that he won’t be able to afford Biktarvy without assistance from the ADAP program.
“I don’t know what to do right now. I’m like panicking to be honest with you,” he testified under oath.
Davis said his viral levels are undetectable, which means that he can’t spread the virus. But he also said that his immune system is weak and he worries what will happen in the coming days and months.
A recording artist, Davis said he doesn’t qualify for Medicaid or Medicare and lacks access to commercial health insurance.
“I’m praying that I don’t die if I don’t have access to medication,” he said.
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