By Jonathan Appelbaum
More than 128,000 Floridians are living with HIV. The state has the second-highest rate of new HIV diagnoses after Georgia, with approximately 4,500 new diagnoses in 2023, the most recent year for which data is available.
But access to treatment could be in jeopardy if potential budget cuts, announced in January 2026 by the Florida Department of Health, are enacted.
These changes, set to go into effect on March 1, would cut funding for the state’s AIDS Drug Assistance Program, which helps more than 31,000 Floridians with HIV/AIDS afford care.
I am an emeritus professor of medicine and a practicing clinician in the Tallahassee area who specializes in HIV/AIDS treatment. Many of my patients have been treated through this state program over the past 17 years, so I am deeply concerned about threats to its funding.
Funding access to care
Since its creation in 1996, the Florida AIDS Drug Assistance Program has been funded through the Ryan White CARE Act, which Congress passed into law in 1990. The law ensures people with HIV have access to clinical care, housing support, nutrition, case management, and behavioral and substance use care. Most importantly, it guarantees access to medications to treat HIV and its complications.
More than half of those served by the Florida AIDS Drug Assistance Program earn less than US$22,024 per year, which is 138% of the federal poverty level. While researchers can’t say exactly how many lives have been saved by this program, modeling studies have determined that AIDS drug assistance programs across the U.S. are cost-effective.
But the Florida Department of Health says that it is facing a $120 million budget shortfall, and that the federal Ryan White funds are no longer enough to keep the program going without major cuts to services.
Loss of care and insurance
Currently, the program provides access to medication for low-income, HIV-positive Floridians either by directly giving them prescription medications or by paying for insurance coverage for them that includes HIV medications.
The proposed cuts would stiffen the eligibility requirement for the program from earning 400% of the federal poverty level or below, about $88,000 per year, down to 130% or below, about $21,000 per year. This would immediately remove financial support used by about 16,000 patients to access lifesaving medications.
The cuts would also stop program funds from being used to purchase health insurance for eligible patients. The Department of Health has also proposed changing which drugs the program can cover, removing the recommended and most commonly prescribed drug for treating HIV, Biktarvy.
Without access to insurance coverage and medication, these patients face worse health outcomes, and HIV transmission is likely to increase. Ultimately, this would lead to higher health care costs in Florida and more deaths from HIV/AIDS.
BSIP/Universal Images Group via Getty Images
Pushing back
AIDS Healthcare Foundation, a national HIV advocacy and provider network, is suing the Florida Department of Health to require that it go through the normal rulemaking process to make changes to the program. Florida statute requires that substantive changes to a program undergo a process of public announcement, followed by a public comment period, before the change is enacted, which did not happen in this case.
An administrative judge has approved an expedited hearing for the lawsuit and will issue a ruling before March 1.
The foundation has also filed a second suit to determine the cause of the Department of Health’s $120 million budget shortfall.
Meanwhile, in the state legislature, both the Florida Senate and House have attempted to include additional funding for the program in their respective budget proposals. But the final budget won’t be voted on until later this March, and Gov. Ron DeSantis has line-item veto authority.
For now, I, along with other health care providers, am scrambling to ensure that patients do not lose access to their medications. We worry that if the drug assistance program is cut, Florida could see a return to the days of increasing HIV-related complications, hospitalizations and deaths.
Jonathan Appelbaum is Professor Emeritus at the College of Medicine at Florida State University.
Deborah Coffey says
“The foundation has also filed a second suit to determine the cause of the Department of Health’s $120 million budget shortfall.”
Check Mrs. DeSantis’ Foundation. They’ve moved lots of Medicaid settlement money there before for political purposes and are under criminal investigation.
https://www.npr.org/2025/04/24/nx-s1-5368535/ron-desantis-florida-governor-political-scandal
Al says
Giving this care to people that contracted AIDS from a transfusion should be continued. People that contract the disease from poor sexual practices or drug use involving dirty needles knew what they were doing. Exposing yourself on purpose is on you not everyone else’s problem. You can’t force people to stop bad behavior and making poor choices so they have to accept what happens. The money spent on treatment for the latter group can be used elsewhere like childhood cancer or correcting birth defects.
Skibum says
What an ignorant statement! To use your illogical and prejudicial “logic”, diabetes medication should be withheld from anyone that biased republi-con politicians believe became diabetic by overeating, because, as you say, they “knew what they were doing” and should pay the consequences as some sort of punishment.
Are you proud to have revealed yourself to be an extremist idiot?
Not surprised says
LOL I need to give you credit on this analysis Skibum, you are right on target, what an idiot
this person is. also to add the highest cases of Aids and sexually transmitted disease cases are
located in the Villiages where alot of seniors have retired, they have sex like crazy without
protection because the women are in menopause, so lets count them in also!
Jim says
@Al says is 100% right! But we can’t stop there.
– Overweight people should not receive health care at government expense. It’s not society’s fault they got fat!
– Alcoholics shouldn’t receive health care either. They knew what they were doing when they started drinking!
– Smokers shouldn’t receive health care either. Nobody made them smoke. It’s on them.
I’m sure there are lots more groups that ought to be identified and a law should be passed to not provide them any government assistance. Maybe the unemployed, the homeless, definitely anyone not born in the USA among others…
But let’s leave those that have money alone! Rich pedophiles, the Sacklers, and all the others. We need to make sure we have a society totally and completely stacked in favor of the rich and powerful. If you’re not in that group, well, f–k’em! That’s the new American way!
Deborah Coffey says
For all MAGA’s sakes, I think a little /s should be used at the end of your comment…or, maybe you need to spell it out so that it’s clearly understood…”sarcasm.”
Samuel L. Bronkowitz says
I think this is a great idea. Society shouldn’t be required to watch out for people that “did it to themselves.” Type 2 diabetics should have watched what they are, people with high blood pressure should just lose weight, people with dementia and Alzheimers should have done their cognitive exercises. For that matter, people at fault in car accidents should be denied medical care. If you’re too old and fragile to work then you should have taken care of yourself, society doesn’t owe you socialisms like social security or Medicare/Medicade. Like Jesus said, “fuck you, got mine.” Empathy has no place in a modern society.
BillC says
By your logic (people making poor choices have to accept what happens) it follows that people who smoke and/or drink should also be denied healthcare.
Over 490,000 people die each year in the United States from tobacco use. Approximately 178,300 people die annually from excessive alcohol use in the U.S.
Keenan Hreib says
A lot of us wonder whether you, Dennis, or BO PEEP are bots. One things for sure though… Your ignorance is only superseded by your rank ugly hatefulness.
Skibum says
Nobody “asked for” or became infected with the HIV virus willingly. There are many people in society who became infected through a sexual encounter with someone who didn’t know themself that they were infected. Others, like Ryan White, through blood transfusions that were medically necessary in a medical setting.
Idiots abound who wish to exact revenge and/or additional punishment on people in society who have HIV are not only ignorant… they are completely irresponsible! There are millions of Americans around the country who are infected with HIV, and it is a medical fact that taking their HIV medication regularly will lead to the virus in their bodies being reduced to such a low level that they are undetectable, and therefore unable to transmit the virus to ANYONE else. Instead of being idiots and making excuses for trying to keep HIV infected people with such low levels of infection through regular doses of medication, extremist politicians are willing to chance spreading HIV infections to more people??? How incredibly irresponsible!
But I guess those who would put someone like RFK Jr., who admits to not only having a brain worm, but also to have snorted cocaine from his toilet seat, in charge of medical research and policy doesn’t care about Americas health anyway!
Deborah Coffey says
There is no doubt that MAGAs want lots of people dead. Do they actually think they’re going to get a bigger piece of the pie if they wipe out 50 to 100 million of us? They can’t see that they’ve gotten nothing so far except permission to hate openly, to promote cruelty, and to adore their false god no matter what? Of course, according to their philosophy, they caused their cult life and deserve everything they get; meaning, we shouldn’t have to support their poor decisions? Wrong again. So, we forgive you, MAGAs, and hope you see the light very soon. You are quite capable of loving rather than hating, being kind instead of cruel, and distinguishing the truth from lies. Let there be light.
Sherry says
Hummm. . . Let’s see. . . how about we sit in righteous JUDGEMENT and deny health care for “ALL” those people who don’t meet our personal “MORAL” requirements? Instead of hypocritically supporting them, Let’s DENY CARE for:
1. Convicted Felons= trump
2. Sexual Assaulters= trump
3. Those Accused of Pedofilia= trump
4. Incessant Liars= trump
5. Adulterers= trump
6. Corrupt Politicians= trump
7. Those that Support Such Immoral People= ALL Maga Cult Members
Done and Dusted!
Atwp says
Republicans in control usually mean cuts to needed programs that help people, tax cuts to the rich folk. Am sure a lot people on aids medication voted for the Republicans, look at the negative return for your votes. Wow! Millions are suffering because of a poor voting choice, don’t feel sorrow for those that cast their ballots for the Republicans. They voted for a felon over an African American woman so you get a felons punishment. Trump will not help anybody. Just saying.
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Al says
These replies were typical of the left. You bring up a rotten apple and they start adding in oranges, pears, pineapples and cherries. The article was about AIDS and now you have to bring everything else to gain sympathy for your non argument. If the doctor that wrote this article felt so involved why doesn’t he treat these people for free. He just wants funding so he can bill by the minute for doing nothing. I’m 72 and don’t have cancer, diabetes, copd or any other complications. I don’t drink, never smoked or done drugs, stupid me for living a good life. Like I said in the first line that those who contracted from transfusions should be helped. ASSHOLE INJECTED,DEATH SENTENCE, YOU ONLY HAVE YOU TO BLAME.