Georgia lawmakers aim to shift millions to shore up HIV program

Lawmakers have added $15.4 million to this year's budget to increase the state Department of Public Health's ability to send aid to low-income Georgians living with HIV who need help paying for medications and treatment. People can enroll through providers like Grady Memorial Hospital's Infectious Disease Program. Photo by John McCosh/Georgia Recorder

High infection rates and economic hardships brought on by the pandemic have put new strain on a program that provides life-saving assistance to low-income Georgians living with HIV.

The rising demand nearly outpaced the state Department of Public Health’s current capacity. That would have made Georgia the only state with a waitlist and hurt efforts to slow the spread of HIV in a state with the highest rate of new diagnoses – 23.8 per 100,000 people – of any state, according to the Centers for Disease Control and Prevention.

But lawmakers are now in the process of shifting $15.4 million toward a program that provides virus-suppressing medication and assistance with insurance premiums to those who cannot otherwise afford treatment.

“We know that Georgia has been very hard hit by the COVID epidemic, and we also know that Georgia, at this point in time, unfortunately, is also leading the country in new HIV infections,” said Jeff Graham, executive director of Georgia Equality, which advocates on behalf of the LGBTQ community.

“I think these two forces have come together to create demands on the program that the federal dollars alone just cannot solve, and it has been a decade or more since we’ve gone to the Legislature asking the Legislature for assistance,” he said. “That’s why we need the legislature to step in.”

House lawmakers first approved the state funding for the program in this year’s $26.3 billion budget last month, and it was part of a rare infusion of state cash targeting public health. The Senate’s budget writers signed off on the funding Thursday, and the full Senate is likely to vote on the spending plan this week.

“Should we let that lapse, we would be the only state in the country that would wind up with a waiting list,” state Rep. Terry England, an Auburn Republican who chairs the House budget committee, said to his colleagues. “So, it’s very important.”

The program connects low-income Georgia residents with the care they need to stay healthy while living with a virus that attacks their immune system and causes AIDS. But from a public health standpoint, the medications used to treat HIV can also help prevent its spread by suppressing the virus. When someone’s viral load is undetectable, there is effectively no risk of transmitting the virus sexually, according to the CDC.

“It’s been extremely important over the years to be able to maintain individuals on treatment and particularly important now, given the pandemic and the challenges we’ve seen with individuals losing their employment and potentially their insurance and also being able to pay insurance premiums,” Public Health Commissioner Dr. Kathleen Toomey told state senators.

More than 12,000 people use the program in Georgia, which is about a 130% increase over the last decade, says Graham. And the state’s contribution to the program during that time has stayed mostly flat.

“It is the value of keeping people healthy,” Graham said of the proposed new state funding. “And in many instances, that means that people are able to retain their jobs.

“People are able to continue to be productive members of society by having this support, and frankly, the cost of medications itself is far lower than the cost of providing the intensive medical care if people don’t have access to medications early on and get sick and get hospitalized,” he added. “And that does still happen, and unfortunately, it still happens at a higher rate here in Georgia than most other states.”

A 2018 state audit of Georgia’s program pointed to potential long-term savings through prevention. At the time, it was estimated that lifetime HIV treatment costs are more than $350,000 per patient.

“Preventing the spread to only 15 individuals who would otherwise be served by the state saves an estimated $5.6 million in treatment costs, which exceeds Georgia’s total prevention funding in fiscal year 2018,” the audit read.