Monday, November 29, 2010

Inside Florida’s Republican Death Panel

How Florida Conspired To Set Up an ADAP “Drop Dead List”

Florida’s mostly Republican leadership has conspired with private conservative advocacy groups like AIDS Healthcare Foundation (AHF) to defund and demoralize people receiving their HIV medications through a Federal/State program called ADAP (AIDS Drug Assistance Program).

People who receive ADAP medication are generally low-income members of the workforce. The ADAP programs were originally set up as a partnership between the Federal Government and States to address the problem of HIV drugs being too expensive for the average person to afford out-of-pocket coupled with the “pre-existing conditions” clause in most health insurance programs which would deny coverage for HIV drugs.

Over the past decade, it has been customary for the Federal Government to increase ADAP funds by about 13.33% per year. Both George W.
Bush and Barack Obama have done that (although Bush only increased ADAP funding to appropriate “catch-up” levels when a Democratic Congress took over during the latter part of his Presidency as he had previously cut domestic HIV spending in favor of global HIV spending). But according to Michael Weinstein, President of AHF “Obama has done very little to support domestic HIV/AIDS funding” and “he’s only good at making nice speeches on the subject” which don’t solve the funding problem.*

This is the message being transmitted to the mostly gay and African American communities affected by HIV/AIDS in South Florida. Both Weinstein and Joey Wynn of
The Broward House (another state-funded HIV care and advocacy organization) snarl Obama’s name through pursed lips as if they are speaking about a fascist dictator and their message isn’t any kinder when it comes to parting House Speaker Nancy Pelosi.**

In fact, Michael Weinstein and his highly paid employees at AHF routinely protest the Federal Government with picket lines and chants like “Hey Feds, Give Us Back Our Meds”. One such stunt had them all carrying faux coffins and crosses and dressed like Grim Reapers while
walking in circles around Nancy Pelosi’s California office.

But what AHF and the Broward House absolutely will NOT tell you, is that Obama and the Congress have done business as usual on ADAP and that it’s actually Florida’s Republican legislature that has made the cuts to the program which resulted in the infamous “ADAP waiting list” and ultimately, the far worse
“ADAP drop list” which FL Health Department officials like Tom Liberti swore just a couple of months ago would not occur…

When AHF protests outside of Pelosi’s office (invariably at the peak of her re-election campaign) with signs and displays indicating that people are dying because of her actions, a subtle lie is being communicated to passers-by. California has no “waiting list” for ADAP medications and is better-funded than South Carolina where
at least three people have already died waiting for medication. California is better funded because their Governor, Arnold Schwarzenegger eventually stepped up to the plate and delivered the $27 million in funds. So it’s intellectually dishonest for Weinstein and his merry crew of tea-party style “deathers” to imply that this is a Nancy Pelosi problem. South Carolina’s Republican government completely de-funded its own contributions to ADAP voluntarily. That is what killed people – not Pelosi.

Weinstein does not seem to care that his message is based on a false notion of the Obama Administration supposedly “cutting funds”*** for HIV. He is working with the State of Florida on a
number of proposals which would elevate his organization’s stature and authority in the United States. One such proposal would allow him to police the pornography industry for safer sex practices and allow him access to confidential medical information which he is currently not given access to.

Another proposal is one by where AHF works with Pharmaceutical companies to negotiate prices and “freebies” called PAP’s (Patient Assistance Programs) so that the “free market” can step in and take care of what the big, bad Federal Government supposedly would not.

Weinstein’s Republican favoritism shows itself quite readily when you look at his supposed solution to the ADAP crisis. His protests are meant to draw negative attention to Democrats while drawing positive attention to
a bill drawn up by far-right Republican Senators called the “Access ADAP Act” (S. 3401).

The bill, which was introduced by Sen. Richard Burr R-NC (whose last campaign was
funded by BlueCross/BlueSheild), aims to take a huge chunk of Obama’s stimulus package and divert it toward ADAP. In essence, the withdrawn funds would damage the effectiveness of the stimulus (sending them into a category which does not produce a return on the investment) but it would also alleviate Republican-controlled states from their fair share of a national burden.

Incidentally, 3 of the co-signing Republican Senators on the bill (which has already died in committee and was never expected to be plausible) have anti-gay legislation languishing in various committees too. In fact, all 5 of the Senators who co-sponsored the legislation that AHF’s Michael Weinstein is urging his followers to support
were also co-sponsors on a Senate Bill last year which would have outlawed individual states from making their own marriage laws – in direct conflict with the United States Constitution.

The sunshine state is not exactly forthcoming with information on exactly which aspects of healthcare funding were cut and by whom specifically. Florida has a set of what are called “Sunshine Laws” (transparency laws that make legislation available and accessible online) which sound just brilliant but are not very effective at all in this situation. Browsing the budget reports from over the last 10 years, it shows that decisions like this are made in sub-committees. Sub-committees in Florida are allowed to, for whatever reason; block their procedures and committee notes on “certain items” from view by the public. This is of course what has happened with the specific itemized budget cuts that resulted in the ADAP Drop List.

Mysteriously, not a single high-ranking Florida official has addressed this issue to the public or responded to media inquiries on the subject. Governor Charlie Crist (R) and his Chief Financial Officer Alex Sink (D) have talked about every issue under the sun during their expensive political campaigns for higher office this year. Hundreds of millions of dollars were spent by Crist, Sink, Rick Scott and Allen West in the last election cycle and even a small fraction of that would solve the problem that HIV positive persons face in being dropped from the program. Even according to AHF, the amount that is needed is only 17 million dollars.

Even some Democratic State legislators who claim to care deeply about the crisis have been unwilling to go to the Republican legislature in Florida and either ask or demand an increase in state level funding for HIV care.
Frederica Wilson, a State Senator at the time, scoffed at the idea and pretended that it was simply impossible. This was after she told her audience that she and Health Department official Tom Liberti had gone to Washington “way back during the AIDS crisis” and tearfully pleaded with congress for funds and concern. Evidently to Florida Democrats, mountains are moveable but not molehills.

* These are actually sentiments from Michael Weinstein who I interviewed and audio-recorded with his permission. The statements about Obama’s supposed uselessness were made two days after Obama released the comprehensive National HIV/AIDS Strategy which is meant to coincide with healthcare reform. The strategy is the culmination of years of research and studies conducted nationwide and abroad and was hailed by many activists as a trailblazing and enlightened approach to the care of persons with HIV/AIDS and prevention for those whom are not yet affected.

** According to Joey Wynn from The Broward House at an AHF-sponsored town hall meeting, he told a bystander that Obama had actually “not increased” funding for ADAP, that he had “kept it the same”. That is untrue as well. The concept that Wynn was twisting around was the fact that Obama had not increased funding by any more than he did the previous year or the last year that Bush was in office. But Obama did, in fact, increase funding for ADAP to the tune of +13.33% in his last 3 annual budgets which are available to browse at the Kaiser Institute website.

*** In my work as a journalist covering the ADAP crisis in Florida, I’ve encountered many concerned people with HIV who have been misled by AHF and Joey Wynn at the Broward House to believe that Barack Obama has personally slashed the budget on their ADAP funds… This is NOT true. However, these organizations buy plenty of advertising in every newspaper, magazine, charity event and venue in South Florida. This is not done because they need to advertise; it’s done in order to harness the media and overpower any voice of dissent that dares to disagree with their rhetoric.


  1. Joey Wynn is not the problem and has never said President Obama slashed the budget on ADAP funds. Joey and I do not always agree, but it is irresponsible to say that he is not fighting for the HIV/AIDS Community. I don't always agree with AHF either, particularly Michael Weinstein, but they have many good employees in Florida who are sincerely trying to help. Funding levels have barely kept up with need for ADAP services, while at the same time we saw a HUGE increase in need for ADAP services due to the Great Recession.
    It would be great if the state of Florida would step up and offer much needed funding, but President Obama and Congress need to increase the funding for ADAP as well. It does none of us any good to be told we do not need Activism on the Federal Level. Joey Wynn and AHF will support any bill that increases the funding to meet the increased demand regardless of which party proposes it. I'm proud to be a Liberal, but the Republican sponsored Access ADAP Act is the only bill I know of to be brought to the floor. I hope for Democratic alternatives or any bill that can get bi-partisan support.
    Please do not let this article discourage you from advocating on BOTH State AND Federal Levels.

  2. Tim S - I appreciate your comment and I agree with you. I never said that Joey was not fighting for a good cause but I stood right there when he spoke over me and told two concerned activists that Obama "had not increased funding" at all and sneered at the suggestion. I am willing to put my honor as a reporter on the line to say so. I have been to all of these events and meetings and rallies and I would not make up such a thing. People have a right to know about where their community might be getting their facts mixed up or where things need some clarification.

  3. This whole issue winds me up, so I'll try and be brief and to the point.

    I don't understand how American healthcare works. It seems utterly wrong. Defenders of the system say everyone gets the choice of the care they need (provided they or their employer pays for it). So how on earth can an insurer deny coverage for pre-existing conditions. Surely that's the POINT of insurance, to pay medical bills..?

    I don't understand what happened to that healthcare bill... has it still not gone through? Or has it been so watered down it's ineffectual anyhow? Or both?

    What I remember most was that during the public debate stage a lot was said about the British system, which was just wrong. That British people hate it blah blah. Most people here love the NHS. Seeing as illness is essentially a random thing, it makes sense to me that we should all throw money in the same giant pot as we are able. And then when we need treatment we get it without any form-filling, without any billing to anyone.

    Yes there are woeful inadequacies in our system. Demand sometimes exceeds supply. But anybody who becomes seriously ill gets treatment quickly. And though you get good and bad doctors everywhere, almost without exception, the very best consultants in the land, specialists of international renown, all look after lists of NHS patients AS WELL as their private practice.

    I'd rather live with a British of European-style system than American any day of the week. I've been to a private clinic for a few months and frankly I just didn't like it. The atmosphere... the whole thing, it felt wrong.

    Well I'll leave it there. This isn't meant to be America-bashing. If I could have chosen a country of birth before I was born I'd probably have picked America. It's just some aspects of the American way seem woefully unfair

  4. It is clear that AHF is infiltrating the gay community to confuse the issues much in the same way other astroturf organizations such as freedomworks did. Recently they hosted a seminar for " Positive Attitudes" an HIV positive support group in Fort Lauderdale to convince members to sign up for the HMO they run. Now their "not for profit " profits are funding a paid trip to the ADAP march on Washington for 30 people on the wait list. Does this not smack of teaparty protests during the 08 election? I am very frustrated with my own community right now. They seem to be in bed with the enemy and don't know it.

  5. Jarret,check this out

    Crisis summit in DC

  6. Now they AHF and AAA are spending shitloads of pharma money in FL at a beachside event.

  7. Have you ever looked at 2009 AHF IRS 990 return. The Florida AIDS WALK was listed at raising 320K, but over 277K was for INDIRECT EXPENSES by AHF leaving 42K for the ultimate cause. An 87% overhead charge? Sounds kind of steep to me.

  8. Blather about ADAP obscures two conditions that already outrank waiting lists: 1) the declining number of new cases in well served jurisdictions and 2) the demonstrated effectiveness of PEP and PrEP in preventing HIV/AIDS in the first place. In Massachusetts, New York, California, and British Columbia (the last the subject of a major study at the international conference last year) the number of new cases is down 10% PER YEAR FOR THE PAST FOUR YEARS! It is NOT coincidental that those locations ignored the "abstinence only" rhetoric and promoted universal testing and easy access to Post-Exposure Prophylaxis and Pre-Exposure Prophylaxis (PEP and PrEP). Nor is it a coincidence that immediate access to Truvada after a potential exposure, and treatment for 30 days, has proven 100% effective AMONG THOSE WHO TOOK THE PILLS, and that Gilead has spiked the research finding to count all who were in the study in order to reduce that prevention rate to the 43% who actually used the medications.

    There's a lot more corruption in HIV/AIDS policy than the claptrap in Florida.

  9. More on Weinstein and AHF:


Florida Squeezed would love to hear your take on it...