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National Journal: Are Insurers Finding a Way Around Obamacare Preexisting-Conditions Protections?

The Affordable Care Act prohibits insurers from denying coverage to individuals with preexisting conditions, but some companies may be limiting their prescription-drug offerings to steer HIV patients to other plans. “We’re seeing policies in place by insurance companies that certainly look like they are intended to make plans look less attractive to patients with HIV,” said John Peller, vice president of policy at AIDS Foundation of Chicago. …Advocacy groups are observing this across a number of major insurance companies in a large number of states. The HIV Health Care Access Working Group (HHCAWG), a coalition of national HIV health policy advocates, has sent letters to insurance companies and to Health and Human Services Secretary Kathleen Sebelius regarding the issue. “We’re making sure that formularies are robust, and [insurance companies] are not utilizing management techniques—like tiering or prior approval—that create unfair or undue burdens on people to meet their standard of care,” says Robert Greenwald, director of the Center of Health Law and Policy Innovation at Harvard Law School, and a cochair of HHCAWG. Greenwald is the main individual behind the effort, and point person on the letters.

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