Florida ADAP Crisis + State Cuts Rapid Response Kit
This kit is designed for fast, clear communication with reporters, producers, policymakers, and the public. It explains what FDOH is proposing for ADAP, why it matters, how people fall out of care in real life, and how to cover the story accurately and with urgency.
OVERVIEW
The Florida Department of Health is proposing sweeping changes to its AIDS Drug Assistance Program (ADAP) effective March 1, 2026. The proposal would eliminate insurance premium assistance, reduce income eligibility for uninsured clients, and restrict access to some of the most prescribed HIV regimens. The outcome is predictable: more people will lose coverage, experience treatment interruptions, and fall out of care — increasing preventable illness, hospitalizations, and HIV transmission statewide. HIV affects people of all backgrounds. HIV treatment and prevention are foundational public health tools that protect families, workplaces, and communities. When access breaks, everyone pays — in emergency room costs, new infections, and worse outcomes.
ABOUT ADAP
The AIDS Drug Assistance Program (ADAP) is a nationwide safety-net program created by the federal government and run by states to ensure that people living with HIV can access the medication and care they need to stay healthy and prevent transmission.
At the federal level, ADAP is primarily funded through the Ryan White HIV/AIDS Program, which Congress reauthorizes and funds to support HIV care nationwide. The federal government sends ADAP dollars to every state based on HIV prevalence, cost of care, and need. States are then responsible for designing and operating their own ADAP programs within federal rules — including deciding who qualifies, which medications are covered, and how insurance assistance is provided.
That means ADAP is both national and local:
- It is national because it is federally funded, federally authorized, and central to the U.S. HIV care system.
- It is state-run because each state decides how to use those federal dollars to build its HIV medication safety net.
In Florida, ADAP has historically played a crucial role not just in paying for HIV medication, but in keeping people insured — covering premiums and copays so people can access doctors, lab tests, and pharmacy benefits. This approach keeps people consistently in care, which is essential for maintaining viral suppression and preventing HIV from spreading.
Because all state ADAPs rely on the same federal funding streams, what happens in Florida is a warning sign for the entire national HIV safety net. Federal policy determines the level of support. State policy determines whether that support actually reaches people. When a state weakens its ADAP program, the impact is felt immediately in doctors’ offices, pharmacies, hospitals, and communities — and it undermines the national goal of ending the HIV epidemic.
SHF CAMPAIGN STATEMENTS
Statement by Jeremiah Johnson, Executive Director, PrEP4All and Co-Founder, Save HIV Funding Campaign: “Visibility on these interrelated and simultaneous attacks will be critical to preventing a catastrophic return to the darkest days of the AIDS crisis. Those working to undermine HIV funding are not only showing inhuman cruelty toward people living with or vulnerable to HIV, but they are also being fiscally reckless. For every dollar invested in HIV prevention, three to seven dollars are saved.”
Statement by Maxx Boykin, Manager, Save HIV Funding Campaign: “We spent all of 2025 fighting massive proposed funding cuts from the House majority, and now, as 2026 begins, the cancer is spreading. After the White House’s unprecedented decision not to honor World AIDS Day last month, we’re seeing a major federal agency scrap critical preventive services that disproportionately benefit red states, alongside a direct attack on people living with HIV from Governor DeSantis’ Department of Health. We are also closely investigating reports of other major funding disruptions across the United States.”
Statement by Kamaria Laffrey, Co-Executive Director, The SERO Project and Florida Resident: “Floridians living with HIV are entering the new year with enormous anxiety, uncertain whether they’ll be able to access treatment in just weeks with very little notice. This is deeply personal for me—not only do I rely on this coverage to stay virally suppressed, but I also need it to manage other health issues as I age with HIV. With no warning and no transparency, this feels like a random and unjustified attack on people simply trying to live.”
Statement by Kathie M. Hiers, CEO, AIDS Alabama: “Alabama organizations are being decimated by the Administration’s sweeping and sudden cuts to SAMHSA grants. Six AIDS Service Organizations, including AIDS Alabama, received notice last night that their grants were terminated, effective immediately. These grants, which provide almost $12 million each year, serve about 5,000 people annually with mental health and substance use treatment, prevention, and housing services. A small state like Alabama cannot replace this funding. We will see a spike in new HIV cases if we have the money to test for new cases!”
Statement by Paul Samuels, Director and President, Legal Action Center:
“The cancellation of $2 billion in SAMHSA grants will directly impact the ability of organizations all across the country to provide critical substance use prevention, treatment, HIV and hepatitis, harm reduction, education, and support services to people who need it most. It is a bizarre and extraordinarily harmful move from an Administration that has claimed to want to end the HIV epidemic and support rural communities that have been hit hardest by the opioid crisis.”
WHERE WE ARE TODAY
Today, Florida’s AIDS Drug Assistance Program (ADAP) functions as a medication and insurance safety net for people living with HIV who are uninsured or underinsured. In practice, ADAP support can include:
- Insurance premium assistance (so people can keep their coverage).
- Medication and/or copay assistance (so people can stay on consistent treatment).
- Access to modern HIV regimens that are easier to take and more tolerable.
This stability keeps people in care, helps people reach and maintain viral suppression, and reduces the likelihood of HIV transmission. It also prevents costly medical crises that strain hospitals and clinics.
WHAT FLORIDA IS PROPOSING (EFFECTIVE MARCH 1, 2026)
Based on the current reporting and provider/advocacy communications, key proposed changes include:
- Reducing ADAP income eligibility for uninsured clients from 400% of the federal poverty level (FPL) to 130% FPL.
- Florida’s chapter of the National Alliance of State and Territorial AIDS Directors (NASTAD) has estimated that this will result in 16,000 people falling off of ADAP in Florida.
- Florida’s chapter of the National Alliance of State and Territorial AIDS Directors (NASTAD) has estimated that this will result in 16,000 people falling off of ADAP in Florida.
- Continuing medication copay assistance for insured clients between 0–400% FPL.
- Eliminating all ADAP insurance premium assistance (clients must pay premiums themselves or drop coverage).
- Eliminating coverage of certain popular single-tablet HIV regimens under ADAP, forcing medically unnecessary switches to other medication regimens. Eliminating the ADAP rebate model, impacting operational funding supported through ADR OCA funding codes.
Note: These changes do not alter Ryan White eligibility — they alter ADAP program eligibility and benefits.
Even if each line item sounds technical, the combined effect is simple: the system becomes harder to navigate, harder to afford, and less clinically effective — right when people need stability most.
HOW PEOPLE FALL OUT OF CARE
Here is the most common pathway in which care breaks down, from today’s structure to the proposed model by FDOH. The process is measurable, human, and preventable:
- A person living with HIV who is treated and undetectable is stable: insured, in care, taking daily medication, and virally suppressed – meaning they cannot pass HIV on through sexual transmission.
- Their insurance premiums are currently paid (in whole or in part) through ADAP premium assistance.
- Florida eliminates premium assistance. The person is told they must now pay the full monthly premium themselves.
- The premium is unaffordable. The person delays payment, misses a deadline, or drops coverage entirely.
- The person becomes uninsured — often abruptly — and loses access to affordable pharmacy benefits and routine lab monitoring.
- Under the new rules, uninsured ADAP eligibility is limited to 130% FPL. Many newly uninsured people do not meet this income threshold.
- Even those who do qualify face administrative churn (re-certification, paperwork, pharmacy changes) that can create treatment gaps.
- If popular treatment regimens are removed, patients may be forced to consider disruptive treatment changes while also navigating a catastrophic loss of healthcare access.
- Medication adherence drops, or treatment is interrupted. Viral load rises, increasing the risk of illness and the risk of HIV transmission.
- Preventable crises follow: more urgent care and emergency room visits, more hospitalizations, more community spread, and higher long-term costs.
For people living with and impacted by HIV, this story is not theoretical.
The policy changes are the first domino; the collapse of coverage, adherence, and health outcomes is the chain reaction.
In plain terms: making treatment harder to take will predictably make treatment less effective — and that is dangerous for individuals and for public health.
ADDITIONAL RESOURCES
FLORIDA ADVOCATES + ADVOCACY ORGANIZATIONS FOR OUTREACH
The SERO Project (SERO) — [email protected]
HIV Medicine Association (HIVMA) — [email protected]
AVAC (AVAC) — [email protected]
Legal Action Center — [email protected]
AIDS Alabama — [email protected]
Press Contact:
Morrison Media Group
About the Save HIV Funding Campaign:
Launched in 2023 by PrEP4All, AVAC, and the HIV Medicine Association in partnership with the Federal AIDS Policy Partnership, the Save HIV Funding campaign is supported by over 150 national and local organizations. The campaign began in response to proposed Congressional cuts to federal HIV programs and successfully helped avert $1.5 billion in domestic HIV funding cuts.
In early 2025, the campaign expanded in response to the Trump Administration’s escalating efforts to dismantle essential HIV services and infrastructure. Today, Save HIV Funding continues to mobilize advocates, patients, healthcare providers, and public figures to ensure access to lifesaving care for everyone impacted by HIV.
FLORIDA ADAP CRISIS FAQ
1) What is ADAP?
The AIDS Drug Assistance Program (ADAP) is a nationwide safety-net created by the federal government and funded primarily through the Ryan White HIV/AIDS Program to ensure people living with HIV can access lifesaving medication and stay in care. Federal dollars flow to each state, but states control how those funds are used — including who qualifies, which drugs are covered, and whether insurance premiums are paid.
In Florida, ADAP has historically helped people stay insured and on modern HIV treatment, which is critical to maintaining viral suppression and preventing transmission. When Florida changes its ADAP rules, it is not just a state decision — it determines whether federal HIV funding actually reaches the people it is meant to protect.
What happens in Florida is therefore a warning for the entire national HIV safety net.
2) What is Florida proposing to change?
Florida is proposing to end ADAP insurance premium assistance, sharply tighten eligibility for uninsured clients, and move people off modern single-tablet HIV regimens.
3) Why should people who don’t have HIV care about this?
Because HIV treatment access is a public health tool. When people stay on treatment and are virally suppressed, HIV transmission drops. When people fall out of care, infections and hospitalizations rise — and costs increase for everyone.
4) What does ‘ending premium assistance’ mean in real life?
It means people who currently rely on ADAP to pay insurance premiums may lose their insurance if they can’t afford the new monthly out-of-pocket payments.
5) What is the ‘coverage cliff’ and why is it dangerous?
It’s the moment people lose insurance and then discover they don’t qualify for ADAP under the tighter income threshold. That gap can mean no medication, no labs, and no routine care.
6) Why is it important to maintain a patient on a stable treatment regimen?
Given different side effects and patient preferences, it can take time to settle on a treatment regimen that works best for an individual. Maintaining a stable regimen supports adherence, reduces side effects for many patients, and helps maintain viral suppression.
7) Why is forcing a medically unnecessary regimen switch a problem?
Forcing an individual off stable treatment introduces more complexity, increasing the possibility of missed doses and side effects, which can lead to treatment interruptions, drug resistance, and worse health outcomes. This undermines the progress and innovation we have achieved by rolling back to drug regimens that existed at the onset of the HIV/AIDS epidemic of the 1980’s.
8) What will we see happen first as this rolls out in March?
Patients are losing insurance, clinics are overwhelmed with urgent re-enrollment needs, treatment gaps, medication switches, and growing anxiety among people living with HIV.
9) What are the stakes if people fall out of care?
Viral rebound, preventable illness, more emergency room visits, higher hospital costs, and increased risk of HIV transmission.
10) What is SHF calling for right now?
Immediate transparency and mitigation in Florida, and stable, fully funded HIV care and prevention systems nationally, so states aren’t forced into rationing lifesaving treatment.
1) What is ADAP?
ADAP (the AIDS Drug Assistance Program) is a federally funded, state-run safety-net program that helps people living with HIV afford their medication and, in many cases, stay insured so they can remain in medical care.
2) Who funds ADAP?
ADAP is primarily funded by the federal government through the Ryan White HIV/AIDS Program, which Congress supports to ensure people with HIV can access treatment regardless of income or insurance status.
3) Why do states run ADAP if it’s federally funded?
The federal government provides the money, but each state decides how the program operates — including income eligibility, which drugs are covered, and whether insurance premiums and copays are paid.
4) Why is ADAP so important?
HIV medication must be taken consistently to keep people healthy and prevent transmission. ADAP ensures that people don’t lose access to treatment simply because they lose a job, insurance, or face financial hardship.
5) How does ADAP protect public health?
When people with HIV stay on treatment and are virally suppressed, they cannot transmit the virus to others. ADAP therefore helps prevent new HIV infections and reduces long-term healthcare costs.
6) What does ADAP cover in Florida today?
Florida’s ADAP has historically helped pay for HIV medication and, for many clients, insurance premiums and copays — allowing people to stay insured and receive full medical care.
7) What is Florida proposing to change?
Florida plans to eliminate insurance premium assistance, sharply reduce eligibility for uninsured clients, and remove certain modern single-tablet HIV regimens from coverage.
8) Why is eliminating insurance support such a big deal?
Without insurance, people cannot afford doctor visits, lab work, or pharmacy access. When people lose coverage, they often fall out of care and miss doses of medication.
9) Why do unnecessary HIV medication switches matter?
It can take time for a patient to settle on a regimen that matches their needs and preferences for HIV treatment. Forcing people to switch regimens increases the likelihood of missed doses, side effects, and the risk of treatment failure and drug resistance.
10) Why should the public care about ADAP changes?
When people with HIV lose access to treatment, viral levels rise, hospitalizations increase, and the risk of HIV transmission grows. ADAP is not just about individual health — it is a core part of protecting public health.
EDITORIAL FRAMING FOR REPORTERS, JOURNALISTS AND CREATORS
This is not just a budget story. It is a measurable human-impact story with clear public health stakes.
Strong reporting angles:
- THE COVERAGE CLIFF: How ending premium assistance pushes people off insurance and out of care.
- THE MEDICATION ROLLBACK: Why removing certain single-tablet regimens forces unnecessary medication switches and risks adherence, resistance, and treatment failure.
- THE PUBLIC HEALTH IMPACT: Viral suppression prevents transmission; treatment gaps increase risk statewide.
- ACCOUNTABILITY: What modeling supports the proposal? What mitigation exists? Who is responsible for continuity of care? Why were providers and patients not warned of the possible need for the restrictions sooner?
SHF is available as an expert voice to explain how HIV treatment protects public health, what continuity of care requires, and why destabilizing ADAP creates preventable harm.