DC Health Link Makes Care for People Living with HIV Free

(Washington, DC) - The DC Health Benefit Exchange Authority (DCHBX) Executive Board voted unanimously to make the treatment and long-term management of Human Immunodeficiency Virus (HIV) free for DC residents and employees of DC employers enrolled in DC Health Link's Essential Plans.

Making primary care for HIV free will improve health outcomes. HIV disproportionally impacts communities of color. Approximately 71% of the people living with HIV in DC are Black and 8% are Latino. Moreover, Black people with HIV face disparities in access to care and health outcomes. Nationwide, at the end of 2022, only 64% of the Black population with HIV was linked to care and 53% were virally suppressed, meaning their HIV was suppressed through treatment. In contrast, 70% of the White population with HIV was linked to care and 63% were virally suppressed.

"Making HIV care free - meaning no deductible, no co-insurance, no copays - will save lives," said Diane C. Lewis, Chair of the DCHBX Executive Board and Chair of the Social Justice and Health Disparities Working Group.

Starting in Plan Year 2026, residents enrolled in a DC Health Link Essential Plan can get free primary care visits, free laboratory tests, and free generic HIV medications. Care that would otherwise cost up to $45 per visit and $55 per lab test will be free. The HIV equity-based benefit design was developed by DCHBX's stakeholder Standard Plans Working Group with support and expertise from Whitman-Walker, a nationally recognized care provider and research leader for those living with HIV.

The DCHBX Executive Board resolution expanding affordability and accessibility for HIV care is available here.

Background: In 2021, the DCHBX Executive Board adopted several policy recommendations developed by its Social Justice and Health Disparities Working Group designed to help eliminate systemic racism in health care. Eliminating cost-sharing for HIV care in Essential Plans is the latest action in this work. Previously adopted equity-based plan design includes free Type 2 diabetes care from family doctors, including free insulin, $5 copays for pediatric mental health services and medications, and free heart disease and stroke care from family doctors, including imaging such as CT scans.

More information on the recommendations of the Social Justice and Health Disparities Working Group is available here, while information on the targeted equity-based benefits of Essential Plans is available here.

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