Last week, Maine Gov. Janet Mills warned of a $118 million gap in MaineCare funding — a shortfall that appears to have been exacerbated at least in part by high demand for an expensive injectable HIV treatment.
In an effort to combat the HIV/AIDS epidemic, in June 2021, Gov. Mills signed LD 1115 into law, becoming the third state after California and Colorado to require that state-regulated health insurance carriers cover certain FDA-approved HIV prevention drug with no out-of-pocket cost to patients.
The law also stipulates that health insurance providers must cover at least one approved drug, and cannot subject any of the HIV prevention drugs to so-called “step therapy,” a process by which patients would be required to use more cost-effective treatments prior to more expensive options.
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While the number of new HIV diagnoses in Maine trended downward from 2014 to 2020, in recent years Maine has seen an uptick in new diagnoses.
In 2022, there were approximately 1,774 people living with HIV in Maine, with the most common transmission categories for the virus being male-to-male sexual contact and intravenous drug use, according to AIDSVu, a project of Emory University’s Rollins School of Public Health.
From October 2023 through Jan. 4, 2025, Penobscot County alone saw 14 new confirmed cases in an “HIV cluster,” with all 14 of those cases being among individuals who injected drugs within one year of their diagnosis, according to the Maine CDC.
Those drug-based cases of HIV transmission occurred even as an unprecedented number of taxpayer-funded clean syringes entered circulation in the Bangor area, a program aimed entirely at preventing the spread of blood-borne illnesses among drug users.
Just months before Gov. Mills signed LD 1115 into law, the FDA approved Cabenuva for medical use, a monthly injectable HIV treatment that can cost thousands of dollars per injection, and that under the law must be covered with no out-of-pocket expense to the patient and without the use of step therapy.
The Maine CDC entered a noncompetitive $3.3 million contract with the Hallowell-based nonprofit Medical Care Development Global Health in April 2023 for services related to the agency’s Infectious Disease Prevention Program, including treatment of HIV patients with Cabenuva.
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That contract was revised upwards by nearly $2 million in September 2024 and extended through March of this year, due in part to the high cost of the monthly injections for HIV-positive patients.
“The purpose of this amendment extends the term of the contract through 3/31/2025 to allow the Department additional time to get a new agreement in place and adds additional funds due to a variety of factors,” state staff wrote in the contract.
“Costs have been driven up by an injectable medication (Cabenuva) that cannot be accessed in the traditional route through our Pharmacy Benefits Manager,” staff wrote.
Upon termination of the contract, the state will be looking for ways to cover the cost of copayments for Cabenuva with federal grants.
Other contributing factors to the $2 million increase and extension of the contract include rising private health insurance premiums, increased utilization of food vouchers, and “[s]ignificant increases” tuberculosis cases in Maine, according to the Maine CDC.
The $118 million MaineCare funding gap comes as the state is projected to face a $450 million budgetary shortfall through fiscal year 2027, according to a memo sent to lawmakers by Finance Commissioner Kirsten Figueroa last Tuesday.
Let’s go invite a whole bunch of HIV infected , illiterate Haitians to become New Mainers .
That should be just what our taxpayers will want to fund .,
More welfare . More crime . More AIDS .
Keep voting for democrats and that is exactly what we will get.
My dislike for queers is based partly on my dislike for the damage they do to my wallet:
“Just months before Gov. Mills signed LD 1115 into law, the FDA approved Cabenuva for medical use, a monthly injectable HIV treatment that can cost thousands of dollars per injection, and that under the law must be covered with no out-of-pocket expense to the patient and without the use of step therapy.
INVEST IN DEPORTATION JANET!!