Louisiana Insurers Agree to Continue Accepting Third Party Payments through mid-November

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“This will maintain critical health care coverage for lower-income Louisianans living with HIV through the current insurance plan year.”
March 10, 2014

(Baton Rouge, LA, March10, 2014) – U.S. District Court hearing came to a positive ending today when BlueCross BlueShield of Louisiana (BCBS) and two other Louisiana insurersagreed to continue to accept federally-funded third party premium payments on behalf of lower-income Louisianans living with HIV through November 15, 2014, when the next open enrollment period begins.

“This will maintain critical health care coverage for lower-income Louisianans living with HIV through the current insurance plan year,” said Scott Schoettes, Senior Attorney and HIV National Project Director at Lambda Legal. “There was a Sword of Damocles hanging over our client and other Louisianans, with these insurers having previously indicated that in just three weeks they would stop accepting the federal Ryan White Program insurance premium subsidies that enable many people living with HIV to afford life-saving health coverage. That imminent threat has been removed.”

Today’s development was the latest chapter in Lambda Legal’s lawsuit filed February 20, 2014, against BCBS, Louisiana Health Cooperative and Vantage Health Plan. The development occurred during a hearing in the U.S. District Court for the Middle District of Louisiana on Lambda Legal’s request for a preliminary injunction requiring the insurers to accept federal Ryan White HIV/AIDS Program funds for the duration of the lawsuit. BCBS had earlier said it would cease accepting the payments after March 31, and the other insurance companies indicated they would follow suit, risking the health and lives of potentially thousands of lower-income Louisianans living with HIV who depend upon the federal funds to purchase and preserve health care coverage.

“Continued insurance coverage and access to health care services and medications is critical for people living with HIV,” Schoettes added. “Moreover, BCBS has been accepting these federally-funded payments for years, and the U.S. Department of Health and Human Services has made it clear that they should continue to do so. The lawsuit alleged that this abrupt move by these insurers was inexcusable and discriminatory, and we are relieved they have agreed to continue accepting these payments for at least another seven months.”

Lambda Legal filed the lawsuit on behalf of John East, a part-time worker in the hospitality industry, and other low-income Louisianans living with HIV. East, a 59-year-old New Orleans man insured by BCBS for nearly 30 years, learned in mid-January that BCBS would no longer accept the federal Ryan White funds for which hequalifies. Without the support, East will not be able to afford his medical care and HIV medications. Lambda Legal’s lawsuit followed earlier efforts—including complaints filed with the U.S. Department of Health and Human Serves Office of Civil Rights—to persuade the insurers to continue accepting federal Ryan White premium funds.

The Louisiana Ryan White Health Insurance Program is a federally-funded program that functions as the payer of last resort, helping lower-income individuals living with HIV purchase health insurance they could not otherwise afford.

Lambda Legal attorneys Kenneth Upton, Scott Schoettes and Susan Sommer are handling the case, joined by pro-bono co-counsel Jeffrey J. Bushofsky, Timothy R. Farrell, Amanda R. Phillips, Nick Berg and Anthony C. Biagioli of Ropes & Gray LLP; and Harry Rosenberg of Phelps Dunbar LLP.  AIDSLaw of Louisiana is also assisting with advocacy in this matter.

The case is East v. BlueCross BlueShield of Louisiana, No.:3:14-CV-00115-BAJ-RLB.


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