The AIDS Drug Assistance Program (ADAP) is a national program that was started by the United States government through the Ryan White Act in 1987 to provide free or low cost drugs to people with HIV who have limited financial resources. Generally, these are people who have an income that is too high for Medicaid, but who do not have private health insurance.

ADAPs vary from state to state in terms of what drugs are available, what the income requirements are, and what measures each state has taken to support the program. Most states add money to the funding they receive from the federal government, but some do not. As a result, most states offer drugs to anyone who qualifies, while some have waiting lists. ADAPs act as the payer of last resort, a "safety net" that catches people with HIV who fall through the cracks in the U.S. health care system. With more than 152,000 enrollees, ADAP reaches about a quarter of all people with HIV who are currently in care. Almost 2/3 of ADAP clients are people of color, and half have incomes at or below the Federal Poverty Level ($9,800 a year for an individual).

The steps taken by some states to control the costs of ADAPs include waiting lists, limiting the number of drugs available (formularies) and lowering the income eligibility criteria.

As of October 17, 2013; there are currently 201 total individuals in 3 states according to the latest Kaiser Foundation Reports:

Alabama: 186 individuals
Idaho: 0 individuals
Louisiana**: 0 individuals
South Dakota: 15 individuals

Latest ADAP News

A FY2014 continuing resolution (CR) for the federal budget was passed by both chambers of Congress in order to end the government shutdown. This CR funds the federal government at FY2013 post-sequestration spending levels through January 15, 2014. As part of this fiscal deal, both the House and the Senate agreed to reconcile their budget resolutions in committee and report on their progress by December 13, 2013. Further, unless Congress provides an alternative to the sequester put in place under the 2011 Budget Control Act, agencies can expect a new round of cuts beginning January 15, 2014.

The FY2013 ERF funds were awarded last month to ADAPs. The FY2013 ERF funds consist of $65 million dollars in competing continuation funds for existing ERF grantees and $10 million in new competing funds available to ADAPs not previously receiving ERF. The budget period for these FY2013 ERF funds will be six months (through March 31, 2014) to allow future alignment of the FY2014 Part B base/ADAP earmark awards and the FY2014 ADAP ERF. HRSA has released both funding opportunities announcements (FOAs). The FY2014 ADAP ERF application is due November 25, 2013. TheFY2014 Part B base/ADAP earmark application is due on December 9, 2013.

Health departments should continue to expect delays and partial awards across programs, including ADAPs, as “regular order” of the appropriations and budget cycle remains in flux.

**Louisiana has a capped enrollment on their program. This number represents their current unmet need.

ADAPs with Capped Enrollment (as of October 11, 2012):
Idaho 197; Utah 450 direct medication clients, 100 insurance clients; Wyoming 135.

Access to Medications: Both ADAPs with waiting lists confirm that case management services assist clients in obtaining medications through either pharmaceutical company patient assistance programs (PAPs) (3 ADAPs) or Welvista (1 ADAP) while clients are on the waiting list.

Case management services are provided to ADAP waiting list clients through Part B (1 ADAP) and other agencies, including other Parts of Ryan White (3 ADAPs).

Waiting List Organization: Waiting list clients are prioritized by one of two models:

First-come, first-served model: placing individuals on the waiting list in order of receipt of a completed application and eligibility confirmation (3 ADAPs).

Medical criteria model: based on hierarchical medical criteria based on recommendations by the ADAP Advisory Committee (1 ADAP).

ADAPs with Other Cost-containment Strategies:

Enrollment Cap:

Expenditure Cap:
Illinois: (monthly)
Kentucky: (annual)
New Mexico: (monthly)
South Dakota: (annual)

Formulary Reduction:
Puerto Rico
Virgin Island (U.S.)

Montana: elimination of all support services
Washington: pay insurance premiums only if client is prescribed and taking ARVs

* ADAPs may have other cost-containment strategies that were instituted prior to April 1, 2012.

ADAPs Considering New/Additional Cost-containment Measures (before March 31, 2013**)

Alabama (capped enrollment)
Maine (formulary reduction)
**March 31, 2013 is the end of ADAP FY2012. ADAP fiscal years begin April 1 and ends March 31.

ADAPs that Eliminated/Modified Cost-containment Measures (since December 17, 2012***)

North Carolina (formulary increased)
*** ADAPs may have eliminated/modified other cost-containment strategies prior to December 17, 2012.

About ADAP: ADAPs provide life-saving HIV treatments to low income, uninsured, and underinsured individuals living with HIV/AIDS in all 50 states, the District of Columbia, the Commonwealth of Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, the Federated States of Micronesia, American Samoa, and the Republic of the Marshall Islands. In addition, some ADAPs provide insurance continuation and Medicare Part D wrap-around services to eligible individuals. Ryan White Part B programs provide necessary medical and support services to low income, uninsured, and underinsured individuals living with HIV/AIDS in all states, territories and associated jurisdictions.

So just because your state does not currently have an ADAP waiting lists or cutbacks does not mean people with HIV in other places in the United States are receiving treatment or quality health care.

In addition to waiting lists, ADAPs have also sought other ways to limit expenditures and some may already have quite limited formularies (number of HIV meds available), lower income eligibility compared to other states, and/or have instituted further restrictions in these and other areas even if they do not have an active waiting list in place.

For more detailed info, visit or or copy this link in your browser:

The above link contains the entire reports including statistics, graphs, status of ADAPs and Ryan White Act.

What's that? You would like to use your voice and help those on ADAP waiting lists in the United States? You do not think it is right for Americans with HIV to die without access to lifesaving medications?

To help financially challenged Americans on ADAP waiting lists, you can contact the following governors whose states have ADAP waiting lists and voice your opinion.

Thanks for helping save lives by calling or writing to the above state's Governors today. An American man, woman or child should never have to die only because they can not afford the life saving HIV medications. My brothers and sisters should not be acceptable casualties in the war on HIV and AIDS in our country.

An American life is a terrible thing to waste!