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HIV Policy & Advocacy

Know the issues.
Make your voice heard.

Educational information only — not medical advice. Talk to your healthcare provider about your specific situation.

HIV funding decisions get made in Tallahassee and Washington, and they change what care people can actually reach. This hub walks through the key issues, then the Florida picture, then exactly how to contact your representatives — including what to say if you were affected by a coverage change yourself.

Updated Aug 2026Refreshed with the June 2025 Kennedy v. Braidwood SCOTUS ruling preserving $0 PrEP coverage, PEPFAR’s post-authorization status, the 340B Rebate Model Pilot (effective Jan 2027), the FY26 win that restored $525M in Ryan White funding, the FY27 House proposal that would eliminate Part F and EHE, Florida SB 254’s ongoing impact on trans PLHIV, and the HRSA Parts A/B formula transition to current residence.
Key Issues

The issues that matter most

A plain-language breakdown of each issue — national picture and Florida snapshot side by side — so you know exactly what's at stake before you call or write.

🤝
Ryan White HIV/AIDS Program & ADAP
Federal Safety Net · Medication Access · Reauthorization
National Picture

The Ryan White HIV/AIDS Program is the largest federal program dedicated solely to HIV care. HRSA says it reaches more than half of everyone diagnosed with HIV in the United States — over 600,000 people a year.[1] Created by Congress in 1990, it funds primary medical care, medications, case management, mental health services, and housing support for people who are uninsured or underinsured.

The program runs through five Parts. Part A funds major metropolitan areas, Part B funds states — including the AIDS Drug Assistance Program (ADAP) — Parts C and D fund community clinics and programs for women, infants, children, and youth, and Part F funds the AIDS Education and Training Centers, dental care, and innovation projects.[1] ADAP is part of Part B: a state-administered program that provides HIV medications to people with low incomes, with each state setting its own eligibility inside federal guidelines.

Ryan White has not been formally reauthorized since its 2009 extension expired in 2013 — Congress has kept it running through annual appropriations ever since.[2] That leaves the program funded but without a renewed legal foundation. Meanwhile the dedicated federal ADAP earmark has sat at roughly $900 million a year since FY2014, even as ADAP enrollment grew about 30% between 2022 and 2024 and drug costs rose. KFF and NASTAD count 18 states that have had to restrict ADAP eligibility, formularies, or services under that pressure.[3]

Where federal HIV funding actually stands. The enacted FY2026 budget sustained every part of Ryan White at prior-year levels and rejected close to $2 billion in proposed cuts — including proposals to eliminate CDC's HIV prevention program and Ryan White Parts C, D, and F.[4] Those proposals came back in the FY2027 budget request, which would end CDC's domestic HIV prevention funding entirely — a $794 million reduction, about 78% — and again eliminate Part F. As of August 2026 that is a request, not law.[5] Globally, the picture is harder: the administration sought to cut U.S. global HIV assistance by at least 40%, and UNAIDS projects millions of additional infections and deaths if the disruption becomes permanent.[6] In June 2026, Lambda Legal and co-counsel sued HHS on behalf of three HIV clinician groups over new rules barring Ryan White funds from covering gender-affirming care.[7]

Florida Snapshot

Florida runs the largest ADAP program in the country, with roughly 33,000 people enrolled in the year before the 2026 cuts.[8] Florida has also ranked among the top few states for new HIV diagnoses in recent federal surveillance years,[9] which makes medication access here a statewide public health question, not a line item.

On March 1, 2026, Florida cut ADAP income eligibility from 400% of the Federal Poverty Level to 130% FPL — roughly $62,600 down to about $20,345 a year for a household of one.[10] Early estimates put the number of people losing coverage above 16,000; NASTAD later revised that to more than 12,000 after the state clarified that some cost-sharing help would continue.[11] Biktarvy, one of the most widely prescribed HIV regimens in the country, was pulled from the direct-dispense formulary, and insurance premium assistance was eliminated.[12]

A preliminary analysis by Johns Hopkins epidemiologist Melissa Schnure, PhD, using the Johns Hopkins Epidemiologic and Economic Model, projected roughly 4,312 additional HIV infections in Florida between 2026 and 2030 if the cuts held. That figure was reported in March 2026 and had not yet been published in a peer-reviewed, Florida-specific paper; Schnure's related multi-state modeling of Ryan White disruption is peer-reviewed.[13] The cuts were reversed in the 2026–27 state budget — details just below.

Read about the Florida ADAP changes →
Where this stands as of June 2026: Florida's 2026–27 state budget, signed into law on June 29, reverses the ADAP cuts. Eligibility is back at 400% FPL, every covered medication including Biktarvy is back on the formulary, and the budget adds $75 million in state funding. Insurance premium assistance was not restored — ADAP will keep helping with prescription copays but will no longer pay premiums.[14] That is the piece advocates are still working on, along with making sure the restored funding is not quietly reversed in a future budget cycle. Full Florida ADAP update →  ·  National ADAP picture →
Ryan White Program → National ADAP Picture → Use the call script →

If your HIV coverage changed — start here

Coverage rules can change faster than notification letters arrive. If you were dropped, downgraded, or told your medication is no longer covered, these are the six steps that most often get people back on treatment quickly. You can start any of them today, and you do not need to have all your paperwork in order first.

01
Call your HIV provider first

Your clinic has almost certainly handled this before and may already have samples, bridge supply, or an assistance application started for other patients. Say plainly that you are at risk of running out. Do not stop or change a regimen on your own.

02
Go directly to the manufacturer

Every major HIV drug maker runs a patient assistance program, and many people qualify for their medication at no cost. These programs are open year-round and are independent of ADAP. The full list is in the next block.

03
Find a Ryan White-funded clinic

Ryan White clinics use 340B pricing and sliding-scale care, and many can dispense HIV medications regardless of insurance status. This is often the fastest path back to a filled prescription. Find HIV care in Florida →

04
Check what coverage you can still get

Florida has not expanded Medicaid, so most adults without children or a disability determination have no Medicaid pathway [19] — but it is still worth screening, and an ACA Marketplace plan may be an option depending on your income and the time of year. Coverage options if you lost ADAP →

05
Call the Florida ADAP Help Desk

For eligibility, enrollment, and formulary questions, Florida's Department of Health runs an ADAP Help Desk at 844-381-2327. Prime Therapeutics handles direct medication services enrollment at 833-604-0925.[18]

06
Ask an advocacy organization for help

AIDS Healthcare Foundation led the legal challenge to Florida's 2026 cuts and operates clinics and pharmacies statewide. Local AIDS service organizations often have benefits counselors who do this work daily. National and Florida organizations →

If you have already stopped taking your medication: restarting matters more than explaining why you stopped. Interruptions can allow the virus to rebound and, over time, can contribute to drug resistance that limits which regimens work for you later. Call your provider and say you stopped and want to restart. No judgment here — just urgency.

Florida's 2026 ADAP crisis, in order

Jan 2026Florida’s Department of Health announces sweeping ADAP cuts effective March 1 — eligibility dropping from 400% FPL to 130% FPL, Biktarvy off the direct-dispense formulary, premium assistance eliminated — citing a projected $120 million shortfall.[15]
Jan 27AIDS Healthcare Foundation petitions Florida’s Division of Administrative Hearings, arguing the department imposed the changes without the public rulemaking state law requires.[16]
Feb 24–25On the eve of a hearing in that challenge, the department files a formal emergency rule enacting the same cuts, effective March 1.[12]
Mar 1The cuts take effect. Thousands of Floridians lose ADAP coverage.
Mar 24Governor DeSantis signs HB 697, a unanimously passed emergency bridge appropriation of $30.9 million that restores 400% FPL eligibility through June 30.[17]
Jun 29Full restoration becomes law in the 2026–27 state budget, with $75 million in added state funding and every covered medication back on the formulary. Premium assistance was not restored.[14]

Sustained pressure from AHF-led litigation and advocacy, clinicians, and people living with HIV — including the calls and personal stories advocates brought to legislators — was widely credited with the reversal.

If you're having trouble affording your medication

Whatever is happening with ADAP, every major HIV drug manufacturer runs a patient assistance program, and these are available year-round.[20] You can apply to more than one.

Gilead — Advancing Access®

Covers Biktarvy, Descovy, Truvada, Sunlenca, and other Gilead HIV medications.

gileadadvancingaccess.com →

ViiV Patient Assistance

Covers Cabenuva, Dovato, Juluca, Triumeq, and other ViiV medications. Call 1-844-588-3288.

viivhealthcare.com →

Janssen CarePath

Covers Symtuza, Prezista, Prezcobix, Edurant, and Intelence, with both copay support and a patient assistance foundation for people who qualify.

janssencarepath.com →

Ask about generic options

Several HIV medications now have FDA-approved generics that can cost dramatically less. Whether a generic is right for you is a clinical question — ask your provider, not the pharmacy counter.

Treatment Hub →

NeedyMeds Database

Search every available patient assistance program by drug name — brand and generic, all manufacturers, free to use.

needymeds.org →

340B pricing at Ryan White clinics

Ryan White-funded clinics use 340B pricing to provide HIV medications at dramatically reduced cost or free, regardless of insurance status.

Find HIV care in Florida →
Do not switch medications without talking to your HIV provider. Some switches that seem equivalent on paper can affect viral suppression or tolerability.

⚖️
HIV Criminalization Laws
Law · Rights · Justice · Reform
National Picture

The Center for HIV Law and Policy counts 32 states that criminalize people living with HIV and 28 states with criminal penalty enhancements tied to HIV status.[21] Most of these laws were written in the 1980s, before effective treatment existed and before we understood that an undetectable viral load means HIV is not sexually transmitted. Many still cover conduct that carries no realistic transmission risk at all, including spitting and biting.

Reform has been slow but real: more than a dozen states have modernized or repealed these laws since 2014, and in 2025 North Dakota and Maryland became the fourth and fifth states to fully repeal their HIV-specific exposure offenses.[22] At the federal level, the REPEAL HIV Discrimination Act has been introduced repeatedly and has not passed.

Read the national overview →
Florida Snapshot

Florida was one of the first three states in the country to pass an HIV-specific criminal law, in 1986, alongside Tennessee and Washington.[23] The HIV Justice Network documents at least 629 HIV-related cases in Florida, making it one of the most actively enforced states.[24] Florida's statutes reach non-disclosure, sex work, and blood donation, and do not require that transmission actually occurred or that anyone intended harm.

Reform bills have cleared committee with bipartisan support more than once. The law remains unchanged — the pattern has been a committee win followed by no full floor vote.

Read the Florida deep dive →
Organizations leading the reform work
  • Center for HIV Law and Policy (CHLP) — publishes the state-by-state criminalization map, drafts model legislative language, and provides legal resources to advocates and defendants.
  • Sero Project — PLHIV-led network fighting criminalization through storytelling, defendant support, and organizing formerly prosecuted survivors.
  • Positive Women’s Network-USA (PWN) — national membership body of women living with HIV; leads on criminalization repeal, reproductive justice, and gender-based advocacy.
Use the criminalization call script →

🌍
Ending the HIV Epidemic (EHE)
Federal Funding · Prevention · High-Burden Communities
National Picture

Announced in 2019, the federal Ending the HIV Epidemic initiative set a national goal of cutting new HIV infections by 90% by 2030. It concentrates testing, treatment, prevention, and outbreak response in 57 priority jurisdictions — 48 counties plus Washington D.C., San Juan, and seven states with high rural HIV burden.[25]

EHE has no permanent funding stream. It is renewed each year through congressional appropriations, which makes it exposed to budget politics. It was funded through FY2026, but the FY2027 budget request would eliminate CDC's HIV prevention division outright while moving the EHE allocation elsewhere — a restructuring that advocacy groups warn would strip out the surveillance and prevention infrastructure EHE depends on.[5]

Florida Snapshot

Multiple Florida counties are EHE priority jurisdictions — including Duval, Broward, Miami-Dade, Hillsborough, and Palm Beach — meaning they receive targeted federal resources for HIV testing, treatment, and prevention.

Cuts to EHE funding would directly reduce resources in these Florida communities, which are already navigating the impact of the 2026 ADAP crisis on care access. Florida has one of the highest rates of new HIV diagnoses in the United States.

EHE Deep Dive → Use the EHE call script →

🏥
ACA Coverage & HIV
Insurance · Medicaid · Coverage Gaps · Legal Threats
National Picture

The Affordable Care Act transformed HIV care access through four core protections: no denial of coverage based on HIV status; no higher premiums for people living with HIV; essential health benefits including HIV treatment and prevention; and out-of-pocket caps that prevent catastrophic medication costs.

The ACA also opened Medicaid expansion to states, and 40 states plus Washington D.C. have adopted it — extending coverage to millions of adults with low incomes, including many people living with HIV who had previously fallen through every gap.[19] Ten states, Florida among them, have not. Ongoing legal and political challenges to the ACA's structure keep these protections in play rather than settled.

Florida Snapshot

Florida has not expanded Medicaid under the ACA. Estimates of how many Floridians sit in the resulting coverage gap — earning too much for traditional Medicaid, too little for Marketplace subsidies — range from roughly 800,000 to 1 million.[19] More on the coverage gap →

For the thousands of Floridians who lost ADAP coverage in March 2026, Marketplace plans became the main alternative route to medication. But premiums and cost-sharing were real barriers, especially for people in exactly the income range Florida's 130% FPL threshold had just excluded — and premium assistance, the thing that made those plans workable, is the piece Florida has still not restored.[14]

Guide to choosing an ACA plan if you lost ADAP →
Contact your rep about ACA & coverage →

💉
PrEP Access & the Coverage Fight
Prevention · ACA Mandate · Legal Battle
National Picture

PrEP reduces the risk of getting HIV through sex by roughly 99% when taken as prescribed, and by about 74% for people who inject drugs.[26] The ACA requires most insurance plans to cover it at no cost to the patient, and that requirement was challenged all the way to the Supreme Court.

That case is resolved, and it resolved well. In June 2025, the Supreme Court ruled 6–3 in Kennedy v. Braidwood Management, Inc. to uphold the ACA's no-cost preventive services mandate, reversing a Fifth Circuit decision that had found it unconstitutional. No-cost PrEP coverage stands for the more than 80% of PrEP users who have private insurance, and as of August 2026 there is no pending Supreme Court case threatening it.[26]

The access problem that remains is for people without coverage. Brand-name PrEP without insurance or assistance can cost well over a thousand dollars a month at list price, which is why manufacturer assistance programs, county health departments, state PrEP programs, and Ryan White-funded clinics still carry most of the weight for people without coverage. If you are uninsured, the practical question is not whether PrEP is covered but which program can supply it to you. How to get PrEP →

Florida Snapshot

Florida has one of the highest rates of new HIV diagnoses in the United States, making PrEP access a critical prevention tool. Loss of no-cost coverage would disproportionately affect low-income Floridians — particularly Black and Latino communities and young people who already face the greatest barriers to accessing PrEP.

Because Florida has not expanded Medicaid, there is no Medicaid-funded PrEP safety net for people in the coverage gap — the Supreme Court ruling that preserved no-cost PrEP applies to insurance plans, so it does not help anyone who is uninsured. County health departments, Ryan White clinics, and manufacturer programs are the practical routes here. How to get PrEP in Florida →

Learn more about PrEP → Use the PrEP call script →

Additional Policy Issues

🎖️

HIV & Military Service

Nationally: For decades, people living with HIV were barred from enlisting and could be discharged. Recent court rulings have challenged blanket deployment bans, finding that HIV-positive servicemembers who are undetectable pose no meaningful risk.

Florida: Florida's large military population makes this policy especially relevant — servicemembers living with HIV have fought for the right to serve and deploy on equal terms.

Military HIV Deep Dive →   Contact your rep →
✈️

Immigration & HIV

Nationally: The U.S. lifted its HIV entry and immigration ban effective January 2010, ending a restriction in place since 1987.[29] Gaps remain, particularly HIV treatment access for undocumented immigrants and asylum seekers who fall outside most federal program eligibility.

Florida: Florida's large immigrant population makes this a significant issue, with treatment access varying widely by documentation status, county, and available Ryan White resources.

Contact your rep →
🌏

PEPFAR — Global AIDS Funding

Nationally: The President's Emergency Plan for AIDS Relief supported HIV treatment for 20.6 million people across more than 50 countries as of the end of FY2025.[27] Both its funding and its reauthorization have faced sustained political opposition.

Why it matters: PEPFAR is widely considered one of the most effective foreign aid programs in U.S. history. Its funding status is a direct reflection of political will to end the global epidemic.

PEPFAR Deep Dive →   Contact your rep →
🏘️

Housing & HIV

Nationally: Housing stability and HIV outcomes move together — people with stable housing are more likely to stay in care and reach an undetectable viral load. HUD's Housing Opportunities for Persons With AIDS (HOPWA) program is the only federal program dedicated specifically to the housing needs of people living with HIV, which makes its funding level consequential.[28]

Florida: Florida receives a significant HOPWA allocation given its HIV burden. Housing instability compounds every other gap — missed appointments, interrupted prescriptions, lost mail during a coverage change. Housing & HIV deep dive →

Contact your rep →
Florida — Close to Home

Advocacy starts in your state

Florida has one of the highest HIV rates in the country. What happens in Tallahassee directly affects whether people can access treatment, testing, and care.

Florida organizations doing advocacy

  • Florida HIV Justice Coalition — statewide advocacy on criminalization, access, and equity. floridahivjustice.org
  • Positive Leaders — peer-led advocacy and leadership development for people living with HIV in Florida.
  • Florida AIDS Action Council — monitors state legislation and connects advocates to the legislative process.
  • Local ASOs (AIDS service organizations) — many do direct advocacy in addition to services. Check your local organization.
  • CHAIN (Community HIV/AIDS Integrated Network) — statewide network connecting HIV service providers and advocates.

How to track HIV bills in Tallahassee

  • Visit MyFloridaHouse.gov and search by keyword — try "HIV", "ADAP", or "Ryan White".
  • The Florida Senate bill tracker: flsenate.gov — search and set bill alerts.
  • Florida Department of Health HIV/AIDS Section: floridahealth.gov
  • Legislative session runs January–March. Advocacy days in Tallahassee typically happen in February.
  • Florida's ADAP program operates through the Department of Health, and eligibility, formulary, and premium assistance are set during the annual state appropriations process — which is where advocacy has the most leverage.
  • Related RiseUpToHIV pages: Florida ADAP changes, HIV in rural Florida, Florida community events.

Florida ADAP Crisis Coverage

RiseUpToHIV has been documenting Florida's ADAP crisis — the cuts, the litigation, the bridge funding, and the June 2026 restoration — alongside updates from people directly affected. The detailed timeline and documents live on the article pages. HIV in Florida →

Florida ADAP Crisis →
In Washington

How HIV funding decisions get made

Federal HIV programs don't run on autopilot. Every year, Congress votes on whether to fund them — and at what level. Here's how the process works.

01
The President proposes a budget

Each year the White House releases a budget request that includes funding levels for Ryan White, ADAP, the CDC's HIV prevention programs, and PEPFAR. This is the starting point — not the final word.

02
Congressional committees set the numbers

The House and Senate Appropriations subcommittees mark up spending bills. This is where advocates can have the most impact — committee members respond to constituent contact more than almost anyone else in Congress.

03
The full Congress votes

Bills pass both chambers and go to the President. Continuing resolutions (CRs) — stopgap funding measures — can freeze HIV programs at prior-year levels, causing disruption even without formal cuts.

04
Reauthorization is separate

Programs like Ryan White require periodic reauthorization — a separate vote that renews the law itself. Without reauthorization, programs can still receive funding but lose legal clarity and protections.

Key committees that oversee HIV programs

House
Appropriations Subcommittee on Labor, HHS & Education
Sets annual funding levels for Ryan White, ADAP, and CDC HIV prevention programs.
Senate
Appropriations Subcommittee on Labor, HHS & Education
Senate counterpart — also votes on Ryan White and HIV prevention funding each year.
House
Energy & Commerce Committee
Oversees reauthorization of the Ryan White CARE Act and healthcare legislation.
Senate
Health, Education, Labor & Pensions (HELP) Committee
Senate jurisdiction over Ryan White reauthorization and health policy broadly.
House
Foreign Affairs Committee
Oversees PEPFAR reauthorization and U.S. global AIDS policy.

The FY2027 proposed budget — and the fight against it

On April 3, 2026, the White House released its Fiscal Year 2027 budget request. It maintains funding for existing HIV care, treatment, and PrEP programs but proposes to cut more than $1.5 billion from HIV prevention, housing, and related programs — and to fold what remains into a single, drastically reduced block grant inside a new agency called the Administration for a Healthy America.[31]

$1.5B+
Proposed cut to domestic HIV programs in FY27, on top of previously proposed cuts.[31]
$220M
All that would remain of federal HIV prevention funding — down from more than $1 billion today.[31]
$529M
Full elimination proposed for HUD's HOPWA housing program, which serves roughly 100,000 households.[31][28]
$74M
Zeroed out for Ryan White Part F — dental reimbursements, clinical training, and community-driven research.[5]

Congress ultimately decides. In FY26, a bipartisan Senate defended Ryan White at $2.571 billion — flat with the prior year — after the House first proposed a $525 million cut and full elimination of the CDC's HIV prevention division.[32] The FY27 fight follows the same pattern: an administration proposal, an initial House bill that goes further,[33] and a Senate and conference process where advocacy makes the difference.

National organizations leading the fight

These are the umbrella campaigns and national organizations most active in defending federal HIV funding in 2026. They coordinate the sign-on letters, congressional testimony, action alerts, and legal challenges — and they are the fastest way for an individual to plug into a national fight.

Umbrella campaign
Save HIV Funding

Launched in 2023 by PrEP4All, AVAC, and HIV Medicine Association in partnership with the Federal AIDS Policy Partnership. Now supported by more than 150 organizations. Its focus: stopping cuts to federal HIV infrastructure, defending FY appropriations, and protecting Medicaid access.[34]

savehivfunding.org →
AIDS United

National advocacy and grantmaking organization. Publishes the annual analysis of the President's HIV budget and coordinates the Federal AIDS Policy Partnership.[35]

aidsunited.org →
HIV Medicine Association

Represents clinicians and researchers who provide HIV care. Its FY appropriations statements set the tone for the medical community's response to proposed cuts.[36]

hivma.org →
PrEP4All

Co-launched Save HIV Funding. Focused on getting PrEP to everyone who needs it and defending the ACA preventive services requirement that keeps PrEP affordable.[34]

prep4all.org →
AVAC

Global HIV prevention advocacy organization. Co-launched Save HIV Funding and tracks federal and global HIV research funding.[34]

avac.org →
HIV+Hepatitis Policy Institute

Nonpartisan policy shop that issues rapid analyses of proposed cuts. Its running tally of the FY27 domestic HIV cuts is the most detailed public breakdown.[31]

hivhep.org →
amfAR

The Foundation for AIDS Research funds cure and prevention research and advocates for continued federal investment in HIV science through the NIH.[37]

amfar.org →
Treatment Action Group (TAG)

Advocates for equitable, evidence-based HIV, TB, and hepatitis C research and policy. Tracks federal HIV research budgets in detail.[38]

treatmentactiongroup.org →
NMAC

Leads with race in advancing health equity for people of color living with and affected by HIV. Convenes the U.S. Conference on HIV/AIDS (USCHA) each year.[39]

nmac.org →

To plug in: subscribe to any of these organizations' action alerts, sign onto Save HIV Funding as an individual or organization, and use the scripts below to call your two senators and one House representative when a bill is moving.

Where things stand

Policy wins and losses — the 2025-26 scorecard

Federal HIV policy in 2025 and 2026 has moved in two directions at once. States repealed outdated HIV criminal laws and Congress protected core HIV funding. At the same time, proposed cuts got deeper, program authorizations lapsed, and legal protections stayed contested.

Wins

What advocates protected or advanced

Mar 2025
North Dakota fully repeals its HIV criminal law

Republican Governor Kelly Armstrong signed bipartisan HB 1217, making North Dakota the fourth state to fully repeal its HIV-specific criminal statute.[22]

May 2025
Maryland becomes the fifth state to repeal

Governor Wes Moore signed the Carlton R. Smith Act (HB 39/SB 356), ending a 1989 misdemeanor statute punishable by up to three years in prison. Effective October 1, 2025.[40]

Jun 2025
Supreme Court preserves no-cost PrEP under the ACA

In Kennedy v. Braidwood Management, Inc., the Court ruled 6-3 that the U.S. Preventive Services Task Force is constitutionally appointed, keeping the ACA requirement that private insurers cover PrEP with no cost-sharing.[26]

Feb 2026
Congress rejects the House's proposed HIV cuts

An initial House FY26 Labor-HHS bill proposed roughly $1 billion in cuts — eliminating the CDC's HIV prevention division and a 20% cut to Ryan White. The final conferenced bill maintained Ryan White at $2.571 billion, flat with FY25.[32]

Mar-Jun 2026
Florida reverses its 2026 ADAP cuts

Florida's Department of Health filed an emergency rule cutting eligibility. Bipartisan legislation (HB 697), a lawsuit, and the June state budget restored 400% FPL eligibility for more than 12,000 people. Premium assistance was not restored in the final budget.[14]

Mar 2026
HRSA updates the Ryan White Parts A and B funding formula

Starting in FY26 and phasing in over five years through FY30, Parts A and B funding will be based on the number of people living with HIV at their current address, not their address at diagnosis. The change directs more resources to states like Florida where large numbers of long-term survivors now live.[41]

Losses & open threats

Where the ground is still shifting

Mar 2025
PEPFAR’s time-bound authorization lapsed

The last PEPFAR reauthorization expired March 25, 2025. The program is permanent in law and continues to be funded, but eight time-bound provisions from prior reauthorizations lapsed. Congress has not renewed them.[27]

Apr 2026
FY27 budget proposes another $1.5 billion in HIV cuts

The White House FY27 request would cut more than $1.5 billion from HIV prevention, housing, and related programs, fold Ryan White and CDC HIV programs into a reduced block grant, and eliminate HOPWA entirely.[31]

Jun 2026
House FY27 bill goes further than the President’s request

As in 2025, the House Labor-HHS bill again targets CDC HIV prevention and Ryan White. HIV Medicine Association called it a “continued assault on HIV programs.” The Senate and conference process is now where the fight lives.[33]

2025-26
PrEP coverage still contested after Braidwood

The Supreme Court preserved no-cost PrEP, but also confirmed the HHS Secretary can remove Preventive Services Task Force members at will and block recommendations before they take effect. Future USPSTF decisions on PrEP and other prevention tools remain vulnerable.[26]

Ongoing
34 states still have HIV-specific criminal or public-health laws on the books

Even with the North Dakota and Maryland repeals, most states retain HIV criminalization statutes. The Center for HIV Law and Policy’s national map tracks the current status jurisdiction by jurisdiction.[21]

Jul 2026
HRSA announces a 340B Rebate Model Pilot, effective January 2027

Under the pilot, participating drug manufacturers would provide the 340B ceiling price to safety-net providers through rebates after the fact rather than as upfront discounts. Ryan White clinics and other 340B entities rely on the current upfront model to stretch every federal dollar — a rebate model shifts cash flow and administrative burden onto providers already running lean. HRSA is accepting rebate plans through Aug 24, 2026 for a Jan 1, 2027 start.[42]

Aug 2024, ongoing
Florida SB 254 restrictions on gender-affirming care remain in effect

Signed in 2023, SB 254 limits gender-affirming care for adults and minors and restricts telehealth provision. A federal court permanently blocked key provisions in June 2024 (Doe v. Ladapo), but the Eleventh Circuit stayed that injunction in August 2024, so the law is in force while the state's appeal proceeds. For transgender people living with HIV in Florida, the law has narrowed access to hormone therapy and to the providers who coordinate it alongside HIV care.[43]

Ready to act?

Find your reps. Use a script. Make the call.

Your representatives' direct numbers and ready-to-use call scripts for every issue on this page — right here, no extra page to visit. Florida's 2026 ADAP reversal happened because people made these calls.

Find My Representatives

Who represents you?

Enter your zip code to find your federal and state representatives with direct phone numbers and websites. Phone calls reach a congressional office faster than anything else, and staffers tally every constituent contact by topic.

Federal — for ADAP and Ryan White funding

The annual appropriation for Ryan White, ADAP, CDC prevention, and PEPFAR is set by Congress. Call your two U.S. Senators and your U.S. Representative.

Find your members of Congress →

State — for Florida budget decisions

Florida's ADAP eligibility, formulary, and premium assistance are state decisions made through the Tallahassee budget process. Call your Florida House member and state Senator.

Florida House → Florida Senate →

If you only have five minutes

You do not need a direct number. Call the U.S. Capitol Switchboard at 202-224-3121 and ask to be connected to your senator or representative's office — the line is staffed around the clock. Florida Governor's Office: 850-488-7146.[30]

Not sure who your rep is? Call the U.S. Capitol Switchboard at 202-224-3121 and ask to be connected. Or visit USA.gov/elected-officials
Contact Scripts

Ready-to-use scripts

Choose your issue, personalize the bracketed parts, and read or email it to your representative's office. These are starting points, not recitations — one sentence about how this actually affects you is worth more than a perfectly delivered script.

🔒 You never have to disclose your HIV status to make this call. Staffers do not verify anything you say, and you are not required to explain why an issue matters to you. If you would rather not say anything about your own health, open with your relationship to the issue instead:
  • “I'm calling as a constituent who cares about HIV funding in our state.”
  • “I work in healthcare and I see what happens when people lose access to medication.”
  • “I'm a taxpayer, and cutting this program costs us more than funding it.”
ADAP Funding
The AIDS Drug Assistance Program provides HIV medication to people who can't afford it.
Your script — personalize the [brackets]

Tip: You can also email this script via your representative's website contact form. Phone calls get logged faster.

National Events & Conferences

Where advocates show up

These events are where the HIV community comes together — to learn, connect, and speak directly to decision-makers.

Annual • Washington D.C. • Spring
AIDS Watch
AIDS United

The largest annual HIV advocacy event on Capitol Hill. Advocates from across the country meet directly with members of Congress and their staff to make the case for HIV funding and policy. Open to people living with HIV, allies, and advocates.

Learn about AIDS Watch →
Annual • Rotating City • Fall
United States Conference on AIDS (USCA)
NMAC

The largest HIV conference in the United States, drawing thousands of advocates, clinicians, researchers, and people living with HIV. Sessions cover policy, treatment, prevention, and community. Scholarship support available.

Learn about USCA →
Biennial • Rotating City
HIV Is Not a Crime Summit
Sero Project & Partners

A national training and strategy summit focused on reforming HIV criminalization laws. Brings together people living with HIV, legal advocates, and legislators to advance law reform and end stigma-based prosecution.

Learn about Sero Project →
Biennial • Washington D.C.
National Ryan White Conference
HRSA / U.S. Department of Health

A federally convened conference for Ryan White-funded providers, advocates, and people living with HIV. Focuses on program implementation, best practices, and the future of the Ryan White program.

Learn about Ryan White Conference →
Biennial • International
International AIDS Conference
International AIDS Society (IAS)

The world's largest HIV science and policy conference. Draws tens of thousands of researchers, advocates, and world leaders. Scholarship programs make attendance possible for community advocates and people from low-income countries.

Learn about IAS Conferences →
Annual • Online & In-Person
TransAction at USCA
NMAC / Community Partners

A dedicated track within USCA focused on transgender people and HIV — addressing the intersection of trans identity, HIV stigma, access to care, and policy advocacy.

Learn at USCA →
Organizations Worth Knowing

Who is doing the work

These national organizations work year-round on HIV policy, advocacy, legal reform, and community organizing. Many offer ways to get involved beyond just donating.

Funding Coalition
Save HIV Funding

A coalition of 150+ organizations working to defend and advance federal funding for HIV, STI, viral hepatitis, and substance use prevention, care, and research. Tracks current federal funding threats in real time.

savehivfunding.org →
Policy & Advocacy
AIDS United

Leads AIDS Watch and funds community-based HIV advocacy across the country. One of the most influential HIV advocacy organizations in Washington.

aidsunited.org →
Community & Conferences
NMAC

Organizes the United States Conference on AIDS (USCA) and focuses on community-led responses to HIV, with a strong emphasis on racial equity.

nmac.org →
State Programs
NASTAD

Represents state and territorial health department HIV and hepatitis programs. Works directly with Congress and federal agencies on ADAP and Ryan White policy.

nastad.org →
Research & Treatment
Treatment Action Group (TAG)

A nonprofit think tank and community research organization that advocates for more and better research into HIV, TB, and hepatitis C. Known for rigorous, science-based advocacy.

treatmentactiongroup.org →
PrEP Access
PrEP4All

Campaigns for universal access to PrEP regardless of income, insurance, or immigration status. Led legal and legislative efforts to protect no-cost PrEP coverage.

prep4all.org →
Women & HIV
The Well Project

Centers the experiences of women and girls living with HIV. Produces resources, runs the A Girl Like Me blog community, and advocates for gender-responsive HIV policy.

thewellproject.org →
U=U / Science
Prevention Access Campaign

The organization behind the U=U (Undetectable = Untransmittable) movement. Works to ensure that the science of treatment-as-prevention is reflected in policy, law, and public health messaging.

preventionaccess.org →
Legal & Rights
ACLU HIV Project

Challenges HIV criminalization laws, healthcare discrimination, and policies that violate the rights of people living with HIV. Provides legal support and resources for law reform efforts.

aclu.org/hiv-aids →
Criminalization
Sero Project

A network of people living with HIV fighting criminalization and related stigma. Organizes the HIV Is Not a Crime Summit and supports advocates working on law reform nationwide.

seroproject.com →
Black Community & Policy
Black AIDS Institute

The only national HIV think and do tank focused exclusively on Black communities. Motto: "Our People. Our Problem. Our Solution." Works on policy, training, capacity building, and direct services.

blackaids.org →
Women, Trans & Gender Diverse
Positive Women's Network — USA

Led by and for women, trans, and gender diverse people living with HIV. Runs a year-long Policy Fellowship and monthly advocacy training series. Open to BIPOC women and trans folks living with HIV.

pwn-usa.org →
Policy, Research & Florida
The AIDS Institute

A national public policy, research, and advocacy organization with offices in Tampa and Washington D.C. Manages the Florida HIV/AIDS Advocacy Network (FHAAN) and works on federal and state HIV policy.

theaidsinstitute.org →
Criminalization & Legal
Center for HIV Law and Policy (CHLP)

A national legal and policy organization working to end HIV criminalization. Home of the Positive Justice Project (PJP) — a national coalition focused on repealing HIV criminalization laws through federal and state advocacy.

hivlawandpolicy.org →

Did we miss your organization? Contact us and we'll be glad to add you.

References & Sources

Every figure, date, and policy claim on this page is sourced below. Policy moves fast — where a number is contested, preliminary, or varies by source, we say so in the reference entry rather than picking the most dramatic version. The individual article pages linked from this hub carry their own sources. This page is education and advocacy information, not legal or medical advice.

  1. Health Resources & Services Administration (HRSA). “Ryan White HIV/AIDS Program: Program Parts and Initiatives.” Updated August 5, 2026. ryanwhite.hrsa.govab
  2. KFF. “The Ryan White HIV/AIDS Program: The Basics.” Updated August 1, 2026. kff.org
  3. KFF. “Constrained Budgets Lead States to Restrict HIV Drug Access Through Ryan White.” Updated August 7, 2026. kff.org  ·  NASTAD. “2026 RWHAP Part B ADAP Monitoring Report.” nastad.org
  4. HIV Medicine Association. “In a major victory, Congress maintains federal funding for HIV programs.” February 3, 2026. hivma.org  ·  HRSA appropriations table: ryanwhite.hrsa.gov/about/budget
  5. KFF. “Domestic HIV Funding in the White House FY2027 Budget Request.” Updated July 29, 2026. kff.orgabc
  6. UNAIDS. “Estimating the potential impact of HIV response disruptions.” 2025. unaids.org (PDF)
  7. Lambda Legal. “The American Academy of HIV Medicine et al. v. U.S. Department of Health and Human Services.” Filed June 10, 2026; case page updated July 21, 2026. lambdalegal.org
  8. Florida Department of Health. “Florida AIDS Drug Assistance Program Annual Report, FY 2023–24.” floridahealth.gov (PDF)
  9. Centers for Disease Control and Prevention. “HIV Diagnoses, Deaths, and Prevalence.” National HIV Surveillance System. cdc.gov — state-level rankings shift by surveillance year; check the current AtlasPlus tables for an exact rank.
  10. Florida Senate, Office of the President. “Senate Introduces Bridge Funding for AIDS Medication” (release and prepared remarks). March 10, 2026. flsenate.gov (PDF)
  11. NASTAD. “The ADAP Watch: February 2026.” nastad.org (PDF) — NASTAD revised its initial estimate of more than 16,000 clients affected down to more than 12,000 after Florida DOH clarified continuing cost-sharing assistance.
  12. AIDS Healthcare Foundation. “FL Health Dept. Signs ‘Death Warrant’ for 16,000 AIDS Drug Recipients.” February 25, 2026. aidshealth.orgab
  13. Preliminary Florida projection by Melissa Schnure, PhD (Johns Hopkins University School of Medicine), using the Johns Hopkins Epidemiologic and Economic Model, reported March 2026. Schnure’s related peer-reviewed multi-state modeling: “Projected Increase in HIV Incidence in 11 States if Ryan White Services Are Disrupted,” American Journal of Public Health, 2026. PubMed Central — the 4,312 figure is preliminary and not from a peer-reviewed Florida-specific paper.
  14. AIDS Healthcare Foundation. “Florida Budget Becomes Law, Securing Reversal of HIV Drug Cuts.” June 29, 2026. aidshealth.org  ·  HealthHIV. “Florida AIDS Drug Assistance Program” advocacy tracker, updated May 31, 2026. healthhiv.orgabcd
  15. WFSU News. “Florida’s AIDS Drug Assistance Program gets stopgap funding.” March 25, 2026. news.wfsu.org — cited for the Department of Health’s own stated rationale (a projected $120 million shortfall), not as an independent finding.
  16. AIDS Healthcare Foundation. “AHF Sues Florida DOH Over Rules Cutting HIV/AIDS Treatment for Thousands.” January 27, 2026. aidshealth.org
  17. AIDS Healthcare Foundation. “Gov. DeSantis Signs Emergency Bill Restoring HIV Drug Access for Over 12,000 Floridians.” March 24, 2026. aidshealth.org  ·  Florida Senate, HB 697 bill summary. flsenate.gov
  18. Florida Department of Health. “AIDS Drug Assistance Program.” floridahealth.gov
  19. KFF. “Status of State Medicaid Expansion Decisions.” Updated July 19, 2026. kff.org — coverage-gap population estimates for Florida vary by source and year; figures from roughly 800,000 to 1 million are commonly cited.abc
  20. HIV.gov. “Patient Assistance Programs and Co-payment Assistance.” Updated July 18, 2026. hiv.gov
  21. Center for HIV Law and Policy. “Mapping HIV Criminalization Laws in the U.S.” Updated June 9, 2026. hivlawandpolicy.orgab
  22. Center for HIV Law and Policy. “North Dakota Becomes Fourth State to Fully Repeal HIV Criminal Law.” March 31, 2025, and “Timeline of State Reforms and Repeals of HIV Criminal Laws” (2025). hivlawandpolicy.orgab
  23. Lehman JS et al. “Prevalence and Public Health Implications of State Laws that Criminalize Potential HIV Exposure in the United States.” AIDS and Behavior, 2014. PubMed Central
  24. HIV Justice Network. “Florida” jurisdiction profile. Updated July 14, 2026. hivjustice.net  ·  Williams Institute, UCLA School of Law. “HIV Criminalization in Florida.” williamsinstitute.law.ucla.edu (PDF)
  25. HIV.gov. “Ending the HIV Epidemic: Overview” and “Ending the HIV Epidemic: A Timeline.” Updated 2026. hiv.gov
  26. KFF. “Kennedy v. Braidwood: The Supreme Court Upheld ACA Preventive Services, But That’s Not the End of the Story.” June 27, 2025, updated August 3, 2026. kff.orgabcd
  27. U.S. Department of State, Bureau of Global Health Security and Diplomacy. “PEPFAR Spotlight: FY25 Quarter Four Public Data Release.” April 17, 2026. state.govab
  28. U.S. Department of Housing and Urban Development. “Housing Opportunities for Persons With AIDS (HOPWA) Program.” hud.govab
  29. UNAIDS. “UN Secretary-General applauds the removal of entry restrictions based on HIV status by the United States.” January 4, 2010. unaids.org
  30. United States Senate. “Contacting the Senate.” senate.gov
  31. HIV+Hepatitis Policy Institute. “Trump budget proposes over $1.5 billion cut to domestic HIV programs.” April 3, 2026. hivhep.orgabcdef
  32. HIV Medicine Association. “In a major victory, Congress maintains federal funding for HIV programs.” February 3, 2026. hivma.orgab
  33. HIV Medicine Association. “House FY 2027 Labor-HHS bill continues assault on HIV programs.” June 15, 2026. hivma.orgab
  34. Save HIV Funding. “About” and campaign homepage. Retrieved August 2026. savehivfunding.org  ·  Campaign homepage: savehivfunding.orgabc
  35. AIDS United. “Statement on the Release of President Trump’s FY27 Budget.” April 3, 2026. aidsunited.org
  36. HIV Medicine Association. “HIVMA urges Congress to reject president’s proposed deep cuts to HIV programs.” April 15, 2026. hivma.org
  37. amfAR, The Foundation for AIDS Research. Organization homepage and policy program overview. Retrieved August 2026. amfar.org
  38. Treatment Action Group (TAG). Organization homepage and HIV policy program overview. Retrieved August 2026. treatmentactiongroup.org
  39. NMAC. Organization homepage and program overview. Retrieved August 2026. nmac.org
  40. The Center for HIV Law and Policy. “Maryland Repeals HIV Criminalization Law.” May 20, 2025. hivlawandpolicy.org  ·  Metro Weekly. “Maryland Ends HIV Criminalization in LGBTQ Rights Win.” May 25, 2025. metroweekly.com
  41. Health Resources & Services Administration. “HRSA Announces Updates to Ryan White HIV/AIDS Program Parts A and B Funding Formulas.” March 16, 2026. hrsa.gov
  42. Health Resources & Services Administration. “HHS Announces the 340B Rebate Model Pilot Program.” July 31, 2026. hrsa.gov
  43. Human Rights Campaign. “Federal Court Blocks First State Law Restricting Health Care for Transgender Adults.” June 11, 2024. hrc.org  ·  Lambda Legal. “Doe v. Ladapo — Case Overview.” Updated 2025. lambdalegal.org