Adopted: February 2026
The National Association of Black Counselors (NABC) expresses deep concern regarding the Florida Department of Health’s decision to significantly restrict eligibility for the state’s AIDS Drug Assistance Program (ADAP), effective March 1, 2026. These changes reduce income eligibility from 400% of the Federal Poverty Level (FPL) to 130% of FPL and remove critical medications, including Biktarvy, from the ADAP formulary. This policy shift, attributed to a projected $120 million budget shortfall, is expected to result in the loss of medication access for more than 15,000 individuals living with HIV across the state.
Announcement Timeline
The Florida Department of Health first communicated the planned ADAP changes to healthcare partners and program stakeholders on January 8, 2026. Shortly thereafter, Florida residents enrolled in ADAP began receiving written notification letters beginning January 12, 2026, informing them that their access to HIV medications and related assistance would be restricted under new eligibility and formulary requirements. These notifications provided affected individuals with fewer than two months’ notice prior to the March 1, 2026 implementation date.
Scope of Impact
ADAP is a core component of the federal Ryan White HIV/AIDS Program and serves as a critical safety net for individuals who are uninsured or underinsured. The substantial reduction in eligibility and removal of clinically indicated medications threaten continuity of care, increase the risk of treatment interruption, and undermine sustained viral suppression, outcomes that carry serious individual and public health consequences.
Implications for Black Communities and Mental Health
NABC is particularly concerned about the disproportionate impact these changes will have on Black communities, which continue to experience higher HIV prevalence, greater barriers to care, and persistent health inequities. The loss of medication access is expected to exacerbate stress, anxiety, and treatment instability among affected individuals. These changes will also place increased demand on non–Department of Health Ryan White services, including mental health counseling, case management, and community-based providers, without corresponding increases in funding or infrastructure.
Legal and Ethical Context
Legal challenges to the ADAP changes were initiated in late January 2026, asserting that the Florida Department of Health’s actions violate state law and conflict with the intent and requirements of the Ryan White HIV/AIDS Program. From an ethical and public health perspective, policies that restrict access to life-sustaining treatment raise significant concerns regarding patient safety, health equity, and governmental responsibility.
NABC Position and Advocacy Commitments
The National Association of Black Counselors affirms that:
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Access to HIV treatment is a public health necessity and a fundamental component of health equity.
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Abrupt policy changes that restrict access to essential medications place vulnerable populations at increased risk and reverse progress in HIV prevention and treatment.
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State and federal stakeholders must pursue transparent, collaborative, and sustainable funding solutions that preserve continuity of care and uphold the purpose of the Ryan White HIV/AIDS Program.
NABC’s Advocacy Committee is actively monitoring regulatory developments, legal proceedings, and policy responses related to the Florida ADAP changes. The Association will provide ongoing guidance, resources, and advocacy opportunities to support clients, clinicians, and communities impacted by these decisions.
Conclusion
NABC recognizes the profound consequences these changes pose for individuals living with HIV and the systems that support them. We urge policymakers to reconsider measures that jeopardize access to life-saving treatment, to meaningfully engage affected stakeholders, and to prioritize equitable solutions that protect public health. NABC remains committed to advocacy, education, and advancing health equity for all communities affected by HIV.
