.jpg)
Over the weekend Florida dramatically cut access to ADAP, reducing coverage eligibility from 400% of the federal poverty line to 130%. This means that as many as 16,000 Floridians living with HIV no longer have premium assistance as of February 28, 2026.
This is the latest and most dramatic case of states moving to limit access to HIV treatment. Driven by rising costs of HIV medications and funding that has stayed flat for more than a decade, about 20 states, led by both Democrats and Republicans, are toughening eligibility requirements for people benefiting from Ryan White AIDS Drug Assistance Programs, or ADAPs.
Against this backdrop, and with five more states considering cuts that would go into effect next month, the HIV community has rallied to monitor changes, develop critical guidance for patients and providers impacted, and chart a path forward. We’ve pulled together the 10 essential resources to understand ADAP, the issues to watch as they unfold across the country, and what just happened in Florida.
ADAP Overview
1. Part B: AIDS Drug Assistance Program (HRSA)
The official federal overview of ADAP explains the mechanics of the program administered by the states. It also details the core services ADAP provides, including direct medication access and insurance premium assistance.
2. The Ryan White HIV/AIDS Program: The Basics (Kaiser Family Foundation)
This is a great place to start. This primer from KFF explains how the Ryan White HIV/AIDS Program works, including the role of ADAP within Part B funding. It also outlines who the program serves, how funding flows to states, and how ADAP helps cover medications and insurance premiums for people living with HIV.
Monitoring Changes to ADAPs Across the Country
3. Constrained Budgets Lead States to Restrict HIV Drug Access Through Ryan White (Kaiser Family Foundation)
KFF analyzes a growing trend of states tightening ADAP eligibility and formularies as drug costs rise while federal funding has remained largely flat for more than a decade. The report documents how roughly 20 states are considering or implementing cost-control measures that could limit access to treatment.
4. States Move to Limit Access to HIV Treatment (New York Times)
This recent article builds on KFF’s report, examining how states across the country are beginning to scale back HIV drug assistance programs. It highlights Florida’s decision to sharply reduce ADAP eligibility as one of the most dramatic examples of this emerging national trend.
5. ADAP Watch (NASTAD)
Since 2002 NASTAD has tracked policy, funding, and cost-containment measures across state ADAPs. The most recent report from February 2026 details which states have lowered income eligibility thresholds, reduced formularies, capped spending, or restricted insurance premium assistance, and identifies additional states considering measures such as waiting lists or tighter eligibility rules.
6. 2026 National Ryan White HIV/AIDS Program Part B ADAP Monitoring Project Annual Report (NASTAD)
This is the gold-standard annual report on ADAP programs across the country, compiling detailed data on enrollment, funding, program structure, and outcomes across all state programs. The report highlights how effective ADAPs are at supporting treatment and long-term health outcomes: 87% of ADAP clients are virally suppressed, compared to about 67% nationally among people living with HIV.
Florida Cuts
7. Florida Department of Health Emergency Rule Reducing ADAP Eligibility (Florida Department of Health)
This is the source document issued by the Florida Department of Health that reduced ADAP eligibility from 400% to 130% of the federal poverty level. It explains the policy change, eligibility criteria, and how the state will administer the revised program.
8. Special Enrollment Period for Florida ADAP Consumers (CMS)
CMS issued guidance confirming that individuals losing ADAP premium assistance qualify for a Special Enrollment Period in the Marketplace. The letter explains how affected individuals can begin the enrollment process and access coverage.
9. Options for Florida ADAP Enrollees when ADAP premium assistance stops (AIDS Institute)
This fact sheet walks through the options available to Floridians who have lost ADAP premium assistance, including other insurance options and support programs. It’s a practical guide for patients and providers trying to understand what to do next.
10. Florida ADAP Consumers: Special Enrollment Period Now Open Through Marketplace (NMAC via POZ)
NMAC outlines the key factors to consider when choosing a Marketplace plan during the Special Enrollment Period, helping patients determine whether a plan will adequately support ongoing HIV treatment.
.png)
