August 19, 2010 

Office of Consumer Information and Insurance Oversight 

Department of Health and Human Services 

Attention: OCIIO-9994-IFC 

P.O. Box 8016 

Baltimore, MD 21244-1850 

RE: Patient Protection and Affordable Care Act; Requirements for Group Health Plans 

and Health Insurance Issuers Under the Patient Protection and Affordable Care Act 

Relating to Preexisting Condition Exclusions, Lifetime and Annual Limits, 

Rescissions, and Patient Protections; Final Rule and Proposed Rule 

 75 Federal Register 123 (June 28, 2010) 

To Whom It May Concern: 

On behalf of The AIDS Institute, I am writing to express our strong support regarding the abovereferenced rule. The AIDS Institute is a national nonprofit and nonpartisan organization, 

providing leadership in HIV/AIDS public policy research, advocacy, and education. 

The Patient Protection and Affordable Care Act will greatly benefit people in the United States 

gain access to affordable and quality healthcare, including people living with HIV/AIDS 

(PLWHA). The law also provides numerous improvements to the private insurance market, 

including several important patient protections. The Patients’ Bill of Rights outlined by the Rule 

includes many provisions that will directly benefit PLWHA, which will allow for greater and 

continued access to care. Until now, PLWHA have been highly discriminated against by private 

insurers and with the finalization of this Rule, those practices will come to an end. 

Under the Patients’ Bill of Rights, there will be no arbitrary rescission of coverage. Since no one 

can be removed from an insurance plan when they become sick, people will no longer have to 

live in fear of losing their insurance if they receive a diagnosis of HIV or AIDS. This will allow 

for greater access to care for those living with HIV/AIDS and help to reduce stigma. 

People living with HIV/AIDS have traditionally been denied coverage from insurance due to 

pre-existing conditions. Under the Patients’ Bill of Rights, insurance companies will be 

prohibited from denying coverage to children under the age of 19 due to pre-existing conditions. 

This will allow youth living with HIV/AIDS to have access to insurance for treatment and care. 

In 2014, this provision will expand to all private insurance beneficiaries. PLWHAs will be able 
to seek private insurance without fear of discrimination. In the meantime, we hope private 

insurers will implement this provision on their own prior to 2014. 

The Patients’ Bill of Rights also prohibits the use of lifetime limits and it begins to phase out 

annual limits. Treating HIV/AIDS can be very costly and many PLWHA suffer from other coinfections or co-morbidities, which can further increase their costs of care and treatment. Under 

this regulation, PLWHA will be able to seek care and treatment without fears of hitting these 

limits and facing gaps in their care and treatment. 

PLWHA will also benefit from other provisions in the Patients’ Bill of Rights. People will be 

able to choose which primary care provider they would like to use in their participating plan’s 

network. In addition, the Patients’ Bill of Rights will prohibit higher costs when emergency 

services are sought out of network. This will ensure that everyone, including PLWHA, will not 

have to face a large financial burden if they need emergency services when not in their network. 

The AIDS Institute believes the Patients’ Bill of Rights will greatly improve the private health 

care system and correct some of the long standing discriminatory practices utilized by insurance 

companies, particularly against PLWHA. We strongly support these patient protections and look 

forward to their implementation. 

Sincerely, 

Carl E. Schmid II 

Deputy Executive Director 

2000 S Street NW 

Washington, DC 20009 

cschmid@theaidsinstitute.org

(202)-462-3042