HMOs warned on discriminating vs persons with HIV-AIDS

MANILA, Philippines — An administration lawmaker from the House of Representatives yesterday warned health maintenance organizations (HMOs) and life insurance companies that they would face the full force of the law should they discriminate against Filipinos afflicted with the human immunodeficiency virus-Acquired Immune Deficiency Syndrome (HIV-AIDS).

“Insurers can no longer discriminate versus Filipinos with HIV under the new law,” Surigao del Sur Rep. Johnny Pimentel said. “All insurers in the country are expected to revise their standard policies to comply with the provision of the law that prohibits the exclusion of persons living with HIV.”

Pimentel was referring to Republic Act 11166 or the AIDS Prevention and Control Law that took effect on Jan. 25. The new law provides that people living with HIV can no longer be left without insurance coverage and protection by reason of their condition.

Section 42 (e) provides: “No person living with HIV shall be denied or deprived of private health insurance under an HMO and private life insurance coverage under a life insurance company on the basis of the person’s HIV status. Furthermore, no person shall be denied of his life insurance claims if he dies of HIV or AIDS under a valid and subsisting life insurance policy.”

Violators of the provision face up to five years imprisonment and a fine of at least P50,000, plus administrative sanctions such as suspension or revocation of business permit, business license or accreditation and professional license, according to Pimentel.

“We’ve gone over several standard insurance policies issued prior to the passage of the law, and we came across a number (of policies) that categorically excluded HIV-related cases from coverage. These exclusions are no longer possible,” he said.

The Mindanao lawmaker cited an unnamed leading insurer’s standard policy which stipulates: “No benefit shall be payable in cases of HIV and or any HIV-related illness, including AIDS and/or any mutations, derivations or variations thereof.”

Pimentel also cited another major insurer’s policy which states: “No benefit shall be payable in malignant cancer cases when the tumors are in the presence of HIV infection.”

HIV causes AIDS, which destroys the body’s natural ability to fight off all kinds of infection. The condition still does not have a known cure, but antiretroviral therapy (ART) slows down the virus.

A total of 11,427 new HIV cases were diagnosed in the country in 2018, according to the Department of Health’s National HIV & AIDS Registry.

The figures brought to 62,029 the cumulative number of people found living with HIV since the government began passive surveillance in 1984.

Of the 62,029 cases, the registry said 3,054 have died, while another 7,098 had “clinical manifestations” of advanced infection based on World Health Organization standards.

A total of 33,575 Filipinos living with HIV have been undergoing ART as of December.