Former Florida Governor and current U.S. Senator Rick Scott (R) refused $70 million in federal money to fight HIV/AIDS, according to an investigation.
The Guardian reports that the Scott administration forced the state health department to reject around $54 million in HIV medication rebates from 2015 to 2017. The former governor also forced two counties with high HIV transmission rates to refuse CDC grant money intended to help prevent HIV transmission with strategies like PrEP.
During his administration, Florida’s HIV epidemic spun out of control. In 2017 – after Florida was rejecting federal HIV money for years – Florida had the most new cases of HIV in the U.S., and the second most for its population out of the top 10 states, after Georgia.
“I think Rick Scott fueled the epidemic in Florida,” said Marlene LaLota, the administrator of the HIV/AIDS section of the Florida Department of Health from 2014 to 2016, who had worked for the department for decades.
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“How many infections could have been prevented with that money? How many lives could have been saved? Shame on them.”
Part of Scott’s motivation was ideological. He ran for governor in 2010, promising to reject the federal Medicaid expansion passed in the Affordable Care Act. The Medicaid expansion provided states with funding for health care for people with low incomes, but many conservative states rejected it for ideological reasons.
According to documents obtained under the Freedom of Information Act, the problem had two sources. First, the HIV/AIDS section could not accept more federal money because receiving new money is considered the equivalent of a budget increase, which requires legislative approval.
While the Department of Health could have requested that the Joint Legislative Budget Commission approve the new spending, LaLota said that the Scott administration blocked them from speaking to the legislature.
“Rick Scott had us all on lockdown,” she said. “It didn’t used to be like that with previous governors.”
Several lawmakers who sat on the legislative budget commission during that period told The Guardian that they never heard any requests to increase the HIV/AIDS section’s budget.
Pharmaceutical companies offered the state rebates on HIV medication for low-income recipients as part of the state’s AIDS Drug Assistance Program (ADAP). In 2012, the HIV bureau started reporting those rebates.
In the 2012-2013 year, Florida received around $6 million from those rebates, but that grew to over $86 million by 2017.
Under federal law, the rebate money has to be spent before the state can accept federal money under the Ryan White CARE Act.
But because the rebates were growing while the HIV/AIDS section was banned from requesting a budget increase, they were forced to return some of that federal money: around $24 million in 2015, $29 million in 2016, and under $1 million in 2017, because in 2017 Scott ran for the Senate as a centrist and refusing federal money became less of a priority for his administration.
“I wrote a plan to end the epidemic,” said LaLota. “But we were stopped at every turn. I could not give that money away to save my life. It was so criminal and so egregious.”
In 2015, Miami and Broward Counties also applied for CDC grants for HIV prevention, which would have awarded them $7.6 million over four years and $8.7 million over three years, respectively. The money would have gone through the state Department of Health.
But before the applications went through, LaLota said that she was told that the governor’s office denied the counties permission to apply for the grants, citing the Department of Health’s lack of authority to increase its budget by receiving federal money.
The CDC confirmed that the grant applications were rescinded.
“I was perhaps naive,” said Stephen Fallon, the executive director of an AIDS organization. “I knew that policies can be more ideological than considerate of the constituents in the state of Florida. But I didn’t assume the Scott administration would be anti–HIV funding in any way.”
“My sense is frankly that [the HIV crisis] just wasn’t a priority for Scott,” said William McColl of AIDS United. “He clearly thinks of healthcare as a profit source.”
That would be a reflection of Scott’s background. Before he was governor, he was the CEO of Columbia/HCA, “the single largest for-profit health care company in the country.”
A spokesperson for Senator Scott said that the Guardian investigation was inaccurate because “the state could only spend the money that it had the budget authority to spend.”