Ryan White Part B Supplemental - The Iowa Department of Health and Human Services (Iowa HHS) seeks Ryan White HIV/AIDS Program (RWHAP) Part B Supplemental funding to restore statewide access to HIV medications and insurance assistance following the sudden collapse of Iowa’s AIDS Drug Assistance Program (ADAP) pharmacy system. On March 6, 2026, the termination of Iowa’s ADAP pharmacy contract resulted in the immediate loss of medication dispensing and insurance support for all 1,127 clients, leading to the creation of an ADAP waiting list that now includes 1,035 [HH2.1]people living with HIV. Supplemental funding will allow Iowa to reestablish ADAP through a new Pharmacy Benefit Manager (PBM) model, purchase antiretroviral medications, reinstate insurance assistance for premiums, deductibles, and copays, and support the rapid re-engagement of clients statewide. The proposed project will integrate case management, benefits navigation, telehealth, and Data-to-Services approaches to stabilize clients’ access to care and treatment. RWHAP Part B supplemental funding is essential to ensure a comprehensive system of HIV care and treatment in Iowa, as the loss of ADAP services has disrupted medication access, destabilized insurance coverage, eliminated 340B program income, and placed more than 1,000 people at imminent risk of treatment interruption. Supplemental funds will enable Iowa to restore antiretroviral therapy (ART) access, support rapid linkage and re-engagement, and prevent reductions in viral suppression, an area where Iowa has historically led the nation. These funds will also strengthen outcomes across the HIV care continuum through improved medication access, enhanced insurance coverage, and integrated support from case managers, Field Benefits Specialists, and Disease Intervention Specialists. Iowa’s restoration of ADAP is grounded in evidence-based HIV treatment practices and strengthened fiscal and program integrity measures that align with HRSA’s 2026 strategic priorities, including the agency’s emphasis on biological and physiological integrity in clinical care. The severity of Iowa’s HIV epidemic further underscores the need for supplemental funding. In 2025, Iowa reported 133 new HIV diagnoses, a 19% increase from 2024 and part of a broader 32% rise since 2020, following the state’s highest-ever peak of 139 diagnoses in 2023. Statewide, 3,715 people diagnosed and living with HIV resided in Iowa in 2025, a prevalence of 113 per 100,000, with individuals living with HIV in all 99 counties. Co-morbidities, including STIs, hepatitis C, and late diagnosis, compound differences in outcomes. Emerging populations such as women, foreign-born residents, and people experiencing heterosexual transmission are growing rapidly, and many face unmet needs for core medical services, transportation, and insurance assistance. Without supplemental funding, Iowa cannot restore ADAP, cannot ensure uninterrupted access to ART, and cannot maintain the comprehensive system of care necessary to advance viral suppression and protect the health of people living with HIV across the state.
