“Restricting access to Texas's AIDS Drug Assistance Program (ADAP) would be a devastating step backward for people living with HIV and for public health across our state.

Texas already has one of the most restrictive ADAP eligibility policies in the nation. Since the program was established in 1987, Texas has maintained an income eligibility threshold of just 200% of the Federal Poverty Level, while most states have expanded eligibility to 400% or even 500% FPL. This is not because Texas lacks the resources to do better. Texas has one of the strongest economies in the country, and the state comptroller projects nearly $195 billion in available general revenue for the upcoming budget cycle, including approximately $25 billion in the Rainy Day Fund. Keeping ADAP eligibility artificially low is a policy choice, not an economic necessity.

Texas has also refused to expand Medicaid, leaving thousands of low-income Texans living with HIV without the coverage available in most other states. As a result, many people who would otherwise receive care through Medicaid must instead depend on the Texas HIV Medication Program (THMP), our state's ADAP. Rather than strengthening this critical safety net, restricting it even further would leave more Texans without access to lifesaving medications and medical care.

The consequences are already visible. We continue to see far too many late HIV diagnoses, interruptions in treatment, and preventable progression to advanced HIV disease. We are once again seeing young men, particularly young Black and Latino men, develop Kaposi Sarcoma, a disease that became rare after effective HIV treatment became widely available. These are conditions the Ryan White Program was specifically designed to prevent.

Restricting ADAP would not simply harm individual Texans; it would undermine public health statewide. People who cannot consistently access treatment are less likely to achieve and maintain viral suppression. That means poorer health outcomes, higher healthcare costs, and increased HIV transmission. Every barrier we create to HIV treatment moves Texas further away from ending the epidemic.

If Texas is serious about improving health outcomes and reducing new HIV infections, the answer is not to restrict ADAP. The answer is to expand access to care and medications that have already proven they save lives, prevent transmission, and ultimately reduce long-term healthcare costs.”