East, et al. v. Blue Cross and Blue Shield of Louisiana, Louisiana Health Cooperative, Inc., and Vantage Health Plan, Inc., Complaint, U.S. District Court (M.D. La. 2014)

This complaint, filed in United States District Court, Middle District of Louisiana, seeks injunctive and declaratory relief to halt Blue Cross and Blue Shield of Louisiana, Louisiana Health Cooperative, Inc., and Vantage Health Plan, Inc. from enforcing its policy of refusal of federal Ryan White HIV/AIDS Program funds to assist some policyholders with HIV in paying for their health insurance premiums. This federal court complaint follows a civil rights complaint filed by the Lambda Legal Defense and Education Fund, Inc. and AIDS Law Louisiana regarding the same matter.

In this complaint, the plaintiff alleges intentional discrimination in violation of the Affordable Care Act, which prohibits the exclusion of participants in a federally funded health program on the basis of their disability, including HIV. The plaintiff states that at the very least, the defendants’ refusal to accept premium payments from Ryan White has a disparate impact on people with HIV who, as a result of the defendants’ exclusionary policy, will be denied access to medical care. The plaintiff alleges that the defendants’ policy constitutes an unlawful marketing practice that discourages enrollment in health plans by individuals with significant health needs, such as HIV, which the Affordable Care Act prohibits. The insured plaintiffs also claim that that they justifiably relied on the defendants’ longstanding policy and custom of accepting Ryan White funds, and have been harmed by their inability to obtain necessary medical care and medications after the defendants’ abrupt change in position. The plaintiffs also set forth breach of contract, breach of duty of good faith and fair dealing, and negligent misrepresentation claims.