Idaho doctor, patients sue over new law halting public benefits to immigrants in US unlawfully
An Idaho doctor and four residents are challenging a new state law that halts some of the few public benefits available to people living in the U.S. unlawfully, including a program that provides access to life-saving HIV and AIDS medication for low income patients.
The ACLU of Idaho filed the federal lawsuit Thursday night on behalf of Dr. Abby Davids and four people with HIV who are not named because they are immigrants without lawful permanent residency.
The complaint says the new law is vague, contradicts federal law and makes it impossible for health care providers to determine exactly what kind of immigration status is excluded and how to verify that status for patients. They want a judge to grant them class-action status, expanding any ruling to other impacted people.
Dozens of patients treated by one Boise-area clinic stand to lose access to HIV and AIDS medication under the law, according to the complaint, including several cared for by Davids.
'Withdrawing HIV treatment from her patients will not only have devastating consequences on their health, it raises the public health risk of increased HIV transmission,' the ACLU wrote in the lawsuit. 'When her patients are undetectable, they cannot transmit the virus. Without HIV treatment, however, they cannot maintain an undetectable viral level and therefore are able to transmit the virus to others.'
The new Idaho law takes effect July 1, and appears to be the first limiting public health benefits since President Donald Trump ordered federal agencies to enhance eligibility verification and ensure that public benefits aren't going to ineligible immigrants.
The law requires people to verify that they are legal U.S. residents to receive public benefits like communicable disease testing, vaccinations, prenatal and postnatal care for women, crisis counseling, some food assistance for children and even access to food banks or soup kitchens that rely on public funding.
Federal law generally prohibits immigrants in the U.S. illegally from receiving taxpayer-funded benefits like Medicare, Medicaid, Temporary Assistance for Needy Families and Social Security. But there are some exceptions for things like emergency medical care and other emergency or public health services.
Idaho's law still allows for emergency medical services. But in a June 18 letter to health care providers, Idaho Division of Public Health administrator Elke Shaw-Tulloch said HIV is a long-term condition and not an emergency — so people must verify their lawful presence in order to get benefits through the federal Ryan White HIV/AIDS Program.
The HIV patients challenging the new law include a married couple from Columbia with pending asylum applications, a man who was brought to the U.S. when he was just 4 years old and has Deferred Action for Childhood Arrivals status until next year, and a man from Mexico who has been living and working in Idaho since 2020.
One of the patients said she and her husband were diagnosed with HIV in 2019 and immediately started antiretroviral therapy, receiving the medications at no cost through the Ryan White HIV/AIDS Program. The medication has lowered the viral load in her body enough that it is now undetectable, she wrote in a court filing, ensuring that she won't transmit the virus to others.
'My medication protected my daughter while I was pregnant because it prevented me from transmitting HIV to her during pregnancy,' she wrote.
The treatment allows her to be with her child, watching her grow, she said.
Davids has been trying for weeks to get clarity from the Idaho Department of Health and Welfare about exactly what kind of verification her patients will have to show, and exactly which kinds of immigration status are considered 'lawful.' But the state has yet to provide clear direction, according to the complaint.
'I am really scared about what this means for many of our patients. Their lives will now be in jeopardy,' Davids wrote in a May 30 email to the Department of Health and Welfare.
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"I could say 'yes' because I knew I was only going to eat four bites." In October, Spencer saw on Reddit that tirzepatide might also reduce inflammation. She placed a new order for vials that contained cagrilintide and tirzepatide combined, dubbed "cagri-tirz." Now each Monday, Spencer injects herself with tiny amounts of cagri-tirz. On Thursdays, she uses retatrutide, a new obesity medicine by Lilly, also in trials. As she was switching to cagri-tirz, Spencer made a dangerous mistake. She calculated her new dosage without realizing the concentration of cagrilintide in the combined vials was 10 times higher than she had taken previously. "I was an idiot. I didn't do my math. Or rather, I did the math for the tirzepatide but not for the cagri," she said. Almost immediately, she began vomiting. The reaction was so severe she had trouble moving. She forced herself to drink water but couldn't eat. After four days, when symptoms lifted, she had lost seven pounds. Despite the blunder, Spencer didn't consider returning to compounded versions of the drugs or abandoning them altogether. She is not regularly monitored by a healthcare provider, but says her treatment has led to a "life-changing" reduction in weight, joint pain and blood pressure. Gray-market buyer Marie, 41, shows how do-it-yourself drugmakers are organizing. She describes herself as a "soccer mom" from the Midwest and asked to be identified by her middle name to protect her privacy. Last year she bought a compounding pharmacy's version of tirzepatide, paying about $470 monthly, and had lost more than 20 pounds when the FDA announced the ban on compounded weight-loss drugs. She began to worry about her supply. Browsing on Reddit, she discovered links to Telegram and a trove of detailed instructions from experienced users for buying weight-loss drug ingredients from China. Customers said they often paid with Bitcoin or through mobile payment service Venmo. After a month closely following the forums, Marie made a purchase in January. The package that arrived contained 20 small glass vials of white powder with red caps. There were no instructions. The vendor who advertised the package on Telegram said it came from China. Marie returned to the forums and joined a group of 52 other customers who paid a total of $1,020 to a Tennessee-based company called Peptide Test. Six members mailed in a vial each and the others chipped in their share of the fee. The lab found the samples were pure. Peptide Test declined to comment. "It's an honor system," said Marie. "These groups are very supportive in a way I haven't seen on the internet before." Before her first injection, Marie gave her husband details of what she had done. They agreed that if needed, he would disclose everything to the emergency medics. But she was fine. In March, Marie volunteered to organize testing a new order of tirzepatide. The group formed on Telegram after users received vials from the same vendor which they judged to be from the same batch based on the color of the caps. In all, 38 buyers agreed to chip in for the $1,300 bill, and decided by poll that five vials would be enough. Five people sent drugs to the lab, Janoshik Analytical in the Czech Republic, which found the vials contained tirzepatide, as purported, with purity between 99.78% and 99.85%. Janoshik's CEO, Peter Magic, is a former amateur weight-lifter. He said his company started out more than a decade ago testing performance-enhancing drugs for online buyers. Last year, it tested 3,050 samples of obesity drugs, up from just over 650 samples in 2023. "We're testing hundreds of these every week," said Magic, whose company helps customers navigate customs requirements for shipping chemicals.
