Nearly four years after new direct-acting hepatitis C virus (HCV) medications hit health care markets across the United States, a new report and interactive project by the National Viral Hepatitis Roundtable (NVHR) and Harvard Law School’s Center for Health Law and Policy Innovation (CHLPI) has ranked all 50 states on their HCV treatment access. The findings thus far are bleak. According to the study, more than half of state Medicaid programs are still imposing discriminatory restrictions on hepatitis C cures.

Titled “Hepatitis C: State of Medicaid Access,” the report, which was recently unveiled at the American Association for the Study of Liver Diseases (AASLD’s) annual Liver Meeting in Washington, DC. graded each U.S. state, as well as the District of Columbia and Puerto Rico, according to its overall “state of access” for hep C treatment. Each grade was determined by Medicaid restrictions related to three areas: liver disease progression, or fibrosis scores; sobriety and substance use requirements; and prescriber limitations.

It turns out, 52 percent of Medicaid programs examined received a D or an F score. Analysts also noted that these discriminatory measures contradict guidance from the U.S. Centers for Medicare and Medicaid Services, as well as current HCV treatment recommendations from the AASLD and the Infectious Disease Society of America.

“Giving Medicaid recipients broad access to curative treatment is critical if we are really serious about ending this country’s deadliest disease,” said Ryan Clary, executive director of NVHR, in a press release about the report. “Our hope with this project is to provide a roadmap for states—and the Centers for Medicare and Medicaid Services—in order to get more people treated, cured and ultimately protected from hepatitis C.” 

That said, the report did note progress since 2014, when a similar study found that 42 state Medicaid programs might have been in violation of federal Medicaid law. That’s because several states (including Massachusetts, Nevada and Washington) have taken steps to ensure widespread HCV access over the last few years.

Click here to view the report and visit its accompanying interactive site to see how your state is faring in ensuring hepatitis C treatment access.