HIV/AIDS: Bill Would Ease Medicaid Expansion
House Minority Leader Richard Gephardt (D-MO) and Rep. Nancy Pelosi (D-CA) introduced legislation yesterday that would make it easier for states to extend Medicaid coverage to low-income, HIV-positive individuals. HR 1591, the Early Treatment for HIV Act, is sponsored in the Senate in identical form by Sen. Robert Torricelli (D-NJ). At a press conference attended by all three sponsors, Gephardt said, "We must take this important step to address the Catch-22 faced by thousands of low-income HIV- positive Americans who don't have health insurance. Medicaid should be providing them with the therapies that help keep them healthy and live longer, more productive lives." Pelosi added, "Powerful new drugs have given people with HIV renewed hope in fighting this disease. It is imperative that our government health care programs catch up with the recommendations of government health care experts." And Torricelli said, "This bill is simple logic. It is a real step toward improving the quality of life for thousands of low-income people with HIV. This legislation eliminates a glaring flaw in the Medicaid program by allowing access to vital medical services" (congressional release, 4/28). The Philadelphia Inquirer reports that while HHS recommends the use of antiretroviral drugs soon after infection, federal Medicaid guidelines do "not make the drugs available to people with HIV who have not been diagnosed with AIDS" (Pugh, Philadelphia Inquirer, 4/28). Noting the disparity, AIDS Action Executive Director Daniel Zingale said, "Today, an entire class of Americans is denied access to drugs and care that prevent full-blown AIDS until they develop full-blown AIDS. If automobile safety regulations followed the current model, air bags would only be required in cars that have already crashed." He added, "The new AIDS drugs, which have ended the automatic death sentence of an HIV diagnosis, are in reality ending nothing for many HIV-positive men and women" (AIDS Action release, 4/28). Craig Thompson, executive director of AIDS Project Los Angeles, said. "In one fell swoop, this would raise the entire national standard of care and even out the disparity in the level of services and availability of treatments across the country."
Ask the Oddsmakers
An aide to Rep. Michael Bilirakis (R-FL), chair of the House subcommittee that would first consider the bill, "said Bilirakis was sympathetic to the bill's intent but needed more information about the costs and, more importantly, what would have to be cut to provide the additional care." The Inquirer reports that the "measures will face a tough battle in Congress, where balanced budget requirements make any program expansion difficult," but notes that several studies have found that providing AIDS treatment earlier could actually save money (Inquirer, 4/28). The bill has 59 other cosponsors in the House. It is also supported by the Presidential Advisory Council on HIV/AIDS, which lobbied the president for his support earlier this month (Congressional release, 4/28).