December 9, 2005
UN-MERRY MEDICAID PLAN
Why should we care about this year's federal budget process? Because Medicaid is under attack in Washington, D.C.—and that could hurt America's fight against AIDS here in our community.
Medicaid is the cornerstone of our nation's response to the HIV/AIDS epidemic in the United States. Here in New York State and in every city and town across the country, Medicaid is helping vulnerable people living with HIV/AIDS.
People living with HIV/AIDS and people who care about them should urge members of Congress to reject Medicaid proposals from the House of Representatives and accept the Senate Medicaid package instead.
Medicaid provides access to health care to over half of all people living with HIV/AIDS—the lowest-income and most vulnerable—as well as 90% of all children living with HIV/AIDS.
When private insurance coverage is declining and the economy is uncertain, Medicaid really shouldn't be cut. And the truth is that our other AIDS programs won't be able to fill the gap if people living with HIV/AIDS lose Medicaid coverage.
The Senate's plan avoids serious harm to low-income Medicaid beneficiaries—and it will actually help those in need and improve public health by funding a demonstration program that allows states to provide Medicaid coverage to low-income people with HIV infection who are not yet disabled by AIDS.
By contrast, the House Medicaid reconciliation package, if implemented, would badly hurt low-income people with HIV/AIDS and other Medicaid beneficiaries. Low-income seniors and people with disabilities whose serious medical conditions result in serious costs would be hurt the worst.
Why is the House package so bad?
First, it would give states a free pass to offer minimal-benefit packages that won't work for people with disabilities or high medical needs.
New limits on prescription drugs, diagnostic tests, or acute and long-term services could be deadly for people with AIDS and other serious and complex diseases. The non-partisan Congressional Budget Office estimates that disability-related spending could drop by a third under the House plan—that means almost $10,000 less health-care per person next year. And that's at a time when costs are going up, not down.
Second, the House package would give states a free pass to deny services to low-income and disabled beneficiaries who can't meet new cost-sharing requirements.
Right now, Medicaid beneficiaries in most states are asked to make co-payments and meet some deductibles—and millions do.
But because Medicaid is a safety-net program for the lowest-income Americans, our current law requires that medically necessary benefits and services are still provided even when the patient is short a few dollars and can't make the copay. It's the right thing to do, and it helps make sure people with AIDS, for example, can stick to their HIV medications and stay out the hospital, where care is much, much more expensive.
Finally, people with HIV/AIDS are urging members of Congress to improve provisions in the Medicaid bills that could threaten case-management programs that coordinate care to improve health and save money.
While some of these details may seem technical or bureaucratic, for people living with HIV/AIDS, they can mean the difference between life and death. That's why we're speaking up and speaking out, and asking others in our communities to do so, too.
Take a minute from your holiday hustle and bustle this week to do something important for the poor and vulnerable among us: Call your representatives in the House and Senate at 888-802-1207and tell them you want to protect Medicaid for people living with HIV/AIDS and others who need it to survive. Tell them to reject the House Medicaid package and support the Senate plan—and tell them it's a matter of life and death.
Click here for a final version of the letter the HIV Medicaid and Medicare Work Group has sent to congressional conferees to urge them to choose the Senate Medicaid package.