May 18, 2007
A FOOT IN THE DOOR
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ETHA pilot possible, ETHA itself coming through |
It's not much by itself, but it's getting the ball rolling.
That's what HIV treatment access advocates were saying about the inclusion of a pilot Early Treatment for HIV Act (ETHA) initiative in the Congressional Budget resolution agreed upon this week.
Congress agreed to aim for $954 billion in new discretionary spending as part of the resolution — and $500 million of that could be an ETHA pilot that would allow a handful of states to apply for funding to extend Medicaid to poor people with HIV before they are diagnosed with AIDS.
Inclusion means there's room for Congress to consider the ETHA pilot — along with trillions in other competing priorities — during the appropriations process this summer.
The full Early Treatment for HIV Act is also under consideration in Congress; it's been introduced in the Senate by Hilary Clinton (D-NY) and Gordon Smith (R-OR), and it's expected to be introduced in the House by Speaker Nancy Pelosi in the next month or so.
Both ETHA and the ETHA pilot (mini-ETHA?) address a big problem with the current Medicaid system: In most states low-income folks with HIV have to become disabled through an AIDS diagnosis before they can access treatment and care that would have prevented their AIDS diagnosis in the first place.
ETHA would allow states to cover folks with asymptomatic HIV infection in their regular Medicaid program, and provide enhanced federal funding to boot.
"If we could get a state like South Carolina to expand its Medicaid program through ETHA, that would be huge," says Housing Works legislative counsel Michael Kink. "The hundreds of people who can't get HIV meds there because there is not enough money in the state's AIDS Drugs Assistance Program could get treatment through Medicaid."
A fully enacted ETHA could cut the U.S. death rate by two- thirds.
Keeping the ball moving
The ETHA demonstration project is part of the agreed-upon Congressional Budget Resolution for 2008, which maps out a nonbinding fiscal blueprint. Originally the project was introduced as an amendment to the Senate Budget Resolution by Clinton and Smith earlier this year but inexplicably failed to appear in the final version.
Thanks to effective Senate Democratic leadership, it was reinstated in conference. Says the AIDS Institute's Director of Federal Affairs Carl Schmid: "It's very satisfying to see the Senate signaling that HIV/AIDS is an important issue to them."
ETHA still has a long road to travel. House Speaker Nancy Pelosi (D-CA), Rep. Eliot Engel (D-NY) and Rep. Ileana Ros-Lehtinen (R-FL) will soon introduce ETHA in the House. "Speaker Pelosi has always been a champion of people with HIV. She's once again showing her leadership by introducing ETHA," says Ryan Clary of Project Inform in San Francisco.
ETHA advocates are now focusing on building Republican support in the House (six reps are already on board) before Pelosi introduces her bill, finding House cosponsors, and encouraging the Energy and Commerce and Finance Committees to hold hearings on ETHA.
"We just have to keep on pushing," says Schmid.
ETHA needs cosponsors! Call the Capitol switchboard at 800-614-2803, ask to be connected to your representative's office, and encourage your representative to sign on.
For more information about ETHA, visit www.campaigntoendaids.org/etha.