As many as 20 percent of nearly 12,000 Texans who rely on a state program to get lifesaving AIDS drugs will lose their coverage if a proposed regulation goes into effect early next year. The regulation would lower the income eligibility cutoff, now 200 percent of the individual federal poverty line ($17,720), to 140 percent, or $12,404. And medication costs could not be first deducted from income, as is now allowed.

Existing enrollees would be given a six-month grace period to find other options, officials say. An estimated 2,500 people would lose coverage by August 2005.

Texas Department of Health officials, who proposed the changes, say a budgetary crisis gives them no choice. The nearly $60 million program faces a $3 million shortfall this fiscal year, which ends next August, and a total of $30 million more during the next two fiscal years, said Dr. Celine Hanson, bureau chief of HIV and STD Prevention. Hanson said about 9,000 clients were served in 1999 compared with a projected 11,500 in 2002. The average cost per client has nearly doubled since 1996 to about $9,500 annually, and it is expected to increase further due to treatment expenses.

AIDS advocates say they were blindsided by the proposal, approved unanimously at the department's Oct. 18 board meeting. They question why the Health Department does not wait to learn whether the Legislature, which convenes early next year, approves funding to cover the program's shortfall. The proposed regulation, which is expected to be posted in the Texas Register today, is open for 30 days of public comment.

The Health Department requested an additional $34 million for the next two-year budgetary cycle, which ends August 2005. The Health Department will likely revisit the regulation at a January or February board meeting before it can become final, Hanson said. And the changes can be reversed at any time if additional state or federal funds are appropriated, state officials say. If finalized, the changes would affect new enrollees immediately.

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