A New York Senate Republican proposal for a "fundamental restructuring" of Medicaid is drawing mixed reactions from AIDS and gay groups. The state will spend $41 billion on Medicaid in the current fiscal year. The proposal would save $2.5 billion over the next five years - money that would be returned to the state's 62 counties.

In 2000, Medicaid paid $1.8 billion for services for about 65,000 state residents with AIDS, according to data from the HIV Medicine Association. The program's greatest expense was $702 million for inpatient services, followed by $459 million for drugs. The remainder was spent on outpatient services, doctor visits, long-term care, home care, and other services.

Under the proposal, beneficiaries could use Medicaid only to buy drugs on a preferred drug list. The state would negotiate lower prices with companies to get their drugs on the list.

But David Wunsch, director of health policy at Gay Men's Health Crisis (GMHC), said people with AIDS should be exempt from a preferred drug list because AIDS drug regimens are complicated, have side effects, and interact among other drugs. Seventy percent of GMHC's clients are on Medicaid, and the agency is "strongly opposed" to a preferred drug list.

However, the AIDS service group Housing Works supports the list proposal as long as beneficiaries had a fair and effective way to appeal any denial of access to a drug. "We think it is important to bring down the costs of AIDS drugs in particular," said Michael Kink, the group's legislative counsel. Medicaid pays just over one-third of Housing Works' $29 million budget, and most, if not all, of the group's clients are on the program.

Some advocates were remaining cautious until they see if Gov. George Pataki adopts the Senate's advice in his proposed budget, expected Jan. 20.

Back to other news for January 15, 2004

Search the Newsroom archive