New York: HIV Advocates Oppose GOP Medicare Deal

"GMHC is opposing the Medicare bill and urging New York State Senators Clinton and Schumer to oppose and filibuster the bill," David C. Wunsch, director of health policy at Gay Men's Health Crisis, said recently. "Not only does the bill wholly undermine the Medicare program, but it does specific harm to HIV-positive folks who are on Medicare."

Some 50,000 people with AIDS, including 20,000-25,000 New Yorkers, receive health insurance from Medicare, which traditionally covers health costs for senior citizens. But because Medicare does not pay for prescription drugs, Medicaid -- the health insurance plan for the poor and disabled -- pays for their drugs. Such "dual eligibles" may see their drug coverage cut under a plan to add prescription drug coverage to Medicare that passed Senate and House earlier this year. A conference committee released its bill on Nov. 17. [Editor's note: The House passed the bill 220-215 early Saturday morning. Debate continued Sunday in the Senate.]

"This bill would give the state the option to require dually eligible folks to get their drug benefit under Medicare," Wunsch said. The bill would require Medicare to pay for only two drugs per class, meaning that HIV drug cocktails, which typically contain three drugs, would only be partially covered for dual eligibles. "Medicare can have very restrictive formularies. That is an absolute catastrophe for standard, state-of-the-art HIV therapy which requires three drugs." The bill bars states from using federal Medicaid funds to pay for additional Medicare drug coverage for dual eligibles as they have in the past.

States could likely use their own Medicaid funds to cover those costs, but most states are facing large deficits and are cutting Medicaid expenses. AIDS Drug Assistance Programs might cover some dual eligibles, but many states have ADAP waiting lists and are restricting the drugs they pay for.

Back to other news for November 24, 2003