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Governors' Medicaid Reform Plan "Unacceptable," Does Not Protect Health Care Guarantee for PWAs.

Statement of Christine Lubinski
Deputy Executive Director, AIDS Action Council

February 6, 1996

President Clinton today expressed support in comments delivered before the National Governors Association for a Medicaid reform plan that strays widely from his repeated promises to protect the guarantee to basic health care and life-saving drugs that Medicaid has come to represent to almost half of all Americans living with HIV/AIDS. While President Clinton expressed an interest in seeing the Congressional Budget Office's analysis of the plan presented by a bipartisan group of Governors, he called the plan "a step in the right direction." AIDS Action, however, finds the Governors' Medicaid restructuring plan, a plan similar to the GOP "Medigrant" proposal vetoed by the President late last year, is a step in the wrong direction. This ill-conceived plan is unacceptable and raises five particular concerns for people living with HIV/AIDS:
  • Eligibility. The states are granted complete authority to define disability for Medicaid eligibility purposes. In the name of "state flexibility," people living with HIV and AIDS could either be deemed ineligible for benefits or could be eligible for completely inadequate benefits.
  • Benefits. Under the Governors' proposal, people living with AIDS who are currently receiving benefits under medically needy provisions, could be denied access to both mandatory (doctor's visits) and optional (prescription drugs) benefits. People with HIV/AIDS could be denied or limited access to benefits afforded other Medicaid beneficiaries purely because they have a greater need -- therefore will incur greater costs for the state.
  • Affordability. The proposal eliminates federal protections that ensure cost-sharing requirements are not insurmountable barriers to health care. If states require co-payments to receive services, people with HIV could be forced to choose between physician visits and prescription drugs, at great cost to their overall health.
  • Quality. States would be allowed to force Medicaid beneficiaries into managed care plans without federal oversight to ensure that quality protections are in place. With lower payments and less oversight, quality of care will be jeopardized.
  • Accountability. Mechanisms now in place that allow consumers and providers to hold states accountable for obeying the law would be eliminated. Instead of streamlining Medicaid, enforcement by fifty different state courts with 50 different criteria would create a regulatory quagmire. The elimination of virtually all federal standards undermines the fundamental principle of Medicaid as an entitlement program.

A little over two months ago, the AIDS community breathed a collective sigh of relief as President Clinton vetoed a budget reconciliation bill that included devastating cuts and disruptive structural changes to the Medicaid program. The AIDS community applauded President Clinton's vow then to protect Medicaid and other vital federal AIDS programs from those who would balance the federal budget on the backs of this nation's most vulnerable citizens. Today, as he appears ready to take a step in the wrong direction, we urge the President to keep a promise he made to this country's most vulnerable citizens by rejecting any plan that puts at jeopardy the entitlement status of this vital health care program. Contrary to what President Clinton told this nation's Governors earlier today, the plan now on the negotiating table does not guarantee basic health care to this country's most vulnerable citizens, but instead is a prescription for disaster for which there can be no antidote.

For more information, contact
AIDS Action Council
1875 Connecticut Avenue NW #700
Washington DC 20009
202-986-1345 (fax)
202-332-9614 (tty)

Founded in 1984, AIDS Action Council is the only national organization devoted solely to shaping federal AIDS policy and legislation, and to advocating for increased AIDS funding. AIDS Action represents more than 1,000 community-based AIDS service organizations throughout the United States.

This article was provided by AIDS Action Council.
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