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AIDS Action Weekly Update

January 31, 1997

Welcome to AIDS Action Council's Weekly Washington Update, an on-line newsletter that reviews what is happening in Washington on AIDS policy issues each week. If you have any comments or questions, please feel free to contact us at the e-mail address listed below.

AIDS Action Speaks Out Against Clinton Medicaid Plan

AIDS Action Council was joined by the Human Rights Campaign in a press conference today to denounce President Clinton's budget policy which is expected to cut Medicaid funding by implementing a per capita cap. The per capita cap would limit the federal payment per Medicaid beneficiary to a certain dollar amount. This plan would have a severe impact on people living with HIV/AIDS whose health care tends to cost more than the health care for those with other chronic illnesses, and whose expenses would substantially exceed the federal cap. Because of this, states, particularly the ten states with the highest number of AIDS cases, will be left with a higher fiscal burden for Medicaid beneficiaries with HIV/AIDS and might move to restrict benefits or eligibility categories as cost-saving measures. States could eliminate or reduce prescription drug coverage, which is currently an optional Medicaid benefit that states are not required to provide. Obviously, the loss of prescription drug coverage could mean the loss of the very health care benefit that keeps people with HIV/AIDS alive. States are also not required to cover "medically needy" individuals, and may opt to eliminate Medicaid coverage for this group which consists of people who "spend down", by demonstrating that their medical expenses are so significant that they are forced into poverty. Many individuals with HIV/AIDS fall into the medically needy category.

AIDS Action Council's Deputy Executive Director for Programs Christine Lubinski stated at the conference, "President Clinton championed the Medicaid program in the 104th Congress, refusing to acquiesce to efforts to dismantle this vital program. It would be nothing short of tragic if, just when we have the most hope for saving the lives of people with HIV/AIDS, those very people are deprived of access to health care."

AIDS Drugs Cut Down On Hospitalization Costs

Two studies released during last week's fourth annual retrovirus conference revealed the cost effectiveness of new combination AIDS drug therapies in terms of decreasing hospitalization costs and increasing lifespan. For many patients with HIV/AIDS, combination therapy which includes a protease inhibitor, has resulted in longer, healthier, more productive lives, and less time in the hospital for AIDS-related illnesses. While this is good news for those who can afford and have access to these drugs, the new drugs remain prohibitively expensive and inaccessible to many individuals living with HIV/AIDS.

The "hit early, hit hard" message regarding early treatment with combination drug therapies of at least three drugs was reiterated during the conference. Some researchers, following the International Conference on AIDS in Vancouver last year, seemed to have backed away from this message and, instead, advocated for a more conservative approach to treatment. However, a panel of experts convened by the National Institutes of Health late last year supported, as a standard of care, the more aggressive approach of beginning treatment as soon after infection as possible with at least three drugs for treatment of HIV/AIDS.

Blue Dog Democrats Working On Their Own Budget

Representative Charles Stenholm (D-TX), a member of the conservative Blue Dog Democrats, also known as the Coalition, announced that his group is working on an alternative proposal to balance the budget. They expect to release their plan shortly after the President's plan is unveiled next week. According to reports the plan will not deviate drastically from the Blue Dog proposal of the 104th Congress, which included no tax cuts until the budget has been balanced and smaller cuts in Medicaid and Medicare than were requested in the Republican proposal. President Clinton's budget plan is scheduled for release February 6.

Balanced Budget Amendment Action Heats Up

The Senate Judiciary Committee approved a balanced budget constitutional amendment (S.J. Res. 1) yesterday, 13-5. Debate in the full Senate on the amendment is scheduled to begin next Wednesday, February 5. The last Senate vote during the 104th Congress on a balanced budget amendment was one vote shy of the two-thirds majority needed to pass, and a close vote is expected again this year. The current amendment would require a balanced budget by the year 2002 and every year following, unless a three-fifths majority of Congress votes to waive the requirement. AIDS and other advocacy groups oppose a balanced budget amendment, because in the absence of tax increases, such a policy would require dramatic spending cuts to programs such as Medicaid and discretionary health, social services, and housing programs that are vitally important to the country's most vulnerable populations, including people living with or at risk for HIV/AIDS. The Administration remains adamantly opposed to a balanced budget constitutional amendment.

On the House side, the balanced budget amendment vote is scheduled for February 26. The House approved the amendment two years ago, 300-132, but the Democratic electoral gains from the past election will likely make for a much closer vote this time.

Legislation To Prevent Government Shutdowns Pushed By GOP

In order to avoid federal government shutdowns which for the past two years won great disfavor for the GOP, Congress is pushing a bill that would prevent government shutdowns. The Senate bill (S.228) sponsored by Senator John McCain (R-AZ) would, in the absence of approved appropriations bills, continue to fund programs in these spending bills at the lowest of five possible levels: the previous year's appropriation, the level in the House-passed appropriations bill, the level in the Senate-passed appropriations bill, the President's budget request, or the level established by a special spending measure.

The House version of the bill, sponsored by Representative George Gekas (R-PA), would fund programs in unpassed spending bills at 75 percent of the lowest possible level. Either measure would be detrimental to AIDS programs, which are already often underfunded as spending level increases fail to keep pace with the growth of the epidemic. The legislation could become part of a FY 97 supplemental appropriations bill which may be introduced in March of this year.

For more information contact:
Lisa White
AIDS Action Council
1875 Connecticut Ave., NW Suite 700
Washington, DC 20009

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This article was provided by AIDS Action Council. It is a part of the publication AIDS Action Weekly Update.