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AIDS Care Safety-Net in Jeopardy

Medicaid per capita cap threatens PWAs

May 1, 1997

As the White House and Congress come ever closer to agreement on a five-year balanced budget deal, the fate of tens of thousands of people with AIDS hangs in the balance. Negotiations between the Clinton administration and the Republican congressional leadership threaten to deliver deep Medicaid funding cuts which will effectively limit federal spending per Medicaid beneficiary and thus threaten to deny people with AIDS access to basic health care.

Medicaid finances clinic, hospital and nursing home care, and prescription drugs, including promising new AIDS therapies, for over half of all people with AIDS nationwide, and that number continues to rise as the epidemic expands and the average income status of people with AIDS continues to decline. In addition to the $1 billion per year the Ryan White CARE Act provides for the care of people with AIDS, more than $3 billion each year in federal Medicaid dollars goes for medical services for the poorest and sickest of people with AIDS.

To balance the budget and offer tax cuts over the next five years, budget negotiators are moving at lightning speed to cap federal spending per Medicaid beneficiary. With significant numbers of people with AIDS exceeding the per capita cap because of the high costs associated with their care, most states -- especially those with the highest incidence of AIDS cases -- will struggle with financing AIDS services which were previously federally-funded. How will states address this cost shift? The National Governors' Association answered that question last month in testimony before Congress: "The cost shift associated with a federal cap would present states with a number of bad alternatives ... choose between cutting back on payment rates to providers, eliminating optional benefits [including prescription drugs] provided to recipients, ending coverage for optional beneficiaries, or coming up with additional state funds to absorb 100 percent of the cost of services." The latter is highly improbable in a time of budgetary retrenchment. And people with AIDS can ill-afford the remaining alternatives.

AIDS Action Council is not convinced that slashing Medicaid funding is necessary to balance the budget. We are quite sure, however, that a Medicaid per capita cap plan means losing ground in fighting the AIDS epidemic by threatening the health care that tens of thousands of people with AIDS now receive. AIDS Action Council urges you to call, write or e-mail President Clinton, the Republican congressional leadership, and your members of Congress to demand that they preserve Medicaid as an AIDS care safety-net by saying NO to slashing Medicaid funding and NO to the Medicaid per capita cap.


President Bill Clinton
1600 Pennsylvania Ave., NW
Washington, DC 20500
voice: (202) 456-1414

Sen. Trent Lott
SR-487 Russell Senate Office Building
Washington, DC 20510-2403
voice: (202) 224-6253
fax: (202) 224-2262

Rep. Newt Gingrich
2428 Rayburn House Office Building
Washington, DC 20515-1006
voice: (202) 225-4501
fax: (202) 225-4656

Christine Lubinski is Deputy Executive Director of AIDS Action Council, the nation's foremost AIDS advocacy organization. AIDS Action Council represents all Americans affected by HIV/AIDS and over 1,400 community-based organizations that serve them.

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This article was provided by AIDS Action Council.
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