Early Treatment for HIV Act Introduced in the House

On Aug. 2, the Early Treatment for HIV Act (ETHA) was introduced in the House of Representatives. The bill boasts 27 Republican and 27 Democratic legislators as lead sponsors.

ETHA would give states the option of amending their Medicaid programs for low-income persons to allow for early treatment of HIV, before they develop AIDS. It follows the pattern of an existing program for breast and cervical cancer as well as a component of the State Children's Health Insurance Program that would create coverage for more children. A Senate version of ETHA was introduced in March by Sens. Hillary Clinton (D-N.Y.) and Gordon Smith (R-Ore.).

For more than a decade, advocates have pushed for the changes found in ETHA, but political and financial issues have blocked it.

Budgetary restraints adopted by Democrats in the current Congress require that new spending be offset by budget cuts or new taxes. The Congressional Budget Office must score each new piece of legislation for its effect on the budget. But the CBO has only two persons scoring health care proposals, and they concentrate on more immediate costs and savings, said Rep. Eliot Engle (D-N.Y.). Engle said he will work with the CBO to incorporate a broader calculation of savings, including the advantages of having more patients continue working and paying taxes for a longer time, in their cost/benefit analysis. Some observers say it may take pressure from Speaker Nancy Pelosi (D-Calif.) for the CBO to apply a cost/benefit measure that will result in a more favorable rating for ETHA.

Also on Aug. 2, Rep. Barbara Lee (D-Calif.) introduced legislation that would lift the ban against letting people with HIV/AIDS travel or immigrate to the United States. Although President Bush last December signaled his intention to streamline the waiver process for visas, the administration continues to have internal discussions over how to do so.

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