California: Politicians Urged to Include People With AIDS in Health Care Reform

As various proposals make their way through Congress, AIDS advocates have crafted their own agenda for health care reform.

In a Sept. 24 letter to President Barack Obama, a coalition of 84 AIDS service organizations known as the HIV Health Care Access Working Group spell out their goals for a revamping of the health care system.

"I really want to remain optimistic that we can do something really historic if we all work hard at it," said Anne Donnelly, a member of the steering committee and director of health care policy for San Francisco-based Project Inform.

The coalition's agenda focuses on four major points:

• expansion of Medicaid to all low-income individuals. Childless adults are generally excluded from Medicaid coverage, and people with HIV usually are not eligible for Medicaid until they become disabled.
  
  The letter targets eligibility at 150 percent of the poverty level; federal guidelines currently establish the poverty level at $10,830 for one person and $14,570 for a family of two. The group would even like eligibility to be set at 200 percent of poverty, Donnelly said.
• a strong national public insurance option. A public insurance option would enhance benefits, ensure affordability and help lower costs, the letter says.
• a cap on out-of-pocket expenses and subsidies for premiums. Subsidies should be available to families up to 400 percent of the poverty level, the letter said.
• funding for prevention and public health.

A spokesperson for House Speaker Nancy Pelosi (D-San Francisco) said that the expansion of Medicaid proposed in health reform legislation would have a significant impact on people with AIDS. Drew Hammill noted that in many states, Medicaid eligibility now is "well below" 133 percent of federal poverty level.

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