Last month the House of Representatives passed a bill to reauthorize the State Children's Health Insurance Program. This bill, the Children's Health and Medicare Protection Act of 2007 (CHAMP), also includes critical patient protections for the Medicare prescription drug program.

Specifically, the House-passed bill includes two provisions that would improve access to lifesaving medications for Medicare beneficiaries with HIV/AIDS -- at no or little cost to the federal government. The measure allows costs paid by AIDS Drug Assistance Programs (ADAPs) and the Indian Health Service for Medicare Part D beneficiaries to count toward the annual out-of-pocket cost threshold under Part D and requires Medicare Part D prescription drug plans cover classes of drugs critical to the treatment of HIV/AIDS, mental illnesses, cancer, epilepsy, autoimmune diseases and organ transplants.

The Senate bill does not include these protections and the Senate leadership and Finance Committee Chair Max Baucus (D-MT) and Ranking Member Chuck Grassley (R-IA) have not committed to include these important provisions in any future negotiations.

Please help make sure that these essential Medicare improvements become law. Take a few minutes to call both your Senators to let them know that these provisions are important to people living with HIV/AIDS, and to ask them to fight for the inclusion of our low-cost Medicare provisions in the final SCHIP bill.

Call the Capitol toll-free at 888-802-1207, ask for one of your two U.S. Senators, and then ask to speak to the staff person who handles health care. Give them this message:

"My name is ____________ and I live in (your state). I am calling to urge Senator________________ to talk with Senator Baucus and Senator Reid about the need to include two low cost but important Medicare Part D provisions in the state children's health insurance bill.

Specifically, I support two provisions in the House bill that will cost the government virtually nothing. The first would allow AIDS Drug Assistance Program expenditures to count towards out of pocket costs in Medicare Part D. The second would require Medicare Part D drug plans to cover all antiretrovirals required for the treatment of HIV/AIDS."

If you need to find out who represents you, check out www.congress.org.

Talking points on why these Medicare Provisions are so critical:

• 82 percent of ADAP clients live at or below an income of $1,701 a month (200 percent of the Federal Poverty Level). People with HIV/AIDS who live on less that $1150 per month (just missing the cut off for the full low-income subsidy program) are burdened with co-payments, for HIV drugs alone, of more than $800 per month while they are in the "donut hole" period. Many people with HIV/AIDS also need to pay for a host of other expensive medications to treat other conditions and side effects from their HIV treatment, making their medical cost burden completely unaffordable.
• Currently ADAP dollars used to provide important assistance to Medicare beneficiaries who cannot afford their HIV drugs are dollars that cannot be used help other needy people with HIV/AIDS who do not have any drug coverage. If ADAP dollars could count toward Medicare out-of-pocket costs, Medicare beneficiaries would eventually get meaningful coverage and ADAP dollars could be used for others in need.
• The six protected drug classes are critical to some of Medicare's most vulnerable beneficiaries including those with HIV/AIDS, cancer, schizophrenia, bipolar disorder, transplant patients, epilepsy and autoimmune disorders.
• Surveys of HIV and mental health medical providers indicate that Medicare beneficiaries with the above conditions have been hospitalized or experienced dangerous treatment interruptions because they were not able to get the drugs that should have been easily accessible on all Medicare plan formularies.

Thanks to the HIV Medicaid/Medicare Working Group for this important action alert.