On
Wednesday, July 20,
2005, ATAC endorsed a letter
developed by the HIV Medicare and Medicaid Working Group (HIVMMWG) asking key
Senate and House Committee members to reject proposed policy changes to Medicaid
that would enable States to adopt greater costing sharing measures and limit
services for recipients. The full text of the HIVMMWG letter is included
below.
**
Dear Senate Finance Committee Member/House Energy and
Commerce Members,
We are writing on behalf of Medicaid beneficiaries living
with HIV/AIDS to ask you to seriously consider the medical needs of Medicaid
beneficiaries with HIV/AIDS and other Americans who are disabled by chronic
medical conditions as you consider cost-saving changes to the Medicaid program.
We urge you, in the strongest possible terms, to resist policy changes that
impose additional financial burdens on individuals who are poor and chronically
ill or that undermine their access to a comprehensive and medically necessary
set of services.
Medicaid finances more than 55 percent of all AIDS care and
90 percent of all AIDS care for children in the
United States
.
The Medicaid program and the federal rules that ensure access to a comprehensive
set of benefits and prohibit cost-sharing from serving as a barrier to medically
necessary care has allowed many low-income persons in the
U.S.
to benefit
from remarkable HIV treatment advances. These treatment advances have led to an
80 percent reduction in mortality and morbidity due to AIDS and related
complications. Current proposals
from the National Governor's Association that would permit broad state
discretion in the imposition of cost sharing and in the rationing of health care
services threaten the gains in longevity and quality of life enjoyed by
low-income persons with HIV/AIDS.
Cost sharing imposes a disproportionate burden on those
individuals in need of numerous health services and prescription drugs. Current
federal regulations strike an important balance between the health care needs of
beneficiaries and the fiscal constraints of government by allowing only nominal
cost-sharing for most beneficiaries while requiring providers to deliver
services regardless of whether or not they receive a co-payment. If these rules
are relaxed or modified, beneficiaries will undoubtedly find themselves making
impossible choices between one critical medical service or prescription
drug and another, because they simply do not have the money
to pay for all of the services they need. Persons with HIV/AIDS
require regular medical visits, lab tests and generally must take 3-5
antiretroviral medications, in addition to other drugs used to
treat treatment side effects and co-existing conditions. Without access to the full array
of Medicaid benefits, persons with HIV/AIDS will not be able
to benefit from treatment regimens that require frequent physician oversight, laboratory
tests and strict adherence. State flexibility to impose greater cost sharing and to offer very limited
services will hurt those who need medical care the most. Moreover,
since the federal government provides the majority of funding for this
vital safety net program, it is critical and appropriate that the
federal government continue to ensure that Medicaid benefits and cost sharing continue
to meet the needs of the vulnerable citizens served by the
program.
On behalf of Medicaid beneficiaries with HIV/AIDS who
literally depend upon the Medicaid program as a lifeline, we urge you to
minimize funding reductions to the Medicaid program and to ensure that any
policy changes enacted do not put lifesaving medical care out of reach for those
for whom the program was created.
Sincerely,
A-Team Clinic, Neptune,
NJ
AARTH Ministries, Seattle,
WA
ACT UP/Southern
California,
Los Angeles,
CA
The Advocacy Project,
Houston,
TX
AIDS/HIV Health Alternatives, Los Angeles, CA
AIDS Action, Washington,
DC
AIDS Action Baltimore,
Baltimore,
MD
Aids Action Project NorthWest(AAPNW),
Portland,
OR
AIDS Alabama,
Birmingham,
AL
AIDS Alliance of
Northwest Georgia,
Cartersville,
GA
AIDS Drug Assistance Protocol Fund,
Chicago,
IL
AIDS Education Global Information System,
San Juan
Capistrano,
CA
AIDS Foundation of Chicago,
Chicago,
IL
AIDS Foundation of St.
Louis, St. Louis,
MO
AIDS Housing
Alliance
, San
Francisco
AIDS Info Net, Arroyo Seco,
NM
The AIDS Institute,
Washington,
DC
AIDS Legal Council of Chicago,
Chicago,
IL
AIDS Medicare Coalition, San Francisco, CA
AIDS Network of Madison,
Madison,
WI
AIDS Project Los Angeles, Los Angeles,
CA
AIDS Project of Central
Iowa,
Des Moines,
IA
AIDS Resource Foundation for Children,
Jersey City,
NJ
AIDS Services of Austin,
Austin,
TX
AIDS Treatment Activists Coalition (ATAC),
New York,
NY
AIDS Treatment Data Network, New York, NY
Allies Linked for the Prevention of HIV and AIDS,
Boise,
ID
American
Academy of HIV Medicine,
Washington,
DC
American Medical Student Association,
Reston,
VA
Amigos Volunteers in Education and Services, Inc.,
Houston,
TX
Association of Nurses in AIDS Care,
Akron,
OH
Bailey House, New York,
NY
Betances Health Center,
New York , NY
Bethlehem House,
Indianapolis,
IN
Bienestar Human Services, Inc., Los Angeles, CA
Brother-To-Brother, Seattle,
WA
California
Prison Focus, San Francisco,
CA
Catholic Charities Diocese of Fort Worth, Inc.,
Fort
Worth,
TX
Center for AIDS Information and Advocacy,
Houston,
TX
Center for Health Policy Development, Inc.,
San Antonio,
TX
Chicagoland Youth Against AIDS (CYAA), Division of Adolesent
and Young Adult Medicine at Stroger
Hospital of
Cook
County,
Chicago,
IL
Christie�s Place, San Diego,
CA
Citizen Action/Illinois,
Chicago,
IL
Community Health Outreach Workers,
Detroit,
MI
Community HIV/AIDS Mobilization Project (CHAMP),
New
York,
NY
Conscious Contact of New York, Inc., New York, NY
Council of Religious AIDS Networks,
Washington,
DC
Dayspring AIDS Support Services,
Augusta,
ME
Derek Silva Community, San Francisco, CA
DIGNITY
USA National
HIV/AIDS Project, Washington,
DC
Dooley House, Inc., Camden,
NJ
East
Bay AIDS
Center,
Oakland,
CA
Ecumenical Ministries of
Oregon, HIV Services Program,
Portland,
OR
Empire
State Coalition of Youth and Family
Services, New York
The Evangelical Catholic Diocese of the Northwest,
Chicago,
IL
Families� and Children�s AIDS Network,
Chicago,
IL
Families
USA,
Washington,
DC
Fargo Cass Public
Health, Fargo,
ND
F.O.U.N.D., Los Angeles,
CA
Foundation for Integrative AIDS Research (FIAR),
Brooklyn,
NY
Francis House, Camden,
NJ
Gay Men�s Health Crisis, New York, NY
Georgia
Rural Urban Summit,
Decatur,
GA
Global Network of People Living With HIV/AIDS -
North America (GNP+NA),
Washington,
DC
Hackensack
University Medical
Center
Haitian Centers Council, Inc.,
Brooklyn,
NY
Harm Reduction Coalition, New York, NY
The Harm Reduction Project, Salt Lake City, UT
Health Equity Project, New York, NY
Health Mentoring Services,
Dover,
AK
Heartland
Alliance for Human Needs & Human
Rights, Chicago,
IL
Hepatitis, AIDS, Research Trust, Florence, CO
Hep C Advocate Network, Inc.,
Longview,
TX
Hepatitis C Action and Advocacy Coalition (HAAC-SF),
San
Francisco,
CA
Hispanic
Family
Center,
Camden
NJ
HIV/AIDS Policy & Research Institute,
College of
Health Sciences,
Chicago
State
University,
Chicago,
IL
HIV/AIDS Services for African Americans in
Alaska,
Anchorage,
AK
HIVictorious, Inc., Madison,
WI
HIV Advocacy Council of
Oregon and SW Washington, Portland,
OR
HIV Alliance,
Eugene,
OR
HIV Law Project, Inc., New York, NY
HIV Medicine Association,
Alexandria,
VA
HIV Planning Council,
Cumberland,
NJ
House of Mercy, Belmont,
NC
Housing Works, New York,
NY and
Washington,
DC
Hyacinth AIDS Foundation, New Brunswick, NJ
International AIDS Empowerment, El Paso, TX
International Community of Women Living With HIV and AIDS,
Washington,
DC
International Foundation for Alternative Research in AIDS,
Portland,
OR
Iowa
HIV
Community Planning Group, IA
Irvington Neighborhood Improvement Corporation,
Irvington,
NJ
Jelani Unified Men's Project,
Chicago,
IL
Jersey City Connections, Inc., Jersey City, NJ
Jersey City
Lesbian + Gay Outreach, Jersey
City,
NJ
Jordan
Hospital, ACCESS Program,
Plymouth,
MA
KC HIV Social Group
Liberty Research Group,
Rochester,
NY
Lifelong AIDS
Alliance,
Seattle,
WA
Living Hope Organization,
Nigeria
Living Room, Inc., Atlanta,
GA
Maine HIV
Advisory Committee, Augusta,
ME
Maitri
Center (Greyston Foundation) Adult
Day Health Care program for PLWHA, Yonkers,
NY
MANA de Hidalgo
County,
Weslaco,
TX
Matthew 25 AIDS Services, Inc.,
Henderson,
KY
McGregor Clinic, Fort Myers,
FL
Michigan
Positive Action Coalition (MI-POZ), Ferndale,
MI
Midwest
AIDS Training & Education Center
(MATEC), Iowa City,
Iowa
NAMES Project Foundation/Central
Jersey Chapter, New Brunswick, NJ
Nashville CARES,
Nashville,
TN
National Association for Victims of Transfusion-Acquired
AIDS, Bethesda,
MD
National Association of People With AIDS,
Washington,
DC
National Association of Social Workers,
Washington,
DC
National Minority AIDS Council,
Washington,
DC
Nebraska AIDS
Project, Omaha,
NE
New Jersey
Association on HIV Over Fifty, Newark,
NJ
New York City
Association and Street-Involved Youth Organizations, New York
North
General
Hospital, Department of HIV/AIDS,
New
York,
NY
North
Idaho AIDS
Coalition
Northern Kentucky District Health Department,
Ft. Mitchell,
KY
Okaloosa AIDS Support and Informational Services, Inc.,
Ft. Walton
Beach,
FL
One Earth Foundation,
Decatur,
GA
Open Door Clinic of Greater
Elgin,
Aurora and
Elgin,
IL
Our Common Welfare, Inc.,
Decatur,
GA
PACO/GRIP, Jersey City,
NJ
Pan Pacific Consulting, Los Angeles, CA
Partnership Project, San Francisco, CA
Pediatric AIDS
Chicago Prevention Initiative,
Chicago,
IL
Pierce
County AIDS Foundation,
Tacoma,
WA
Planet Poz/New
Mexico POZ
Coalition, Rio Rancho, NM
Project Inform, San Francisco, CA
Project Response, Inc.,
Melbourne,
FL
Public Personalities Against AIDS Trust,
Harare,
Zimbabwe
Pueblo Family
Physicians, Phoenix,
AZ
Recovery Options, Los Angeles, CA
Resources Unlimited Foundation, Oak
Park and Chicago,
IL
Ryan White Title 1 Las Vegas EMA Planning Council,
Las
Vegas,
NV
Ryan White Title II Advisory Committee,
Augusta,
ME
San Fernando
Valley HIV Faith Based
Coalition, North Hollywood,
CA
San Francisco
AIDS Foundation, San
Francisco,
CA
San Jose Clinic,
Houston,
TX
San Luis Obispo
County
AIDS Support Network,
San Luis
Obispo,
CA
Sisters Together And Reaching, Inc.,
Baltimore,
MD
South Carolina
Women's Advocacy Council, Columbia,
SC
South Jersey Council On AIDS, Inc.,
Camden,
NJ
South
Mississippi AIDS Task Force,
Biloxi,
MS
Southern AIDS Coalition,
Washington,
DC and
Birmingham,
AL
The Southern New
Hampshire HIV/AIDS
Task Force, Nashua,
NJ
Special Audiences, Inc.,
Newark,
NJ
Straight From The Heart,
Lakeland,
FL
Tapestry Health, Florence,
MA
Title II Community AIDS National Network (TIICANN),
Washington,
DC
Topeka AIDS Project, Inc.,
Topeka,
KS
Treatment Access Expansion Project,
Washington,
DC and
Boston,
MA
Treatment Action Group, New York, NY
Turning Point, Brooklyn,
NY
Turning Points of Connecticut, Inc.,
Bridgeport,
CT
UCSD Owen Clinic, San Diego,
CA
Utah AIDS
Foundation, Salt Lake City,
UT
Visiting Nurse Association of Central Jersey, North Brunswick,
NJ
VNA of Southern New
Jersey,
Runnemede,
NJ
Wellness HIV/AIDS Services,
Flint,
MI
West Alabama AIDS Outreach, Inc.,
Tuscaloosa,
AL
West County Health Centers, Inc.,
Guerneville,
CA
Western Pacific Re-Hab,
Glendale,
CA
WORLD, Oakland,
CA
Wyoming AIDS
Project, Casper,
WY
Wyoming
Positives For Positives, Cheyenne,
WY