 |
|||
   |
In the news ... 2006 archivePI ACTION UPDATEMarch 9, 2006In this issue President Continues Attack on Health
Care President Continues Attack on Health Care In addition to calling for an overall cut to the Department of Health and Human Services, which funds health and social service programs nationwide, the President's budget includes $13.7 billion in new cuts to Medicaid. This is on top of the $4.8 billion cut in the 2006 budget. Last year's budget also included new power given to states to increase co-pays and other cost-sharing to their Medicaid recipients, and refuse services if beneficiaries can't pay. With the passage of the Deficit Reduction Act, the battle to maintain Medicaid programs has moved to the state level. State advocates will have to work hard to ensure that their Medicaids don't enact these harmful cost cutting measures. While many of the cuts in the new budget are considered "administrative", the reality is that states can't absorb any more hits in their Medicaid funding. The likely result is that these cuts will be passed to the Medicaid recipient in the form of increased cost burdens. The non-partisan Congressional Budget Office has analyzed the Deficit Reduction Act and found that 80% of the savings in Medicaid will come from denying care and treatment to those who can't pay higher co-pays and premiums. The new cuts proposed by the President will only make this situation worse. We need to tell our elected representatives "enough is enough" and stand firm against any more cuts to this lifesaving health program. HIV/AIDS Care and Treatment Still Underfunded His proposed budget for domestic HIV/AIDS care and treatment programs, however, fell far short of matching those strong words. Once again, the President has called for flat funding for all of the Ryan White CARE Act, with a couple of exceptions. This will make it even harder for people with HIV around the country to get vital primary care and support services. The President called for a $70 million increase to help states with ADAP waiting lists. While this funding is badly needed, it falls short of the $197 million increase identified by treatment experts as the amount that will help states provide a basic level of service to everyone who needs it. It also means that states without waiting lists, many of which are still in severe need, won't receive any extra money, potentially creating more problems with their ADAPs. The budget also asks for $25 million for outreach efforts by faith and community-based organizations to reach underserved populations. While the money is proposed to go through the CARE Act, details are still unknown. Although outreach is clearly important, outreach without sustaining necessary health care and support services is wasted money and bad public health. In addition to continuing our calls, letters, and meetings with elected representatives to fight for adequate HIV/AIDS and health care money, with mid-term elections coming up in November, we have a great opportunity to make sure we are electing Members of Congress who commit to making health care a priority. In the next few months, look for ways you can get involved in talking to candidates about issues important to us and in helping others register to vote and getting to the polls. Part D Implementation Off to a Rocky Start Dual eligibles are among the sickest and lowest income of all Medicare beneficiaries. Over half are in fair or poor health and they are more likely to have mental health concerns and to live in nursing homes. This very vulnerable population was the wrong place to start with the launch of a new and untested benefit system. Advocates have been warning elected officials, the administration and the Centers for Medicaid and Medicare Services (CMS) that this population would likely have a very difficult time under the new benefit, especially because it is delivered by private companies with little to no experience with a high-need population. Unfortunately, this group was among the first to be forced into the benefit. Implementation was plagued with problems, including impossible wait times for help, inaccurate information on beneficiaries plans and benefits, and customer representatives who had incorrect information. The result was hundreds of thousands dual eligibles without access to the drugs they needed. Project Inform has prepared an article with detailed information on implementation, and some tips for those can't access their medication. New Guidelines for Part D Formularies Medicare beneficiaries living with AIDS are particularly vulnerable to delays for new drugs as they are a more treatment-experienced population who have often exhausted existing options and need access to newer options. CMS Gives More Time to Fill Prescriptions The Centers for Medicaid and Medicare Services has recognized the situation and belatedly issued a memo that calls for a "one-time across the board extension of the transition period to March 31 for those individuals who were enrolled in the first few months of the program." For individuals who enroll on March 1 or thereafter, the thirty day transition policy remains in place. Part D plans were required to respond to CMS by February 6 as to whether they would implement the policy. California Extends Emergency Coverage
for Duals Medi-Cal (California's Medicaid) will provide drug coverage for a dual eligible when: (1) the Part D plan has denied payment for reasons other than pharmacy error, lack of medical necessity, or health and safety reasons; (2) the pharmacy can't submit a claim because Part D information is inadequate; (3) the Part D plan requires a deductible or a co-pay higher than what should be charged to a dual eligible beneficiary -- between $1 and $5 under the low-income subsidy or extra help. For complete detailed information on how to submit claims, go to Medi-Cal's website. What's Happening with Ryan White Reauthorization? Staff of the House and Senate committees that oversee the CARE Act are meeting regularly in a bipartisan process to draft a reauthorization bill. Last week, Senator Tom Coburn (R-OK) released his own bill. Project Inform has been working with many coalition partners to reauthorize the CARE Act, including Communities Advocating Emergency AIDS Relief (CAEAR) Coalition, and the Federal AIDS Policy Partnership (FAPP) Ryan White Reauthorization Group. We are also advocating, along with colleagues who participated in a "Ryan White Unity Summit" last November, for a mechanism in the reauthorized bill that would provide supplemental Title II funding to states without Title I EMAs, or whose AIDS caseloads are outside of urban areas. We have released a statement for organizations and individuals to sign in support of this proposal. California Advocates Release Budget Request The Alliance is asking for funding for treatment and prevention programs to address the use of methamphetamine among gay men and men who have sex with men, particularly those who are also HIV positive, and an extension of a one time increase of HIV prevention funding approved in last year's budget. Treatment Advocacy Update We've worked collaboratively and privately with Tibotec, a new company soon to get approval of its first product for HIV, and with Merck, one of the pioneers of protease inhibitors. Merck is about to pioneer another new field of drugs for HIV called integrase inhibitors. Tibotec is in the final stages of testing the new protease inhibitor TMC114, also known as Darunavir. We have worked with other groups to make sure people in need have wide access to the drug without waiting for final approval. Most importantly, the community has worked with the companies to make it possible for people in studies and in expanded access programs to get two new drugs at the same time, greatly increasing chances of success. Tibotec and Merck will also make sure that each company's new drug could be used along with the other company's. Project Inform has begun working with both companies to try to restrain the prices that will be charged for these drugs. Beginning last October, Project Inform began a collaboration with the Elizabeth Taylor AIDS Foundation (ETAF) to help people with HIV in the New Orleans area, where nearly all the HIV clinics had been closed by the flooding. With the financial backing of ETAF, Project Inform consulted with the New Orleans AIDS Task Force to define the local need. This led to the construction of a mobile medical unit (the equivalent of two medical offices) that will be utilized throughout New Orleans and the surrounding area, bringing HIV treatment and care to those in need. The unit, called the CARE VAN, was finished in mid February, and is currently in use. It will be shared by the Task Force, the State Department of Public Health and the Department of Public Health of the City of New Orleans. It was a rare honor and privilege to work with ETAF and with Elizabeth Taylor, a pioneer in both philanthropy and AIDS activism since the earliest days. Changes ... and a Retooled Health Care
Advocacy Webpage We've also retired the name of our grassroots network after a 15 year run. The Treatment Action Network (TAN) is now called PI Action. This network of people across the country continues to make a difference by urging their elected representatives to commit to a true fight against HIV/AIDS and to protect the health care of those in need. Please ask your friends and family to join in this effort and to receive our information updates by signing up for PI Action! A Quote We Like Senator Arlen Specter (R-PA), February 6, 2006, |
IN THE NEWS
|
|
|
© 2008 Project Inform 1375 Mission
Street, San Francisco, CA 94103 415-558-8669 |
|||