In the news ... 2007

Project Inform Congratulates Congresswoman Nancy Pelosi on Becoming Speaker of the House

January 10, 2007

The Honorable Nancy Pelosi
Speaker, House of Representatives
Washington, DC 20515

Dear Speaker Pelosi:

On behalf of the staff, board, and volunteers of Project Inform, we congratulate you on your historic election as Speaker of the House of Representatives. You have more than earned this position through your tireless work, your leadership and your integrity in serving your constituency. You also serve as a wonderful inspiration for the women and girls of our country and we thank you for that role. We are proud and honored to have our own Representative, and a tireless champion of people living with HIV/AIDS, as the new leader of the House.

We were very pleased to read that expansion of health care is one of your top priorities for the new Congress. After seven years of attacks on Medicaid, a Medicare prescription drug benefit that falls far from its promise for people with disabilities and seniors with high drug costs, and insufficient funding for discretionary HIV/AIDS programs, we are very excited to have new leadership that will address the national disgrace of the rising number of uninsured and underinsured Americans.

Like you, we strongly support universal health care for everyone in the country, regardless of ability to pay, disease status, or other factors. However, we know that in this political environment, a more incremental approach will likely be necessary to achieve our shared goal. As advocates for people with HIV/AIDS, we understand that a strong health care system that serves its most vulnerable beneficiaries well will work for everyone in the United States. We look forward to working with you and your staff on any legislation that would expand health care coverage, particularly for the most vulnerable populations.

While we know that you have a full agenda for the coming months, we wanted to outline some of our top priorities in Project Inform’s Health Care Advocacy program. We hope there will be opportunities to work with you on these issues in the coming months:

Medicare Part D:
In addition to supporting the stated Democratic goal of requiring the federal government to negotiate lower drug prices for the Medicare beneficiaries, we will have a set of priorities that will strengthen the benefit for people with HIV/AIDS. We are steering committee members of the HIV Medicaid/Medicare Working Group (HIVMMWG) and are in the process of finalizing our recommendations in the next two weeks.

These recommendations will include assuring that AIDS Drug Assistance Program (ADAP) payment count toward an individuals True Out of Pocket expenditure or TrOOP, codifying the protection for six categories of essential drugs (including anti-retrovirals), and ensuring that there is at least one Medicare plan that offers coverage on both brand and generic drugs through the coverage gap in all states. Additionally, we will seek to address the problem that approximately 3500 Californians face in plan year 2007. These are dual eligibles in the Medi-Cal medically needy program who will lose their Medicare low income subsidy or extra help because they were unable to meet their Medi-Cal share of cost in 2006.

Medicaid:
We are also working through the HIVMMWG on our Medicaid advocacy priorities for 2007. We will have this document available in the next few weeks. We will continue to advocate for protecting Medicaid as an entitlement program and with sufficient funding to meet the needs of those it serves. We also strongly support expanding Medicaid to provide early access to care and treatment for low-income people with HIV disease. We continue to support your legislation, The Early Treatment for HIV Act, as the ideal vehicle for that expansion and hope that the House and Senate will pass ETHA and other thoughtful Medicaid expansion proposals in the 110th Congress.

Ryan White CARE Act:
As you know, the CARE Act was reauthorized at the end of the 109th Congress. While Project Inform was not able to support the final compromise legislation because it was based on the concept of shifting funding from one area to another – rather than providing additional funding, targeting states in need – we recognize the bill as a thoughtful compromise. We also thank you for your leadership in protecting San Francisco and California from major funding cuts.

As you know, the CARE Act continues to suffer from years of inadequate funding. States and localities have been forced to limit access to lifesaving care and treatment services. In particular, many states have created waiting lists and other cost saving mechanisms in their AIDS Drug Assistance Programs. While we recognize the current economic challenges facing our country, we can’t balance the budget on the backs of low-income people living with HIV. We encourage you to support full funding for all Titles of the Ryan White CARE Act.

At a minimum, we strongly support the inclusion of a $70 million increase for Title II (base) in the final Fiscal Year 2007 appropriations bill (or continuing resolution). The reauthorized CARE Act was crafted on the assumption of this increase, and it is the bare minimum necessary to ensure that states can improve access to lifesaving care and treatment. We also need a $18.8 million increase in FY 07 for Title I in order to incorporate the new Title I jurisdictions that gain eligibility in the reauthorized CARE Act and strongly support the inclusion of a $25 million increase for Title III of the CARE Act, which was proposed by President Bush in his original FY 07 budget.

Hepatitis C:
Project Inform is also gravely concerned about the hepatitis C epidemic in this country. About 4.1 million American have been infected with hepatitis C virus (HCV), yet only 40% are aware of their status. Additionally, an estimated 225,000 HCV-infected people are coinfected with HIV. Infection with HIV hastens the progression of HCV-related liver diseases.

e urge you to support increased funding for hepatitis C activities of the Viral Hepatitis Division in the Centers for Disease Control and Prevention. The Hepatitis C Appropriations Partnership has asked for a minimum $10 million increase for these activities in the final FY 07 appropriations bill, while estimating the need at a $32.3 million increase.

In addition, we hope you will consider supporting the Hepatitis C Epidemic Control and Prevention Act. This bill (S. 521 and H.R. 1290 in the 109th Congress), authored by Senators Hutchison and Kennedy and Representatives Wilson and Towns, would establish, promote, and support a comprehensive prevention, research, and medical management referral program for HCV. We hope that under your leadership, this bill can become authorized so that the country can begin to mount a true fight against this deadly disease.

We again congratulate you on your election to lead the House of Representatives in the 110th Congress. If you have any questions about our advocacy priorities, or if there is ever anything we can do as a constituent organization (and/or a national organization) to help you advance your health care agenda, please don’t hesitate to contact us.

Sincerely,

Anne Donnelly and Ryan Clary
Director and Associate Director, Health Care Advocacy Program