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In the news ... 2007PI ACTION UPDATEMarch 2007In this issue 2007 Health Care Advocacy Agenda
2007 Health Care Advocacy Agenda Our national priorities include improving the Medicare Part D drug benefit, protecting Medicaid from funding cuts, passing the Early Treatment for HIV Act, and securing badly needed increases for all Titles of the Ryan White CARE Act. We have also expanded our focus to advocate for increased appropriations for hepatitis C programs. Project Inform also works at the California state level because many, if not most, decisions regarding health care programs are made at the state level. This year, Project Inform will work with the California HIV Alliance and other advocates on many issues, including full funding for the AIDS Drug Assistance Program (ADAP) and fighting for protections for dual eligibles (Medi-Cal and Medicare) in California who find it difficult to access their meds under Medicare Part D. Final 2007 Appropriations Bill Underfunds
AIDS Care Fortunately, the final bill includes a $75 million increase for Title II base. This money will go to all states for primary care, support services, and/or to put in their ADAPs. The reauthorized CARE Act was developed assuming this increase, and it will help many states in need increase access to health care and treatment. However, the rest of the CARE Act, including the ADAP line item, received no increase. These programs have suffered from years of insufficient funding. The result has been waiting lists for care and treatment nationwide. Next year’s bill must contain increases for the entire CARE Act. Look for Alerts from PI Action to assist you in making your voice heard on this issue. President’s 2008 Budget: Same Old
Attack on Health Care The President’s budget proposes cutting almost $26 billion from Medicaid over the next five years. This is on top of cuts of over $4 billion over five years signed into law in the Deficit Reduction Act in 2006. The proposed funding level for SCHIP falls below what it would cost states to simply maintain current enrollment, much less cover the 7 million children who are currently eligible for SCHIP or Medicaid but not covered. The proposed Medicare cuts are harder to analyze but they appear to impact areas that could affect access to care and shift more costs to beneficiaries. At the same time, they do not address overpayments to Medicare Advantage private plans. Independents studies show these plans are significantly overpaid to serve beneficiaries. The President continued his lack of leadership on the Ryan White CARE Act. Once again, his budget proposal calls for no increases to most of this program. He proposes a $25 million increase for ADAP and a $6 million increase for Title III, which funds community-based clinics. However, the $6 million is not new money, but a shifting of funds from the AIDS Education and Training Centers. Finally, the President offered private market proposals that would direct federal funds toward people who are healthy and have good incomes. Two national organizations, Families USA and Center on Budget and Policy Priorities have posted comprehensive analyses of the effect of the President’s budget on major health care programs. Medicare Part D Update Probably most troubling was the loss for some beneficiaries of Low Income Subsidy or extra help in the Medicare benefit. We know this affected about 3,500 Californians with HIV and have reason to believe that it affected many others in the 36 states that operate a Medicaid medically needy program. Not only did individuals lose their extra help, greatly impairing their ability to access necessary drugs, but most were unaware of their status until January 1, 2007. This was due to the completely inadequate education provided by Centers for Medicaid and Medicare on the loss of the benefit. For more information, here read our comprehensive update on Medicare Part D. New Congress Means Renewed Opportunity
To Pass ETHA This legislation, which has been pending in Congress for several years, would give states the option to expand their eligibility requirements to include low-income people with HIV/AIDS who are not yet disabled. It would also provide more funds to states to help them take on this new population. In most cases, a person currently needs to be disabled by conditions associated with AIDS before receiving services from Medicaid. ETHA would allow Medicaid to be more in line with the federal guidelines on standards of HIV care. ETHA would then provide access to care and treatment immediately after a person is diagnosed with HIV. If states enacted an ETHA program, it would also help relieve CARE programs struggling to meet the needs of people who could otherwise qualify for Medicaid under ETHA. Senators Gordon Smith (R-OR) and Hillary Clinton (D-NY) are longtime champions of this legislation and plan to reintroduce this bipartisan bill soon. In the House, Speaker Nancy Pelosi (D-CA) will again be a lead co-sponsor of the bill and will work with Representative Elliot Engle (D-NY). Efforts are underway to identify a Republican co-sponsor. Project Inform will work with our advocacy colleagues, including the Treatment Access Expansion Project and the HIV Medicaid/Medicare Working Group to pass this important bill. To learn how to get involved in this effort, email Ryan Clary or call him at 415-558-8669 x224. PI Expands Health Care Focus To Include
Hepatitis C Last year, we joined the Hepatitis C Appropriations Partnership (HCAP), a national coalition of community-based hepatitis and HIV organizations and pharmaceutical companies that advocates for increased funding for federal viral hepatitis programs. Like much of the CARE Act, these programs have been flat-funded for years. Hopefully, with new leadership in Congress, this will change. HCAP is requesting a modest increase of $11 million in federal funding for HCV programs. We also urge President Bush to issue a Presidential Proclamation supporting May as National Hepatitis Awareness Month. Even though public health officials and advocates have recognized this month since 1995, the President has yet to respond to pleas to issue this proclamation. His leadership is needed to help educate Americans about this disease and to encourage testing. Please take a moment to respond to this PI Action Alert and send a message to the President! California State Advocacy That allows us an opportunity to address the static portion of the epidemic. California estimates the following: about 1 out of 4 who have HIV do not know their status; of those who do know, about 1 in 5 do not seek care for a number of reasons; and we experience 8,000–9,000 new HIV infections each year. Our budget and legislative proposals focus on allowing more people to know their status and get connected to care. You can read the full advocacy agenda for the California HIV Alliance, including budget and legislative issues. In spite of the best efforts by the Low Income Health Advocates to work with the administration and the Legislature, California’s Emergency Drug Benefit ended on January 31, 2007. The EDB provided temporary access to needed medications for dual eligibles when they were unable to get them through their Medicare plans. Although the program served more than 50 people each day, there was no political will to continue the program into the new plan year. This could leave dual eligibles without options to access needed meds. Project Inform Updates from CROI A Quote We Like — Representative John Dingell, |
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