PROJECT INFORM IN OTHER MEDIA ... 2008
Senate Medicare reform fails
to correct gaps in AIDS coverage
by Bob Roehr, June 12, 2008
(mention of Project Inform in bold below)
Washington, DC — AIDS advocates are outraged
that the proposed Senate version of Medicare reform does not correct
technical problems that have created a gap or "donut hole" of coverage
in the prescription drug benefit known as Medicare Part D, for
people living with HIV.
"Congress has turned its back on people with AIDS by failing to
address their needs," said Kali Lindsey of the National Association
of People with AIDS (NAPWA). "Saving lives would cost the country
next to nothing. We call on Congress to show leadership in the
fight against AIDS and correct this flaw immediately."
Medicare provides healthcare coverage for about 100,000 people
with AIDS in the U.S. It is the second largest provider in the
country. Medicare Part D was created to cover prescription drug
costs, with beneficiaries making a copayment until they reach a
certain dollar threshold and then Medicare picks up nearly all
of the costs.
Unfortunately expenditures under the AIDS Drug Assistance Program
(ADAP) are not counted toward those out of pocket expenses, so
people with AIDS are stuck in the donut hole. They are not able
to reach the threshold where Medicare will pick up the full cost
of their drugs.
Project Inform's Anne Donnelly explained, "In California, most
people with HIV/AIDS receive two months of partial coverage under
Medicare before they go into the donut hole." ADAP can cover HIV
drugs but not drugs used to treat high blood pressure, cancer,
diabetes and other conditions that occur more frequently among
those living with HIV.
She said the state budget crisis "has forced the Governor to propose
cuts to the current ADAP formulary," so it won't be able to pick
up the slack.
AIDS advocates have pushed for a solution to this technical problem.
Senate Finance Committee chairman Max Baucus (D-Montana) put forward
a Medicare reform bill last week that addresses many technical
issues but not this one. The estimated cost is less than one percent
of the entire Medicare package.
Baucus is taking the unusual step of bringing the bill to the
floor without a vote in committee where there is bipartisan support
to correct the problem. It is perhaps a coincidence that Montana
has one of the lowest incidences of HIV infection in the country.
"You can't blame this on the White House or the Republicans," said
Carl Schmid with the AIDS Institute, Baucus did it on his own.
The House version of the bill contains the desired changes but
it is unclear what version of the legislation will serve as the
basis for conference to resolve differences between the two chambers."
Julie Scofield, executive director of the National Alliance of
State and Territorial AIDS Directors (NASTAD) said, "ADAPs have
struggled to keep up with client demand due to limited funding
from Congress."
She called on Congress to provide critical relief for ADAPs by
changing Medicare. "This is a very inexpensive fix that would have
a huge impact for people living with HIV/AIDS and ADAPs alike."
