Medicaid Matters to People with HIV/AIDS

Medicaid provides health coverage to 55% of people living with AIDS and 44% of those living with HIV nationwide. This safety-net health program offers low-income persons with disabilities in Illinois a vitally important payment source for regular medical care, including expensive pharmacy coverage. Jointly financed by federal and state governments, Medicaid is the nation's public health insurance program for low-income families and individuals who are blind, disabled, and aged. Medicaid is the single largest payment source for AIDS care in the U.S.

Unfortunately, current Medicaid regulations only provide coverage for low-income children, pregnant women, the elderly, blind, and disabled. The disability requirements are so strict that many low-income, uninsured people with HIV are unable to qualify for Medicaid until their disease has progressed from HIV to late-stage AIDS. By providing low-income, HIV-positive individuals access to Medicaid-sponsored primary care and HIV medication before they become debilitated by AIDS, lawmakers can reduce and oftentimes prevent the occurrence of costly and disabling health crises.

Efforts to expand Medicaid coverage are pending on both the state and federal levels. If enacted, the Early Treatment for HIV Act would allow states to extend Medicaid to HIV-positive, low-income individuals before they are disabled by full-blown AIDS. Currently, states may respond to the gap in HIV coverage by seeking an HIV-related Medicaid Waiver, which requires federal approval and state compliance with several complex requirements. AIDS advocates nationwide and across Illinois are working to pursue both strategies in order to make Medicaid more responsive to the needs of people with HIV.

Further complicating matters, the Bush Administration recently proposed a plan that would hamper states' ability to respond to the healthcare needs of their poorest residents. Instead of approving the Bush plan, Congress should help bolster states' Medicaid programs, where enrollments have increased as a result of the economic slowdown. An increase in federal matching dollars to states for Medicaid, in the form of adjustments to the Federal Medical Assistance Percentage, would help states avert reductions to the program.

If you would like to learn how you can help promote Medicaid expansion, please consider getting involved in AFC's Sensible Medicaid campaign.

SENSIBLE MEDICAID CAMPAIGN:

Campaign Overview (PDF)

Petition/Endorsment Sheet (PDF)

Supporting Organizations



State Process for Improving Medicaid (PDF)


MEDICAID FACTSHEETS:

Kaiser "Medicaid and HIV/AIDS" Factsheet (PDF)

ETHA Short Summary (PDF)
ETHA Detailed Summary

HIV Medicaid Waiver (PDF)

Bush Proposal (PDF)

FMAP (PDF)

CAMPAIGN PARTNERS:

AIDS Legal Council Chicago
National Center on Poverty Law
Health & Disability Advocates
Treatment Access Expansion Project