Medicare Expansion: A Misnomer for People with AIDS

Dear Editor:

As we prepare to formally recognize and honor the global fight against HIV and AIDS on December 1, World AIDS Day, the outlook appears bleak for tens of thousands of Americans who live with the disease. In the name of Medicare "expansion," six million of the nation's sickest and poorest seniors and people with disabilities, including 50,000 people with HIV/AIDS, will find that their drug benefits have been cut, rather than expanded by the passage of the recent Medicare bill.

A seldom-publicized provision of the new Medicare Prescription Drug Bill eliminates supplemental drug coverage for the six million people who are eligible for both Medicaid and Medicare (known as "dual eligibles"). Before the bill passed, Medicaid would pay for services and benefits for dual-eligibles that weren't provided for by Medicare. Under the new law, states are barred from using Medicaid to cover the cost of medications, deductibles, and co-payments that Medicare does not include. For people who are HIV-positive and others with serious, chronic conditions who take 10 or more medications each day, the loss of the supplemental Medicaid coverage is devastating.

At a time when more people than ever before are living with HIV/AIDS, cutting access to life-saving drugs is unacceptable. Without the support of Medicaid, the 50,000 HIV-positive people affected by the Medicare provision will have to rely on the ailing AIDS Drug Assistance Program and Ryan White CARE Act services to afford the costly medications on which they depend. But these programs are already in a fiscal crisis—many cannot meet the current needs—and it is unlikely that they will be able to make up this terrible gap.

Congress must remedy this dangerous Medicare "expansion" that threatens the lives of people with HIV/AIDS before the law takes effect in January 2006. The outlook may be bleak on this World AIDS Day, but there is still time for Congress to turn back the harmful provisions of the Medicare bill. We cannot allow our nation's most vulnerable populations to become casualties in a misguided effort to improve healthcare.

Sincerely,

David Munar
Associate Director of Policy and Communication
AIDS Foundation of Chicago