Important note: Information in this article was accurate in 2009. The state of the art may have changed since the publication date.
Bay Area Reporter - January 22, 2009
Bob Roehr
Some $3 billion in new money is being set aside for disease prevention and wellness. Earmarked within that is $355 million more for domestic prevention programs for hepatitis and sexually transmitted diseases, with expectations that about 70 percent will go to HIV.
HIV prevention programs at the Centers for Disease Control and Prevention have seen a 20 percent decline in purchasing power over the last five years. In testimony last year before a House subcommittee, CDC Director Julie Gerberding said they would need an additional $877 million over the next five years to significantly reduce the number of new infections. The proposed increase would be an important step toward that goal.
The AIDS Institute praised the proposal. Lobbyist Carl Schmid said, "We strongly agree with the House, preventing disease, such as HIV/AIDS, will dramatically reduce future health care costs." He added that health care should be "a top priority for the economic health of our country and our society."
The federal share of Medicaid will go up $87 billion over the short term. That will help states that are hit hard by declining state tax revenue, rising unemployment, and increased numbers of low income households that now qualify for Medicaid.
Estimates are that about 40 percent of persons living with HIV rely upon Medicaid to access their healthcare. Frank Oldham, executive director of the National Association of People With AIDS, applauded the effort as crucial to maintaining their health.
However, the AIDS Drug Assistance Program, another key safety net program, will not receive any new money under the stimulus proposal. That is troubling because waiting lists for drugs are growing again in a number of states, and the burden on the program increases as the economy declines.
In California, Governor Arnold Schwarzenegger has agreed to fully fund ADAP, as was reported in last week's Bay Area Reporter.
While most ADAP funds are used to purchase drugs, they also can be used to pay health insurance premiums. This includes assisting workers who lose their job, but under the so-called COBRA law can continue to pay for health insurance coverage under their old employers group plan.
Additional billions from the stimulus package will go to the National Institutes of Health, Department of Veterans Affairs, Indian Health Services, and community health centers.
House Speaker Nancy Pelosi (D-San Francisco) said that the leadership has put the measure on the fast track, with committee mark-ups and a floor vote by the end of the month. The Senate plans to consider it in early February and have it on the president's desk before the mid-month recess.
In another matter, on January 6, Representative Jose Serrano (D-New York) introduced the Community AIDS and Hepatitis Prevention Act of 2009 (H.R. 179). It would remove all legal barriers to states and cities spending federal funds on needle exchange programs. It has 35 co-sponsors.
Estimates are that about 11,000 new HIV infections and 30,000 new hepatitis C infections a year are directly or indirectly linked to contaminated drug injection equipment. Needle exchange programs have demonstrated effectiveness at reducing this transmission and they do lead to increased use of injection drugs.
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