San Francisco Chronicle - Thursday, July 18, 2002

It's not a fantasy. Assemblyman Paul Koretz, D-West Hollywood, has proposed a pilot program to increase the levels of care and efficiency in services provided to low-income Californians with HIV and AIDS.

Under his bill, AB2197, the state could extend comprehensive Medi-Cal coverage to low-income people in the early stages of HIV. Under current law, many nondisabled single people with HIV received state-subsidized drug treatments, but are not eligible for Medi-Cal.

Such restrictions on coverage amount to a false economy. Access to wide- ranging medical care in the early stages of HIV is essential to making sure that drug regimens do not result in dangerous side effects. It can help delay the onset of AIDS, when medical costs rise exponentially. And it can keep people with HIV healthy and working, thus paying taxes.

Passage of AB2197 is a matter of compassion and fiscal prudence.

Of course, in a state facing a $24 billion deficit, policymakers should demand more than a promise when told that a new benefit will not cost any more. The Koretz bill comes with such a guarantee.

Under AB2197, the pilot program would be contingent on California being able to show the federal government that the extension of health-care services to people in the early stages of AIDS would be "cost neutral" within a five- year period.

The Koretz bill aims to achieve those required savings by forcing the state Department of Health Services to encourage AIDS-disabled Medi-Cal beneficiaries to voluntarily switch from fee-for-service to managed-care coverage. The savings from the lowered costs of treating people with AIDS- related diseases could then be applied to expanding treatment to people in the early stages of HIV.

As Michael Weinstein of the AIDS Healthcare Foundation so aptly put it, "For too long in California, those who are HIV positive have had to become sick and develop full-blown AIDS in order to get treatment under Medi-Cal, when earlier intervention could have kept them healthy and productive."

AB2197 is an experiment worth trying -- and has been gaining bipartisan support in the California Legislature. It cleared the Assembly on a 52-to-26 vote, and was approved by its first Senate committee, Health and Human Services, on an 8-to-1 vote. But nothing can be taken for granted in a budget- gridlocked Capitol, and Gov. Gray Davis has yet to take a public position on the bill.

We urge state senators to pass AB2197 and Davis to sign it into law.
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