AEGiS-WSJ: Medicaid Won't Cover Healthy Individuals With the AIDS Virus

Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.

Medicaid Won't Cover Healthy Individuals With the AIDS Virus

Wall Street Journal - December 8, 1997

WASHINGTON -- Because of the high price tag, the Clinton administration has decided against extending Medicaid coverage to people who are infected with the AIDS virus but too healthy to qualify for the program.

Currently, most people infected with HIV become eligible for Medicaid, the federal-state program for the poor and disabled, only after they are diagnosed with full-blown AIDS, and thus disabled by the illness. Administration officials had hoped to extend Medicaid coverage to relatively healthy people to give them a jump on battling the virus and keep them healthier longer. Last April, Vice President Al Gore told AIDS activists the administration was searching for ways to expand Medicaid to "ease suffering, renew hope and help ensure that good people are not priced out of lifesaving medicine."

But after extensive review, the Department of Health and Human Services concluded that such an expansion would substantially increase Medicaid spending, even with a projected decrease in hospitalizations and other costly care. Combination HIV drug therapy can easily run $10,000 to $15,000 a year per patient. Department officials said they plan to try to explore other ways of getting expensive drugs to relatively healthy people with HIV.

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