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Medicare bill an AIDS nightmare

By Sandy Bartlett, December 12, 2003, Columns

Congress' recent Medicare overhaul is a behemoth coming around the corner, about to crush the unwary. In particular, it eliminates "wrap-around" drug coverage for 6 million people who are currently eligible for both Medicaid and Medicare, including 50,000 people with AIDS.

Medicaid serves Americans with low or no income; Medicare serves the elderly and the disabled. People who are "dual-eligible" for both are obviously among the sickest and poorest.

Previously, Medicaid provided dual-eligibles with benefits not covered by Medicare, but now states won't be able to use Medicaid funds for medications not included in Medicare. Unfortunately, the new Medicare prescription-drug benefit won't be adequate for most people with AIDS.

Poor people with AIDS then may have only their state's AIDS Drug Assistance Program for obtaining their pills. However, ADAPs (including the Texas HIV Medications Program) are already in a financial crunch, and a significant influx of participants could push crunch to crisis.

A meaningful Medicare drug benefit has been long-sought. Especially in this election cycle, touting their "achievement" will be important to the Bush administration. The truth is, however, their health issues record is still abysmal: "Drug benefit" or not, the Medicare changes are going to pose serious new difficulties for poor people with AIDS and other costly chronic diseases.

Sandy Bartlett

Community Education Coordinator, AIDS Services of Austin

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