HIVHealthReform.org - National Health Reform with an HIV Lens

HIVHealthReform.org is your source for news and information on the impact of national health reform on the lives and health of people with HIV. 

 

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Here's a sample of what you can find there...

Living with HIV? Top 5 Things You Need to Know about Health Care Reform

The new health reform law offers people with HIV unprecedented opportunities to improve their health.  Here are just some of the reasons:

1. Comprehensive, free health coverage for all very low-income people:  Medicaid is the nation’s safety net health program for low-income people, currently covering about four in ten people with HIV/AIDS.  In 2014, Medicaid will expand to provide most low-income people living with HIV access to comprehensive health care.  Read more about this critical low-income health care program.

2. Get affordable, private health insurance: Moderate and middle-income people living with HIV earning between about $15,000 and $44,000 a year will be able to receive tax benefits and financial assistance to purchase private health insurance with comprehensive benefits. Learn why this will transform the fight against HIV.

3. Private health insurance companies will have to play by the new rules:  The health reform law will finally force health insurance companies to treat consumers fairly. Learn more about how people with HIV will benefit.

4. Better Medicare:  For people with HIV who are disabled and on Medicare, the Part D prescription drug benefit is already becoming more affordable. Read more about this and other improvements.

5. Get coverage now:  Need health coverage now before 2014?  Health reform sets up some programs that could help you now, and there are some oldies but goodies you might not know about.  Learn more.

Debt Ceiling Negotiations Could Halt Progress Against HIV/AIDS

via Huffpost Chicago, By David Ernesto Munar

As part of its debt ceiling negotiations, the Obama administration is on the verge of undermining one of the most significant policies it has put in place to alleviate the nation's 30-year HIV/AIDS crisis, which directly affects more than 1.2 million Americans.

In a sad twist of irony, the White House proposal to rollback critical health benefits, essential to the control of HIV/AIDS, is emerging on the one-year anniversary of the National HIV/AIDS Strategy, unveiled by President Obama in July 2010.

The Center on Budget and Policy Priorities reports that the White House is considering deep federal funding cuts for state Medicaid programs, a proposal which could have an immediate, chilling effect on efforts to meet the benchmark goals described in the National HIV/AIDS Strategy. Moreover, it would render the federal health reform law virtually meaningless for millions of low-income Americans.

Medicaid expansion for all low-income Americans, regardless of their health status, is the centerpiece of the health reform law championed by President Obama in 2010. Without full funding from the federal government to help states finance Medicaid expansion, low-income individuals -- including hundreds of thousands with and at risk for HIV -- will struggle to gain access to adequate healthcare services from bankrupt Medicaid programs, which will be unable to make up the shortfall in reduced federal funding.

The White House contends that its proposal for a "blended rate" of Medicaid financing for states is far superior to GOP plans to give states a fixed block grant to cover all their low-income healthcare needs, no matter how extensive. While indisputably better than the draconian GOP proposal, a blended rate would likely shortchange states of billions in Medicaid financing that they otherwise would receive under a fully implemented health reform law beginning in 2014.

Faced with reduced federal funding, most cash-strapped states will have no choice but to ration healthcare services and further erode already dangerously low provider reimbursement rates

Read more.  

New Medicaid policy is more important than it may seem

 via Hunter of Justice by Nat Hunter

The Obama administration issued guidance last Friday delineating how same-sex couples can be financially protected if one becomes Medicaid eligible in the process of securing long-term care for a serious disability (often age-related).

As the letter explains, married heterosexual couples have a variety of legal mechanisms that allow the non-disabled spouse to retain some basic assets such as their home. Because of DoMA, same-sex marriages cannot be recognized. Thus no same-sex couples have had access to the same options for preventing spousal impoverishment.

The new guidance letter on Medicaid rules for same-sex couples suggests a variety of ways that the same kinds of considerations can apply to same-sex couples, whether married or not.  This may sound like a mush of bureaucratic legalese, but it is much more than that. Aside from the smart lawyering involved in producing this analysis (kudos to the HHS legal staff), this development is important in both the short and the long term.

In the short term, along with every other baby booomer in the U.S., more and more same-sex couples are entering the final third of life.  Medicaid, originally set up as a health insurance system for the poor, including the "medically indigent," now pays more than half the total costs of long-term care in the U.S. Given the expense of nursing homes even for middle-class Americans, Medicaid has been necessary for millions of elders to receive decent care.  For senior same-sex couples, the new Administration position is a huge and immediate change.

But there is another, potential long-term effect of the new guidance as well. It's less obvious but, with a little investment of energy, one that could help end routinely anti-gay policies in social services agencies.  Here's why -


Read more.

Washington Blade: Obama extends protections to gay couples under Medicaid

via Washington Blade, by Chris Johnson

The Obama administration is set on Friday to issue policy guidance to states expanding their ability to offer same-sex couples the same protections afforded to straight couples when they receive long-term care under Medicaid, the Washington Blade has learned exclusively.

Under the new guidance, dated June 10, states have the option to allow healthy partners in a same-sex relationship to keep their homes while their partners are receiving support for long-term care under Medicaid, such as care in a nursing home.

Medicaid kicks in for a beneficiary to receive care after an individual depletes virtually all of their money. To pay for the beneficiary’s expenses under Medicaid, a state could impose a lein, or take possession, of a beneficiary’s home to pay for Medicaid expenses.

However, federal law prohibits imposing this lein if beneficiaries are married to someone of the opposite-sex who’s still living in their home. The new guidance, signed by Deputy Administrator of the Centers for Medicare & Medicaid Services Cindy Mann, clarifies that states can offer this protection to the healthy partner of a Medicaid recipient in a same-sex relationship.

“A State can have a policy or rule not to pursue liens when the same-sex spouse or domestic partner of the Medicaid beneficiary continues to lawfully reside in the home,” the guidance states.

The Obama administration previously hadn’t articulated whether gay couples could receive these protections under the Defense of Marriage Act, which prohibits federal recognition of same-sex marriage. The guidance doesn’t mandate that same-sex couples receive this protection, but allows states to “incorporate their criteria for determining when to impose a lien in the Medicaid State plan.”

The Department of Health & Human Services had been examining ways to offer more protections to same-sex couples under Medicaid as part of the work it has undertaken for LGBT people, but until now hadn’t issued the policy guidance to states.

Secretary of Health & Human Services Kathleen Sebelius said in a statement the new guidance represents a path for low-income same-sex couples to receive care under Medicaid.

“Low-income same-sex couples are too often denied equal treatment and the protections offered to other families in their greatest times of need,” she said. “That is now changing. Today’s guidance represents another important step toward ensuring the rights and dignity of every American are respected by their government.”

Read the rest.

HIVers and Friends Head for the Hill in April

Every year, hundreds of AIDS advocates from all across the amber waves of grain, from sea to shining sea, head for Capitol Hill in Washington, DC to demand adequate funding and sound public policy for HIV/AIDS programs.

LifeLube has gone many a time and highly recommends it.

Be a part of the solution.

Click here to register.

AIDS Action Supports Early Treatment for HIV Act (ETHA)

WASHINGTON, Aug. 2, 2007 -- AIDS Action today registered its full support for the Early Treatment for HIV Act (ETHA), which will be introduced in The House of Representatives today by the bill's lead sponsors, Speaker Nancy Pelosi (D-CA) and Representatives Ileana Ros-Lehtinen (R-FL) and Eliot Engel (D-NY), with more than 50 bipartisan co-sponsors.

In addition to sending a bipartisan letter of thanks and support to the bill’s lead sponsors, Rebecca Haag, Executive Director of AIDS Action said, “This law will prolong and dramatically improve the quality of people’s lives by increasing access to care and treatment when it is most helpful. In most states, Medicaid now only covers HIV drugs and treatment after a person receives an AIDS diagnosis, when it is much too late in their disease progression; not when treatment and drug therapy can most improve people’s health outcomes. Current Medicaid eligibility rules are out of date with federal guidelines on the standard of care for treating HIV. ETHA will maximize health outcomes and reduce the financial burden on Federal and State healthcare programs.”

ETHA will help eliminate barriers to early drug therapy and comprehensive care for people living with HIV by giving states the option to allow HIV positive people with low incomes to qualify for Medicaid coverage earlier in the course of their infection. As HIV reaches later stages, complications of the disease make treatment more expensive and the costs for antiretroviral (ARV) therapy increases substantially. Early access to medication and quality health services is a necessity for people living with HIV. Unfortunately, ARV therapy is often prohibitively expensive, costing more than $12,000 annually, making it virtually impossible for low-income people, who are often uninsured or underinsured, to access these lifesaving medications.

A 2003 study by PricewaterhouseCoopers showed that if ETHA were passed, over a ten-year period it would lead to net savings overall in State and Federal programs. In addition, those living with HIV who access treatment through Medicaid as a result of ETHA would experience slower progression of their disease. Most importantly, initiation of the program would decrease the number of deaths from people living with HIV on Medicaid from 12% to 6%.

“In 2007, it is sad and shocking that most low-income and uninsured Americans living with HIV do not qualify for state Medicaid programs until they have received an AIDS diagnosis that may come too late for ARV treatment to be optimally effective,” said Ms. Haag. “Without this needed care people may become so sick that they are unable to stay in their jobs and are robbed of their mobility and dignity – it is a shame that we have not had the political will to enact this simple, cost-effective legislation in the previous ten years. Passing ETHA would not only increase the number of people who have access to care, but it would save lives at a 50% greater rate than under current law. We applaud all of the Members of Congress who are coming together to reintroduce this legislation. We will marshal our members and resources to help ensure passage of this lifesaving bill. We will not rest until it passes,” she continued.

POZ - Meet Me in the Lobby: How AIDSWatch Took PWAs to Capitol Hill

April 27, 2007

by Lucile Scott

This past week in Washington, D.C., with the cherry blossoms in full bloom, about 300 HIV positive people converged on Capitol Hill demanding federal AIDS-care reform. But the posse wasn’t marching out front, waving picket signs. Indeed, they could have been mistaken for legislative staff as they strode, in business attire, among the palatial Congressional offices across from the Capitol building. Carrying binders and policy proposals, they scurried from office to office, catching meetings with Congressional Representatives, passing through hallways filled with civic-minded vacationers and a massive contingent of lobbying steelworkers.

The events marked the 14th annual AIDSWatch, organized and sponsored by the National Association of People With AIDS (NAPWA) and the Treatment Access Expansion Project (TAEP). Each year positive people from across the country head to D.C. for three days of lobbying, telling their personal tales to hammer home how seemingly abstract bills affect their lives and others’. “For people on the Hill programs become budgets and numbers,” says participant Jim Pickett, director of Public Policy at the AIDS Foundation of Chicago, who was diagnosed in 1995. “But when people come into the office and tell their stories it resonates with the legislators, like it would with anyone.”

Read the rest.