California governor Gray Davis signed legislation Wednesday that expands the state's Medi-Cal coverage to include people with HIV infection that has not progressed to full-blown AIDS. Currently only people with an AIDS diagnosis who are considered disabled are eligible for benefits under Medi-Cal, the state's Medicaid program. "For the first time Californians who are infected with the virus that causes AIDS, but who have not yet developed the full-blown disease and who also don't have insurance, will be eligible for Medi-Cal," Davis said. "It's high time that our Medi-Cal system met the needs of those living with HIV."
The bill, sponsored by Assemblyman Paul Koretz (D-West Hollywood), grants full Medi-Cal benefits to HIV-positive people already enrolled in the state's AIDS Drug Assistance Program who are not disabled. Medi-Cal, however, will not cover prescription drug costs for those now eligible for coverage; that health care benefit will still be provided through ADAP. As many as 10,000 HIV-positive Californians will now be eligible for the Medi-Cal program. The law now must be approved by federal officials, which oversee all state Medicaid programs.
The program expansion will be paid for by shifting on a voluntary basis current Medi-Cal patients with AIDS from a current fee-for-service system to a less-expensive managed care program, with the savings paying for the new Medi-Cal enrollees. Some AIDS advocates worry that the funding scheme will not adequately cover the new enrollees and that too few current AIDS patients will switch to the managed care option, possibly resulting in across-the-board cuts in benefits.