The Early Treatment for HIV Act, which would expand Medicaid coverage of anti-HIV drugs to include people with asymptomatic HIV infection, was introduced Thursday in the U.S. House of Representatives. The bill, introduced by Rep. Nancy Pelosi (D-Calif.) and Jim Leach (R-Iowa), and supported by 68 other House Democrats and Republicans who signed on as cosponsors, could reduce by 60% the AIDS death rate among HIV-positive people on Medicaid, according to independent researchers. The bill is supported by a wide coalition of health care providers, HIV activists, AIDS caregivers, and the pharmaceutical industry. A similar measure was introduced in the Senate last year by Sen. Hillary Rodham Clinton (D-N.Y.) and Sen. Gordon Smith (R-Ore.) and is expected to be reintroduced this year.
If adopted, the law would allow state Medicaid programs the option of providing medical services to people living with HIV who have not progressed to an AIDS diagnosis; Medicaid currently only covered AIDS patients. According to researchers at PricewaterhouseCoopers, ETHA would not only significantly slash the AIDS-related death rate among Medicaid participants, but it would actually reduce long-term Medicaid costs; it would do so by helping to keep HIV-positive people healthier and prevent AIDS-related opportunistic infections, which are difficult to treat and often require extensive and expensive hospital stays.
"The cruel irony of the current situation is that poor people living with HIV are denied treatment and care under Medicaid until they develop serious AIDS-defining conditions [that would have] often [been] preventable if Medicaid coverage had been available to them sooner," says Paul Feldman of the Washington, D.C.-based National Association of People with AIDS. "Making HIV care and treatment available before AIDS sets in protects health and reduces public health care spending." According to Laura Hanen, policy director of the National Alliance of State and Territorial AIDS Directors, "ETHA gives states the opportunity to bring their Medicaid eligibility rules in line with federal government guidelines on the standard of care for treating HIV."
Democratic presidential candidates John Edwards, John Kerry, and Dennis Kucinich all support ETHA, according to responses to a questionnaire posted on the Web site AIDSvote.org. Democrat Al Sharpton and President Bush did not respond to the questionnaires, which covered a number of AIDS-related issues.