Streamlining HIV care by shifting current federal spending, including Medicaid funds, into a single entitlement program would help the thousands of low-income Americans with HIV who are not getting proper care, a report by the nonprofit Institute of Medicine recommended Thursday. Such expanded coverage--including mental health and substance abuse assistance--would cost $5.6 billion over 10 years, according to the IOM study, which was sponsored by the Department of Health and Human Services.
Currently government programs are hindered by state budget shortfalls and confusing eligibility standards that vary from state to state, resulting in thousands of people lacking access to new and improved anti-HIV drugs, the report notes. "Failing to provide these cost-effective, lifesaving drugs to all Americans who need them--including individuals who lack insurance or cannot afford them--is indefensible," says Lauren LeRoy, chair of the committee charged by Congress to examine the public finance structure of HIV care for low-income, uninsured, and underinsured people.
Providing a single public financing arrangement--including uniform eligibility requirements and a federally defined set of services--would address gaps and coordination lapses in the current system. "The current federal-state partnership for financing HIV care is unresponsive to the fact that HIV/AIDS is a national epidemic with consequences that spill across state borders," according to the panel. The study's authors also stress that a single entitlement program would relieve cash-strapped state Medicaid programs.
Under the proposed program the report estimates that as many as 58,000 more people would receive HIV treatment, and immediate access to drug therapy could prevent around 20,000 deaths over a 10-year period. The "committee has recommended fundamental changes, in effect arguing that existing cooperative programs should be replaced by a new federal entitlement program. Such an approach would require sweeping legislative changes," HHS officials say in a statement, suggesting the panel's recommendations were overreaching. HHS adds that it is reviewing its existing programs. (AP)