California governor Arnold Schwarzenegger on Saturday used his line-item veto power to cut $750,000 from the state's 2005 budget that would have maintained Medicaid reimbursement rates for anti-HIV medications distributed at local clinic pharmacies, the Los Angeles Times reports. The veto won't affect the drug prices charged to Medicaid patients but could reduce how much clinic-based pharmacies are reimbursed by the state for the Medi-Cal medications they disburse to HIV-positive patients. That could force many to simply stop participating in the state Medi-Cal program to avoid financial losses, AIDS advocates say. While HIV patients would still be able to get their medications at pharmacies that continue to participate in Medi-Cal, particularly at large chain pharmacies, it would eliminate "one-stop shopping" services offered at community-based AIDS clinics.
The Los Angeles-based AIDS Healthcare Foundation, the nation's largest provider of HIV care, plans to challenge the veto in court. "The [Schwarzenegger] administration is attempting to save money to the Medi-Cal program through pharmacy rate restructuring," AHF president Michael Weinstein told the Times. "But driving very ill patients away from clinic-based pharmacies...is just bad policy and bad medicine."
Schwarzenegger and state lawmakers were praised by AIDS activists for boosting spending on the state's AIDS Drug Assistance Program by $27 million in 2005. The funding increase will allow the program to avoid capping its enrollment to keep costs down. Schwarzenegger had originally proposed capping enrollment in the program at its current level of 23,900 enrollees. Activists say the enrollment cap would have created a waiting list of more than 1,400 people by the end of 2005.