The Senate voted 54-44 Tuesday to overhaul the nation's Medicare program with legislation AIDS activists say will adversely affect HIV-positive people who receive anti-HIV drugs through government health programs. The bill provides the most sweeping changes to Medicare since its creation in 1965, including a new prescription drug benefit for 40 million older and disabled Americans. The measure passed the House last week by a 220-215 vote. President Bush has said he will sign the bill into law.
Seniors "will finally have the prescription drug coverage they need and the choices they deserve," said Senate majority leader Bill Frist of Tennessee, a supporter of the measure. "At the same time, it preserves traditional Medicare." But 35 Senate Democrats and nine conservative Republicans voted against the bill, claiming it will eventually force seniors into health maintenance organizations and that it contains too many perks for insurance and pharmaceutical companies. AIDS activists, including AIDS Project Los Angeles and New York's Gay Men's Health Crisis, lobbied against the bill because it restricts access to anti-HIV medications for HIV-positive people on Medicaid. Because Medicare provides only direct medical services, many low-income HIV-positive people in the Medicare program receive their anti-HIV medications through Medicaid, making them dually eligible for both government programs. But the Medicare overhaul bill limits dually eligible program participants to only two medications in any one drug class, a potentially deadly restriction for HIV-positive people who take three or more drugs as part of combination therapy to treat HIV infection.
"The current bill will actually do harm by reducing access to medications that low-income people need to survive," said APLA executive director Craig Thompson last week in a press release urging senators to vote against the bill. "And we are not talking about just a few people. Approximately 38% of APLA's 10,000 registered clients are eligible for Medicare." Ana Oliveira, executive director of GMHC, said the Medicare overhaul will affect as many as 50,000 HIV-positive people. "It is unacceptable that HIV-positive Medicare beneficiaries will have less access under this bill than they do now," she said last week in a press release.