Early Treatment for HIV Act
S. 860
The Early Treatment for HIV Act would permit state Medicaid programs to cover low-income, HIV- positive Americans before they develop AIDS. The act would amend Title XIX of the Social Security Act to provide states with the option of covering low-income HIV infected individuals as "categorically needy." States taking advantage of this option would be provided with an enhanced federal Medicaid match. The legislation is very similar to the successful effort in 2000 that gave states the option to provide Medicaid coverage to women diagnosed with breast or cervical cancer through a federally funded program.
Current Medicaid Coverage Inadequately Addresses HIV/AIDS
Currently, childless adults living with HIV generally only qualify for Medicaid coverage once they become eligible for Supplemental Security Income. Because an individual is not eligible for SSI until he or she becomes disabled, a person with asymptomatic HIV infection is not eligible for Medicaid until he or she has progressed to full-blown AIDS. Since HIV-positive individuals do not qualify for Medicaid, many lack the ability to receive medical care and medicine to help slow the progression of the HIV and to prevent the onset of opportunistic infections.
Early Coverage Will Improve Quality of Life and Slow Infection Rates
Treating those who are HIV-positive early in the progression of the disease provides numerous benefits. Providing therapy earlier keeps individual viral loads suppressed and delays the immune system weakening that permits opportunistic infections. Additionally, new HIV infections will decrease because of the lower viral loads, the AIDS Drug Assistance Program will be able to provide care to more individuals with HIV because of related savings, and most importantly, the quality of life for countless HIV-positive individuals will be improved. ETHA could help thousands of HIV-positive individuals gain early access to treatment to help them live longer, happier and more productive lives. Simply put, providing coverage earlier, rather than later, is the right thing to do.
ETHA Could Save Taxpayers Money by Reducing Long-Term Healthcare Costs
ETHA could realize federal savings of $31.7 million over a 10-year period.1 Since early treatment for HIV-positive individuals would both delay their need for more expensive forms of treatment and delay the time at which they would become medically disabled, enacting ETHA could produce savings for the SSI, Social Security Disability Insurance Savings, Medicaid and Medicare programs. Additionally, ETHA would lessen the strain on other federal AIDS programs, such as those funded by the Ryan White CARE Act.
What is the Current Status of the Bill?
Sens. Gordon Smith, R-Ore., and Hillary Clinton, D-N.Y., reintroduced ETHA on March 13, 2007. In the 109th Congress, the measure was introduced by Smith and had 38 co-sponsors.
For more information, please contact legislation@hrc.org.
1. PricewaterhouseCoopers, An Analysis of the Early Treatment for HIV Act, May 27, 2003.
Last Updated: Saturday, August 25, 2007