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Expand Access to Universal
Health Care Coverage
Summary,
Status, Action You Can Take
and Read More
Updated:
September 19, 2006
Summary:
Health care access for persons living with HIV can literally add decades
of life. It is also an important part of a comprehensive strategy to hold
new HIV infections in check. Research shows that persons living with HIV
who are in regular health care also tend to know more and do more to reduce
risk of infecting others.
It is estimated that almost half of the 4,600 people known to be living
with HIV in Minnesota get their health care through private insurance.
The other half depend upon one or more publicly-funded programs. For some,
it is Medical Assistance, the Minnesota version of Medicaid that is available
to very low income families. For others, it is Medicare; the health care
option open to low income people who have experienced progressive deterioration
of HIV disease and qualify as disabled. In the past, some very, very low
income persons living with HIV who were not married got health care coverage
through GMAC [General Medical Assistance Care]. However, funding for that
program was substantially cut as part of the State's "no new taxes"
budget deal in 2003. As was funding for Minnesota Care, which resulted
in limiting annual benefits to $5,000, less than half of what it costs
annually to pay for standard HIV drug therapy.
Thanks to an appropriation of a little over $1 million annually from the
State of Minnesota's general fund, along with federal Ryan White CARE
Act dollars, many Minnesotans who are living with HIV get assistance to
pay insurance premiums. Some of these are people who had coverage while
they were working and are getting insurance reimbursement help to convert
their employer group policies to individual policies. Others are getting
comprehensive health services through MCHA, the state's shared risk insurance
provider for people who can't get coverage from anyone else.
Another CARE Act-funded program reimburses the cost of paying for HIV
drug treatments. Minnesota gets about $2.8 million annually from the federal
government for ADAP - the AIDS Drug Assistance Program. Plus, since the
state buys so much from drug companies, it gets an after-the-fact discount
or a rebate from the drug companies at the end of each year -- dollars
that can be used to expand the impact of the federal ADAP dollars. ADAP
has been Minnesota's safety net of last resort for persons living with
HIV. Traditionally, ADAP has covered the cost of drug therapies for a
short period of time while an effort is made to put one of the more comprehensive
health coverage plans in place that are described above. In some cases,
ADAP has also been a source of funds for paying insurance premiums.
As recent at 2002, there was a surplus of ADAP and rebate dollars that
was big enough to use for a rainy day. In fact, the State "borrowed"
$1 million of the rebate dollars to use in a drug assistance program for
seniors and people with other disabilities. However, the going is getting
rough for ADAP. Along with the good news that people are living longer
as a result of HIV treatments is the budgetary burden of paying insurance
premiums for a longer period of time. Also, at least 120 people, and maybe
more, have become dependent upon ADAP drug or insurance reimbursement
because they lost their health care when GAMC was gutted and Minnesota
Care benefits cut. Finally, drug costs keep going up and up and up, putting
more pressure on an already stretched ADAP.
There are a lot of thoughts about how to keep HIV health care access in
Minnesota from falling apart. Some say the answer is in getting the federal
government to increase funding for ADAP. Others suggest there is a need
for a new, long-term, strategic plan for HIV health care funding, which
might include introducing some "sliding scale" costs as well
as shaving off some benefits. And still others, and MAP is one of them,
tinker with ADAP is not enough -- HIV advocates need to become partners
in a renewed push for affordable, universal health care.
Update March 8, 2004:
Gov. Pawlenty introduced his supplemental budget for 2005. The
budget includes $2.1 million for HIV drug and insurance reimbursement.
Half of the appropriation to the state ADAP budget fund essentially repays
the rebate dollars that were "borrowed" in 2002. The other half
covers a shortfall projected through June 2005 due, in part, to cuts made
last year in various state health programs, increased drug costs, and
the fact that persons with HIV are living longer, thus needing benefits
for a longer period of time.
Action
You Can Take:
1. Keep informed. Check the current issue of the MAP
Advocate to find out what's happening.
2. Write a letter. Send a letter to the editor of your local paper or send and email to a friend.
3. Contact your legislators. Send an email or make a phone call to your State Senator and State Representative.
Read
More:
HF3060
MAP
Advocate
MAP Action Agenda
MAP Facts
Senate Bill Addresses Rising Costs of Drugs, Health Care
Labor Union Coalition Proposes Establishing Health Care as a Right for All Minnesotans
Governor's Budget Recommendation for HIV Drug and Insurance Reimbursement
Senate Bill Addresses Rising Costs of Drugs, Health Care
Labor Union Coalition Proposes Establishing Health Care as a Right for All Minnesotans
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Last Updated:
Friday, March 30, 2007
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