PI Action alerts & updates ... 2007

Project Inform’s Health Care Advocacy Priorities for 2007

The following is Project Inform’s Health Care Advocacy program’s agenda for 2007. We welcome input to our work and would like to hear about problems and challenges you or someone you know might be experiencing in these health care programs. We are also interested in your suggestions for solutions.

Please email Anne Donnelly or Ryan Clary with questions or comments. Anne's experience is with Medicare, Medicaid, and California state issues, Ryan's experience is with the Ryan White CARE Act (including the AIDS Drug Assistance Program), Medicaid, and hepatitis C funding and legislation.

Medicare Part D:
Improving the Medicare Part D prescription drug benefit is one of Project Inform’s top priorities. We do our national advocacy work in coalition with the HIV Medicaid/Medicare Working Group (HIVMMWG), where we participate as steering committee members.

In addition to supporting the stated goal by Democratic leaders of requiring the federal government to negotiate lower drug prices for the Medicare beneficiaries, Project Inform and the HIVMMWG have a set of priorities that will strengthen the benefit for people with HIV/AIDS. These policy recommendations include:

• Assuring that AIDS Drug Assistance Program (ADAP) payments count toward an individual’s True Out of Pocket expenditure or TrOOP,

• Codifying the protection for six categories of essential drugs (including anti-retrovirals), and

• Ensuring that there is at least one Medicare plan that offers coverage on both brand and generic drugs through the coverage gap in all states.

Additionally, we will seek to address a problem that approximately 3500 Californians living with HIV/AIDS face in 2007. Most Dual Eligibles (those eligible for both Medi-Cal and Medicare) who have a share of cost in their Medi-Cal services (participants in the medically needy program) lost their Medicare Part D low income subsidy or extra help because they either did not get billed or meet their Medi-Cal share of cost in 2006. Without the extra help, many will have difficulty getting certain drugs they need through Medicare Part D.

Medicaid:
We are also working with the HIV Medicaid/Medicare Working Group on our Medicaid advocacy priorities for 2007. Our priorities for protecting and expanding Medicaid include:

• Ensuring that Medicaid remains an entitlement program and advocate for sufficient funding to meet the needs of those it serves

• Advocating for passage of the The Early Treatment for HIV Act. This legislation would allow states to expand Medicaid eligibility to provide early access to care and treatment for low-income people with HIV who haven’t yet become disabled under the Social Security definition

• Ensuring that prescription drug coverage become a mandatory Medicaid benefit, as opposed to an optional benefit.

Ryan White CARE Act
The Ryan White CARE Act was recently reauthorized for another three years. However, it continues to suffer from years of inadequate funding.

We will work with our national partners, most notably the Communities Advocating Emergency AIDS Relief (CAEAR) Coalition and the National Alliance of State and Territorial AIDS Directors (NASTAD) to advocate for badly needed increases for all Titles of the CARE Act, including the AIDS Drug Assistance Program.

We will also monitor implementation of CARE Act reauthorization and advocate for a smooth process with fair and accurate interpretations of the law.

Hepatitis C
Project Inform is gravely concerned about the hepatitis C epidemic in this country. About 4.1 million American have been infected with hepatitis C virus (HCV), yet only 40% are aware of their status. Additionally, an estimated 225,000 HCV-infected people are coinfected with HIV. Infection with HIV hastens the progression of HCV-related liver diseases.

We will work with our partners in the Hepatitis C Appropriations Partnership to advocate for increased funding for hepatitis C activities of the Viral Hepatitis Division in the Centers for Disease Control and Prevention.

We will also advocate for passage of the Hepatitis C Epidemic Control and Prevention Act. This bill would establish, promote, and support a comprehensive prevention, research, and medical management referral program for HCV.

California State HIV/AIDS Health Care Issues
Project Inform allocates a portion of its health care advocacy work to the California State level. As a national organization located in California, we recognize the value of working in health care at our own state level. Many of the decisions regarding health care have devolved to the state level, making state advocacy increasingly important

By working in California, Project Inform helps ensure that California continues to be a model of quality HIV care for other state care systems. In addition, we can share our experiences, successes, and challenges with other state level advocates. Project Inform does its California advocacy with partners in two coalitions: the California Alliance of HIV Advocates and the Low Income Health Advocates.

Project Inform’s state level priorities include:

• Ensuring full funding for the AIDS Drug Assistance Program

• Ensuring an increase of funding for the Therapeutic Monitoring Program and work with the California State Office of AIDS to review this program and make recommendations for program improvement

• Supporting legislation that removes barriers to more universal and more effectively targeted testing for HIV disease, while maintaining protections for those choosing to test

• Ensuring protections for dual eligibles (those eligible for Medi-Cal and Medicare) in California who are having difficulty accessing medications under Medicare Part D.