by Bob Roehr
WASHINGTON, DC –
Action by the U.S. Senate would allow states to initiate Medicaid demonstration projects of the Early Treatment for HIV Act (ETHA). The effort was led by Senators Gordon Smith (R-Ore.) and Hillary Clinton (D-NY) and was adopted on March 14 as part of the 2009 Budget Resolution.
ETHA has been the holy grail of AIDS advocates for more than a decade. It would allow states, through Medicaid, to offer access to treatment to low income persons infected with HIV prior to their health deteriorating to full-blown AIDS.
It is modeled after existing programs for breast and cervical cancer and is a component of SCHIP legislation that would have extend health coverage to more children. SCHIP was vetoed last year by President George W. Bush and Congress fell a few votes short of overriding that veto.
The amendment creates a reserve fund for ETHA. Initially that was set at $500 million but the final version of the amendment included no dollar figure for the program, it simply allows the budget chairman to fund it if offsetting funds can be identified elsewhere in the budget.
The overall budget resolution passed the Senate 51 to 44, largely on a party line vote.
A companion ETHA bill was introduced in the House last August. However, it was not included in the Budget Resolution that passed that body 212 to 207 on March 13.
It is not clear whether ETHA will survive a conference between the two chambers to work out differences between the two bills. It is even less clear whether Congress eventually will appropriate funds for ETHA demonstration programs by state Medicaid offices.
Under budgetary restraints adopted by the Democrats known as "paygo" [pay as you go], new spending has to be offset by cuts elsewhere or by the imposition of new taxes. The later course is not considered a viable political option in an election year.
Back in the House, Rep. Maxine Waters (D-Calif.) was pressing the case for more funding for the Minority AIDS Initiative in a March 19 letter to the Appropriations Committee signed by 79 members. They are asking for $610 million in fiscal year 2009, an increase of about 50 percent over current funding.
