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About Just out. (Portland, OR) 1983-2013 | View Entire Issue (Dec. 5, 1997)
ju st out ▼ decom ber 5, 1 9 9 7 ▼ 1 3 The Community’s Home Loan Resource ► New purchase ► Refinance/cash out ► 100% equity loans ► Pre-approved loans ► Pre-qualification by phone or fax Financing HIV care ► Residential, commercial & investment property ► Appointments at your convenience Lawmakers scramble to ensure and expand access to new treatments as Ryan White and ADAP funding shrinks ** ▼ by Bob Roehr ep. Nancy Pelosi (D-Calif.) recently more specifically, how to measure costs and sav introduced the HIV Treatment Im ings. The Clinton administration continues to rely provement Act, which she describes upon a limited accounting that includes only as a comprehensive plan “designed direct medical expenses and savings. Thus it to respond to new treatment opportu concludes that Medicaid expansion will cost more nities created by our investment in AIDS re which the White House opposes. money, search.” Senak argued, “There is no law requiring The bill in part seeks to expand access to budget neutrality [in expanding access to Medic Medicaid— in a limited manner—to those with aid]. This is simply a matter of political will.” HIV who do not have an AIDS diagnosis. Many AI DS advocates are calling for a broader Steve Morin is a Pelosi aide in transition to measurement of federal expenditures, which becoming director of the Policy Research Center would include, among other gauges, the increased at the AIDS Research Institute at the University of tax revenue from those who continue working as California San Francisco. a result of better access to therapy. Such an He briefed the International Association of equation would likely swing the cost/benefit analy Physicians in AIDS Care on the bill at the group’s sis in favor of early intervention. Nov. 11 conference in Washington, D.C. The HIV Treatment Improvement Act, mean Morin said the proposal tries to tackle prob while, would impose new demands upon the lems of accessing the new treatment therapies. states. Many already make their own contribu tions to ADAP, but some are shirking that respon “You don’t have to go too far to find people who are receiving sub-optimal care,” he said, sibility. Morin cited Colorado, which has limited adding that while access to its program early intervention and has foisted large keeps people healthy, numbers of patients it also prevents them onto charity pro from reaching the dis grams. abled status which At the same time, qualifies them for state officials there have called a special Medicaid, an entitle ment program. session of the Legis “We are gradually lature “to figure out ways to rebate their on a course to lose this enormous state sur $3.6 billion in re sources that we cur plus.” rently use for HIV The bill would re care,” he said. quire state ADAPs to meet federal treatment That puts pressure guidelines in deliver on Ryan White and ing services. AIDS drug assistance programs as more pa Steve Morin Morin called the tients seek services. These programs are funded measure a “comprehensive piece to raise visibil under discretionary spending, a portion of the ity around the problem,” but admitted he does not federal budget that must shrink 16 percent over expect the bill to pass in its entirety. the next five years as part of the budget agree eaction to the bill has been cautious. Winnie ment. Medicaid, meanwhile, will be allowed to grow slowly. Stachelberg, political director of the Hu “So if you are phasing people with HI V/AIDS man Rights Campaign, applauded Pelosi’s out of Medicaid, which is a growing program, and leadership on AIDS issues throughout the year. shoehorning them into a shrinking program, you Christine Lubinski, deputy director of the AIDS Action Council, however, said she’s concerned are obviously creating a problem,” Morin said. that putting the matter before Congress might The solution he and Pelosi offered is “a cat result in codifying a lower level of support than egorical eligibility for people who are HIV-in some states offer under existing programs. fected.” In an effort to both control costs and gain She also would have handled the politics dif ferently: “I would have grabbed a Republican broader political support, the proposal would provide more limited benefits than those received cosponsor.” by regular Medicaid recipients. Not everyone favors Medicaid expansion. Kevin Ivers, political director of Log Cabin Re Morin believes the proposed Medicaid expan publicans, said, “It goes in the wrong direction. sion would cost about $5 billion, but it would save It’s a non-targeted generalized expansion of en nearly $4 billion in acute hospitalization and $3 titlements which means an expansion of bureau billion in Social Security Disability payments. cratic spending.” He initially thought there was a real shot at getting it attached to the recently passed Labor/ Jim Driscoll, Log Cabin’s AIDS lobbyist, Health and Human Services budget reconcilia called Medicaid expansion unfeasible for a num ber of reasons. tion bill, but that opportunity slipped away. “One is, what do you do with the other disease Several AIDS lobbyists voiced frustration with the lack of support from the White House, point groups? If you expand for AIDS you’ve got to do ing to Vice President Al Gore’s April initiative on it for Parkinson’s, cancer, all of them. And what Medicaid expansion, now long delayed and ru does that do to the budget? Republicans are terri mored dead. fied of both the budget and attacks from other “The HIV community has seen little tangible disease groups,” he said. results from Health and Human Services,” said Scnak responded, “What we seek is not spe Mark Scnak, policy director with AIDS Project cial treatment for HIV, but for the government to step up to the plate and fix a broken system that Los Angeles. “To promise to study the issues is simply inadequate.” does not serve us adequately.” The sticking point is “budget neutrality,” or R I'm available when you are! ” Office Evenings/Weekends 297-9900 780-1561 M O RTG AG E Colleen Weed 9 9 0 0 S. W. W ilshire Street • Portland, Oregon 9 7 2 2 5 Home of the C% Savings Account sj ’ APY $ 5 0 .0 0 MI NI MUM ATM V IS A C h e c k C a r d A lbina C ommunity B ank 2002 NE Martin Luther King, Jr. Blvd. 503 287-7537 •Annual Percentage Yield Effective August.«), 19V7. 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