:: Medicaid Advocacy Initiatives

Given the important role that Medicaid plays in the lives of those living with HIV/AIDS, ensuring access is the cornerstone of TAEP's work. Medicaid is the single largest public health care provider for people with HIV/AIDS in the United States. For people living with HIV/AIDS, access to comprehensive treatment and prescription medications is literally a matter of life or death. Therefore, TAEP dedicates the vast majority of its work to preserving and enhancing state and federal Medicaid provisions that affect care and treatment access for people with HIV.

On the federal level, TAEP coordinates efforts to secure passage of the Early Treatment for HIV Act (ETHA), which would readily allow states the option to provide Medicaid coverage to persons living with HIV. ETHA was originally filed in the 106th Congress, and reintroduced in the 107th and 108th with increasing bipartisan support. Currently, the 109th Congress Senate bill, S. 311, has 33 cosponsors. This bipartisan support strengthens the chance of ETHA becoming a reality in the near future.

Because Medicaid is a joint federal-state program-and states have incredible discretion in program design-TAEP also provides technical assistance and resources for state-based Medicaid advocacy efforts. As states struggle with dire economic conditions and mounting deficits, many are looking at their Medicaid programs for ways to cut costs. Most states have implemented or plan to implement Medicaid cost-containment measures that gravely affect access. Examples of these cost-containment measures include:

•   Cutting benefits and services covered
•   Eliminating optional services and enrollment categories
•   Restricting eligibility guidelines
•   Imposing premiums and other beneficiary cost sharing
•   Limiting access to prescription drugs

Through its Fighting Medicaid Cuts: A State-based HIV Advocacy Initiative, TAEP will provide technical support, research assistance, and other resources to strengthen state-based advocacy efforts to challenge these and other measures that compromise access to care. TAEP will conduct workshops for consumers, advocates, health care providers, pharmaceutical industry representatives and other stakeholders in select states facing Medicaid challenges. These workshops will begin fall 2004 in Florida and Colorado. Both state governors have expressed interest in applying for a federal waiver that would eliminate Medicaid's entitlement status by capping program spending and enrollment. Future workshop sites will include Alabama, Mississippi and Ohio where public officials are exploring ways to reduce Medicaid costs through elimination of beneficiary categories, increased cost sharing, and restrictions on prescription drug access.

Also in fall 2004, TAEP will release and widely disseminate its Fighting Medicaid Cuts: A State-Based Action Kit. This toolkit provides an overview of Medicaid enrollments and benefits, principles and arguments for fighting Medicaid cuts, and strategies on how to work with the media, providers, the pharmaceutical industry and other health advocacy coalitions to educate and influence public health officials and legislators. TAEP will also provide state-specific technical assistance to those interested in learning more about how to implement this toolkit. If you would like to learn more about TAEP's Medicaid advocacy activities or would like to receive support in your efforts to save Medicaid in your state, contact Kali Lindsey, TAEP Director of Federal Government Affairs, at 240-247-1019 or klindsey@taepusa.org.