Reductions in Medicaid HIV/AIDS Coverage Could Create ‘Public Health Crisis,’ Opinion Piece Says
President Bush's proposed changes to Medicaid coverage for HIV/AIDS care could lead to a "potential public health crisis that could leave many without lifesaving medications and treatment," Dr. John Bartlett, chief of infectious diseases at the Johns Hopkins School of Medicine, writes in a Baltimore Sun opinion piece. Currently, the federal contribution to state Medicaid programs is "open-ended," providing matching funds of "at least dollar for dollar," Bartlett states. But the proposed changes would cap annual federal allocations to states and also give states less federal program oversight, Bartlett says. If states accept the capped amount, they would garner more funds in the short term, but federal funding for HIV/AIDS care through Medicaid would "dramatically diminish in later years," with an estimated decrease of $8.3 billion in 2013, he writes. Bartlett says that states would also forfeit continuous federal funding for unforeseen problems -- such as economic recession, with its subsequent rise in Medicaid caseload -- or for the emergence of new infectious diseases, such as severe acute respiratory syndrome, or SARS. The administration's proposed changes could lead to "many individuals losing their coverage and many others losing critical services, including services that save lives," Bartlett continues, calling on Maryland Gov. Robert Ehrlich (R), who serves on the National Governor's Association task force on Medicaid modernization, to take the "opportunity to preserve Medicaid as a federal entitlement and to prevent the disparities in health care that would occur under a weakened Medicaid program." Bartlett concludes, "The health and well-being of millions of families, people with disabilities and senior citizens here in Maryland and across the nation hang in the balance" (Bartlett, Baltimore Sun, 5/23).
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