California Gov. Schwarzenegger Proposes Capping Enrollment for State AIDS Drug Assistance Program
California Gov. Arnold Schwarzenegger (R) on Monday proposed $2 billion in midyear spending cuts "primarily" targeting social programs, including a proposal to limit enrollment in the state's AIDS Drug Assistance Program starting Jan. 1, 2004, the San Francisco Chronicle reports. Under Schwarzenegger's proposal, new clients would be placed on a waiting list, according to the Chronicle (Lucas, San Francisco Chronicle, 11/25). ADAPs, which are state-managed, federally funded programs, provide HIV treatment to low-income, uninsured and underinsured HIV-positive individuals (Kaiser Daily HIV/AIDS Report, 11/4). Schwarzenegger's announcement came days after the San Francisco AIDS Foundation sent a letter to him requesting that he "significantly increase" ADAP funding to cover a growing caseload and a lack of adequate federal support. SFAF said that California's ADAP would need approximately $45 million for fiscal year 2004-05 to ensure that all low-income state residents living with HIV/AIDS could receive needed antiretroviral drugs (SFAF letter, 11/20). As of the beginning of the month, 16 states had waiting lists or access restrictions on their ADAPs, with 679 people on waiting lists nationwide, according to the latest "ADAP Watch List" released on Nov. 3 by the National Alliance of State and Territorial AIDS Directors (Kaiser Daily HIV/AIDS Report, 11/4).
Schwarzenegger's proposals got a "cool reception" from Democratic legislative leaders, and some lawmakers said that the governor had retreated from promises that he made during the election campaign, according to the Chronicle. "I don't see a lot of this happening," state Senate President Pro Tem John Burton (D) said (San Francisco Chronicle, 11/25). SFAF was "sharply critical" of the governor's proposed cuts, calling them "inhumane and counterproductive to sound public health," according to a SFAF release. Capping ADAP enrollment could result in "at least" 720 people being denied antiretroviral drugs from Jan. 1, 2004, to June 30, 2004, and could "set the stage" for hundreds more being denied access in the next budget year, according to the release. "The ability of low-income people living with HIV and AIDS to access this program is a matter of life and death," SFAF State & Local Affairs Director Dana Van Gorder said, adding, "If Gov. Schwarzenegger's proposal is enacted, many individuals will become sick and some people will die because they are denied access to life-saving medications" (SFAF release, 11/25). Project Inform also "strongly criticize[d]" the cuts, saying that capping ADAP enrollment is "unprecedented" and violates Schwarzenegger's pledge not to "balance the state's budget on the backs of the most vulnerable Californians" (Project Inform release, 11/25). The AIDS Healthcare Foundation said that the proposed cuts would "gut services to the state's most vulnerable citizens," according to an AHF release. "Cutting medical care to poor people with AIDS is simply not the way to solve California's fiscal woes," AHF President Michael Weinstein said (AHF release, 11/25).
SFAF's report, titled "Critical HIV/AIDS Budget Issues for 2004-2005: A Report to the Schwarzenegger Administration," is available online.
Long Island Newsday Examines States With ADAP Waiting Lists
Long Island Newsday on Wednesday examined several states that have growing waiting lists for ADAPs. In many states, waiting lists for ADAP assistance with antiretroviral drugs have gotten longer as patients in the programs live longer, the number of HIV-positive people increases and states facing budget deficits restrict eligibility requirements, according to Newsday (Garrett, Long Island Newsday, 11/26). The complete article is available online.