January 4, 2009

January 4, 2009
New York to Cut ADAP Funding

Welcome back to another day in my life. I hope you are having a great weekend.

Gary and I are traveling back to Florida from South Carolina today. We have been up here because of his mother passing away recently.

Then we have to get up at 2am to head to the Jacksonville airport and fly to Los Angeles where I will receive a life time achievement award for my work in the HIV/AIDS community.

Now on to the topic of today which is New York is cutting their ADAP program. Now most of you know how I feel about ADAP waiting lists now that truly life saving HIV medications are available.

The state budget for the 2009 fiscal year that was proposed by Governor David Paterson slashes funding for AIDS services, including a $65 million cut to the AIDS Drug Assistance Program (ADAP) which pays for anti-HIV drugs and some medical services for uninsured people not eligible for Medicaid, including undocumented immigrants, who are infected with the virus.

"With the incidence of HIV infection on the rise, particularly among communities of color, women, and young gay men, it is ill advised to cut funding to HIV/AIDS treatment and prevention," said Dr. Marjorie J. Hill, chief executive officer of the Gay Men's Health Crisis (GMHC), in a written statement. "On the contrary, additional investments in HIV/AIDS programs will not only work to save lives and create improved health outcomes, but will also save the state money in the long run by cutting down on costs for acute medical care."

Faced with a $13.7 billion deficit in the next fiscal year, which begins on April 1, Paterson allowed the state's Medicaid program, the health plan for the poor and disabled, to grow by just one percent, but only after considering federal contributions. The state expects to spend $45.4 billion on Medicaid in the 2009 fiscal year. Paterson proposed cutting Medicaid spending by $3.5 billion in the upcoming fiscal year and then by $3 billion in the fiscal year after that.

Many people with HIV rely on Medicaid to pay for their healthcare and some AIDS groups get a significant portion of their budgets providing Medicaid-reimbursed services. State budget documents suggest the cuts will fall mostly on hospitals, nursing homes, and long term care facilities.

Altogether, the state will spend $121.1 billion in the next fiscal year if Paterson's budget is approved. That is by no means assured given that his proposed combination of cuts and tax increases has already met some resistance in Albany. GMHC reported that the proposed budget cuts $6.5 million from "the Office of Alcoholism and Substance Abuse Services for people living with HIV/AIDS," more than "$2.5 million from programming for communities of color," and eliminates all "legal services funding for HIV/AIDS providers."

The legal services dollars pay for lawyers who obtain government benefits for people with HIV as well as funding other legal advocacy efforts. In budget documents, the state asserted that the budget "sustains the state's commitment to fighting the AIDS epidemic by providing statewide spending of $3.5 billion for AIDS programs, including $125 million for the AIDS Institute. Emphasis will continue to be placed on prevention and specialized services that target resources to populations with the greatest risk of infection."

The ADAP cut of $65 million, the entire state contribution to that program, is significant. The 2007 ADAP budget was $241 million with the state contributing $45 million, according to data from the Henry J. Kaiser Family Foundation. The federal government contributed $136 million and rebates from drug companies accounted for $59 million.

ADAP pays for anti-HIV drugs and some services for people who may be employed, do not qualify for Medicaid, and are unable to afford private health insurance.

Undocumented immigrants cannot qualify for most Medicaid services and some who are HIV-positive rely on ADAP, which does not ask about immigration status, to pay for a portion of their healthcare. "On behalf of the over 100,000 New Yorkers living with HIV, we are appalled and shocked that the governor would choose to balance the state budget by cutting health care for people with HIV," said Matthew Lesieur, director of public policy at the National Association of People With AIDS and Village Care of New York, a health care provider. "For most people on ADAP, that program is their only option to afford drugs, doctor visits, and lab tests."

State budget documents assert that the ADAP cut will be recouped through rebates from drug companies and from additional federal funds.

"ADAP is already funded with drug rebates and federal funds," Lesieur said. "There is no windfall somewhere else that they can tap into and I don't believe the feds are coming to the rescue on this program."

Lesieur noted that states that provide less generous benefits to people with AIDS still contribute to their ADAP programs. "Even some of the poorer, less progressive states in the union, such as Alabama, contribute to their ADAP programs," he said. "I find it unbelievable that New York would want to fall behind Alabama on its ADAP program."

So everyone needs to start calling, writing and emailing the Governor of New York.

David A. Paterson State Capitol Albany, NY 12224


To contact Governor Paterson by email, click on the link for his website:

Thanks for helping save the lives of financially challenged American men and women in New York. Their lives depend on it.

Wishing you health, hope and happiness.

Big bear hug,

Daddy Dab