Funding problems persist for state AIDS help

Dwindling state dollars, growing disease rates and increasing prices hurt the drug support programs.

By Joel B. Finkelstein, AMNews staff. Jan. 17, 2005.

Washington -- Tough times are increasingly squeezing state AIDS drug assistance programs, which were already struggling to meet the needs of the infected patients.

ADAPs, established as part of the Ryan White CARE Act, are the last stop for HIV and AIDS patients without access to private or public health insurance who need antiretroviral therapy to stay alive. But federal and state funding for the programs has failed to keep up with need. This has led many states to adopt cost-containment measures, such as enrollment caps, waiting lists and formulary restrictions.

Congress added $38.7 million to ADAP funding, for a total of $787.28 million in fiscal year 2005, but experts question whether that money will go far enough.

"It is not going to get us out of the hole that we're in," said Laura Hanen, director of government relations for the National Alliance for State and Territorial AIDS Directors.

Although the extra federal funding is helpful, many ADAPs are getting little or no money from their state governments. In addition, Medicaid eligibility cuts are increasing patient loads for ADAPs, while the cost of drugs for the programs continues to increase.

These trends are troubling but are really just the tip of the iceberg, said Bruce Schackman, PhD, assistant professor of health policy at Cornell's Weill Medical College in New York City.

The Centers for Disease Control and Prevention estimates that there are between 850,000 and 950,000 HIV-positive people in the United States. But as many as a quarter of them don't even know that they are infected.