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N.J. sets income cap for free AIDS medications, cutting off nearly 1,000
  Monday, July 12, 2010
The Record
New Jersey will no longer provide free AIDS medications for 950 people who are HIV-positive, under a little-noticed provision of the state budget enacted this month.
In letters received over the weekend, the state Health Department told patients about new income guidelines for a program that enables thousands infected with HIV or diagnosed with AIDS to receive life-sustaining yet expensive anti-retroviral drugs. As of Aug. 1, a patient's income cannot exceed $32,490, instead of the previous threshold of $54,150.
"We were blindsided," said a southern Bergen County man, whose HIV-positive son, 35, has relied on the program for 10 years to pay for prescriptions, which now run more than $2,500 monthly. "Through the mercy of God and these pills, the HIV is undetectable in his body."
The younger man planned to go fulltime this summer from his part-time job in the food business, but now won't - because it would disqualify him from the program, his father said "That $22,000 [change in the eligibility standard] is the difference between life and death for a person who wants to make it in society," he said. "I don't think Governor Christie has a right to play God."
As President Obama announces America's first comprehensive AIDS strategy Tuesday, one of the nation's most effective programs - drug subsidies through the federal AIDS Drug Access Program - is in crisis. Waiting lists hit a record 2,290 nationwide last week, the National Alliance of State and Territorial AIDS Directors said.
The recession has caused more patients to turn to state drug programs for help, as jobs and insurance are lost. But state contributions have dropped while federal funding remains flat. Meanwhile, better testing programs have identified more patients with HIV who can benefit from early treatment and patients are living longer.
More than 35,000 people in New Jersey are living with HIV or AIDS, including 2,587 in Passaic County and 1,560 in Bergen County.
The New Jersey program enrolled 7,645 people last year, and will probably lose about 1,000 this year, said Dr. Susan Walsh, deputy commissioner of health. The vast majority of recipients are uninsured; nearly half are African-American and 27 percent Latino. Of its $89 million budget this year, New Jersey provides 22 percent, the federal government 38 percent, and drug-manufacturer rebates 38 percent.
New Jersey has not started a waiting list for the program, but it has taken other steps to reduce costs. Besides reducing eligibility from 500 percent to 300 percent of federal poverty guidelines, the state has cut the list drugs it covers.
"It's just a very difficult budget year," said Walsh. New Jersey had been one of only five states to extend eligibility to those up to five times the federal poverty level, she said, and the new income restrictions bring New Jersey into line with 28 other states.
Health and Human Services Administrator Kathleen Sibelius last week announced $25 million in emergency funding for states with waiting lists, but it's unclear whether New Jersey and states that imposed other cost-containment steps will be considered, Walsh said. "I'm doing my darnedest to see what additional dollars are available," she said, "but I don't want to hold up false hope.
"There are no current plans to reverse this."
State Sen. Loretta Weinberg, D-Teaneck, urged the state Health Commissioner in a letter Monday to apply for the funds, and to provide assurance that clients dropped from the program will be able to continue their medications.
"These are people who are actually going to have to make a decision between life and work," said Marie Hill, a caseworker at New Jersey Buddies, a Hackensack service organization for people who are HIV-positive or have AIDS. By noon Monday, she'd received 11 phone calls from affected patients in Bergen County and identified three "casualties" who would no longer be able to afford their medicine, she said.
Kathy Ahearn-O'Brien, executive director of the Hyacinth Foundation, a statewide advocacy and service group for people with AIDS and HIV, said the problem is a "Catch 22": many of those affected are in jobs with health insurance, and use the program to pay prescription copayments, which total hundreds of dollars monthly. To stay in treatment now, they need to quit work.
"This is somebody's medications we're cutting," said Steve Scheuermann, executive director of New Jersey Buddies. "The idea that this saves costs is very shortsighted."
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