America Living With AIDS

2. Medicaid should cover all low-income people with HIV disease.
The Commission recommends eliminating the disability requirement and raising
the income level for Medicaid eligibility for people with HIV disease. By eliminating the disability requirement, low-income people with HIV infection who
have not had a clinical diagnosis of AIDS could be covered by Medicaid and
receive the early intervention treatments and services they need. Increasing the
income eligibility requirement would prevent many people with HIV infection
from having to impoverish themselves in order to qualify for basic health care
services. At the same time it would relieve some of the reliance on public hospitals by the uninsured.
The Commission strongly believes these changes should be mandated; however,
at the very least, states should be given the option of making these changes. In
addition, the Commission believes these changes can and should lead to further
changes that will include people with serious chronic conditions other than HIV
disease.
3. Medicaid payment rates for providers should be increased sufficiently to ensure
adequate participation in the Medicaid program.
Unrealistically low reimbursement rates under the Medicaid program serve as a
serious disincentive for health care providers to care for people who rely on Medicaid. Medicaid rates should be raised to Medicare levels.
4. Congress and the Administration should work together to adequately raise the
Medicaid cap on funds directed to the Commonwealth of Puerto Rico to ensure
equal access to care and treatment.
Because of the existing cap on Medicaid funds allocated to the Commonwealth of
Puerto Rico, none of the Medicaid recommendations the Commission has put
forward to expand benefits for people with HIV disease would include individuals living in this part of the United States.
5. States and/or the federal government should pay the COBRA premiums for lowincome people with HIV disease who have left their jobs and cannot afford to
pay the health insurance premium.
6. Social Security Disability Insurance (SSDI) beneficiaries who are disabled and
have HIV disease or another serious chronic health condition should have the
option of purchasing Medicare during the current two-year waiting period.
Medicaid should be required to purchase Medicare coverage for low-income
SSDI beneficiaries.
7. The federal government should fund the Ryan White CARE Act at the fully
authorized level.

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