Report Three: Continued Step for Presidential Action (Draft)

The Services Sub-Committee received a proposed letter to (he President
regarding Medicaid. This is being submitled to the council for theirre vie w. The
Services commillee will be discussing whether they feel snoher Medicaid letter
should be sent to the Presient and wi discuss tat during theirirport
DRAFT LETTER TO THE PRESIDENT REGARDING MEDICAID
April 1996
President Clinton
The White House
Washington, DC
Dear President Clinton:
In accordance with the voices of people living with HIV/AIDS, AIDS service
organizations, health care professionals and institutions throughout the country, the President's
Advisory Council strongly urges you to protect the integrity of health care services financed by
our current Medicaid system and to oppose all attempts to unnecessarily weaken this already
fragile safety net.
Discrimination, pre-existing condition exclusions, lifetime coverage limits, experience
rating and other health insurance practices have all served as barriers to people with HIV disease
in receiving adequate private health care coverage. Medicaid has, therefore, become the only
form of health care coverage available to many people living with HIV/AIDS. Medicaid works
well in conjunction with Ryan White and other programs to fund health care for people with
HIV/AIDS. Yet, these programs would clearly be unable to survive any significant damage to the
Medicaid structure.
Most of the Medicaid proposals that have been introduced in the 104th Congress as well as
the proposal presented to Congress by the National Governors Association, if passed, would be
devastating for people living with HIV/AIDS. Specifically, the Council makes the following
recommendations regarding all present and future Medicaid reform proposals:
1. Block granting Medicaid would be a sweeping change that would diminish profoundly the
ability of people living with HIV/AIDS to access health care. Block granting of Medicaid.in any
form is unacceptable.
2. Any sizable cuts to projected Medicaid growth would result in a loss of coverage for some,
essential services for others and a loss of both for still others. Without its status as an entitlement,
a Medicaid block grant will provide care only until the allocated money runs out. The cuts in
Medicaid growth set by almost all current Congressional proposals guarantee that the money will
run out. The federal allotment for Medicaid cannot suffer significant cuts. Also, Federal funds
must be used to leverage state participation in the Medicaid program by requiring states to
maintain their current levels of spending on Medicaid.

Rough Draft doe