[Congressional Record Volume 145, Number 59 (Wednesday, April 28, 1999)]
[Senate]
[Page S4364]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. TORRICELLI (for himself, Mr. Kerry, Mrs. Murray, and Mrs. 
        Boxer):
  S. 902. A bill to amend title XIX of the Social Security Act to 
permit States the option to provide Medicaid coverage for low-income 
individuals infected with HIV; to the Committee on Finance.


                  early treatment for hiv act of 1999

  Mr. TORRICELLI. Mr. President, I rise today to introduce the Early 
Treatment for HIV Act. In recent years, exciting scientific 
breakthroughs have led to an improved understanding of AIDS and 
provided powerful new treatments for Americans living with HIV disease. 
Commonly known as the protease cocktail, these drugs have helped 
transform HIV into a manageable chronic disease. To be most effective, 
the medical community and the U.S. Department of Health and Human 
Services (HHS) recommends the use of these treatments early in the 
course HIV infection, before the onset of symptoms. Tragically though, 
the high cost of these drugs means that only those of significant 
financial means have access to them.

  In another tragic irony, vulnerable low-income HIV-positive Americans 
cannot receive AIDS-preventing drugs under the Medicaid program until 
they develop full blown AIDS. By that time, their preventive value has 
greatly diminished. To correct this glaring flaw in the Medicaid 
program, the Early Treatment for HIV Act will ensure that HIV positive, 
low income patients, will be eligible for medical services immediately.
  The benefits of this legislation are overwhelming. A report released 
at the 12th World AIDS Conference in Geneva found that treatment for 
HIV early in the course of the disease is both medically and 
economically effective. Another report by the University of California 
found that expanding Medicaid to provide wider access to HIV therapies 
would prevent thousands of deaths and AIDS diagnoses, leading to 14,500 
more years of life for persons living with HIV disease over five years.
  In terms of economic savings, several recent studies have found that 
money spent ``up front'' on medications are offset by later savings on 
hospitalizations and other expensive care and treatments for AIDS-
related illnesses. A report by the Medical Associates of Los Angeles 
found that each dollar spent on combination drugs therapies resulted in 
at least two dollars of savings and overall treatment costs.
  Mr. President, the Early Treatment for HIV Act will help thousands of 
low-income people with HIV live longer, more fulfilling lives by 
allowing them to overcome the financial barriers to effective medical 
treatments.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 902

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Early Treatment for HIV Act 
     of 1999''.

     SEC. 2. OPTIONAL MEDICAID COVERAGE OF LOW-INCOME HIV-INFECTED 
                   INDIVIDUALS.

       (a) In General.--Section 1902 of the Social Security Act 
     (42 U.S.C. 1396a) is amended--
       (1) in subsection (a)(10)(A)(ii)--
       (A) by striking ``or'' at the end of subclause (XIII);
       (B) by adding ``or'' at the end of subclause (XIV); and
       (C) by adding at the end the following:

       ``(XV) who are described in subsection (aa) (relating to 
     HIV-infected individuals);''; and

       (2) by adding at the end the following new subsection:
       ``(aa) HIV-infected individuals described in this 
     subsection are individuals not described in subsection 
     (a)(10)(A)(i)--
       ``(1) who have HIV infection;
       ``(2) whose income (as determined under the State plan 
     under this title with respect to disabled individuals) does 
     not exceed the maximum amount of income a disabled individual 
     described in subsection (a)(10)(A)(i) may have and obtain 
     medical assistance under the plan; and
       ``(3) whose resources (as determined under the State plan 
     under this title with respect to disabled individuals) do not 
     exceed the maximum amount of resources a disabled individual 
     described in subsection (a)(10)(A)(i) may have and obtain 
     medical assistance under the plan.''.
       (b) Conforming Amendments.--Section 1905(a) of the Social 
     Security Act (42 U.S.C. 1396d(a)) is amended, in the matter 
     preceding paragraph (1)--
       (1) by striking ``or'' at the end of clause (x);
       (2) by adding ``or'' at the end of clause (xi); and
       (3) by inserting after clause (xii) the following:
       ``(xii) individuals described in section 1902(aa);''.
       (c) Exemption from Funding Limitation for Territories.--
     Section 1108(g) of the Social Security Act (42 U.S.C. 
     1308(g)) is amended by adding at the end the following:
       ``(3) Disregarding medical assistance for optional low-
     income hiv-infected individuals.--The limitations under 
     subsection (f) and the previous provisions of this subsection 
     shall not apply to amounts expended for medical assistance 
     for individuals described in section 1902(aa) who are only 
     eligible for such assistance on the basis of section 
     1902(a)(10)(A)(ii)(XV).''.
       (d) Effective Date.--The amendments made by this section 
     shall apply to calendar quarters beginning on or after the 
     date of the enactment of this Act, without regard to whether 
     or not final regulations to carry out such amendments have 
     been promulgated by such date.
                                 ______