[Congressional Record Volume 149, Number 57 (Wednesday, April 9, 2003)]
[Senate]
[Pages S5085-S5091]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. SMITH (for himself, Mrs. Clinton, Ms. Collins, Mr. 
        Bingaman, Ms. Cantwell, Mr. Corzine, Mrs. Feinstein, Ms. 
        Landrieu, Mrs. Murray, and Mr. Wyden):
  S. 847. 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.
  Mr. SMITH. Mr. President, I rise today to introduce the Early 
Treatment for HIV Act, ETHA, of 2003. Senator Clinton joins me in 
introducing this bill, and I want to thank her for her steadfast 
support for people living with HIV. HIV knows no party affiliation, and 
I am pleased to say that ETHA cosponsors sit on both sides of the 
aisle.
  Simply stated, ETHA gives States the opportunity to extend Medicaid 
coverage to low-income, HIV-positive individuals before they develop 
full-blown AIDS. Today, the unfortunate reality is that AIDS must 
disable most patients before they can qualify for Medicaid coverage. We 
can do better, and we should do everything possible to ensure that all 
people living with HIV can get early, effective medical care.
  Current HIV treatments are very successful in delaying the 
progression from HIV infection to AIDS, and help improve the health and 
quality of life for millions of people living with the disease. That is 
why it was so devastating for people in Oregon when, just a few weeks 
ago, the state announced that its Medically Needy program ran out of 
money, and that many patients, including those living with HIV, would 
have to go elsewhere for their treatments. The fact of the matter is 
that safety net programs all over the country are running out of money, 
and are generally unable to cover all of the people who need paying for 
their medical care. As other programs are failing, ETHA gives States 
another way to reach out to low-income, HIV-positive individuals.
  Importantly, ETHA also offers states an enhanced Federal Medicaid 
match, which means more money for States that invest in treatments for 
HIV. This provision models the successful Breast and Cervical Cancer 
Treatment and Prevention Act of 2000, which allows states to provide 
early Medicaid intervention to women with breast and cervical cancer. 
Even in these difficult times, forty-five states are now offering early 
Medicaid coverage to women with breast and cervical cancer. We can 
build upon this success by passing ETHA and extending similar early 
intervention treatments to people with HIV.
  HIV/AIDS touches the lives of millions of people living in every 
State in

[[Page S5086]]

the Union. Some get the proper medications, and too many do not. This 
is literally a life and death issue, and ETHA can help many more 
Americans enjoy long, healthy lives.
  I want to thank Senators Collins, Bingaman, Cantwell, Corzine, 
Feinstein, Landrieu, Murray, and Wyden for joining us as cosponsors of 
ETHA. I also wish to thank all of the organizations around the country 
that have expressed support for this bill. I have received a stack of 
support letters from those organizations, and I ask unanimous consent 
that those letters be printed in the Congressional Record. In 
particular, I want to thank the ADAP Working Group and the Treatment 
Access Expansion Project, led by Robert Greenwald, for helping bring so 
much attention to ETHA. I hope all of my colleagues will join us in 
supporting this critical, life-saving legislation.
  There being no objection, the letters were ordered to be printed in 
the Record, as follows:

                                               American Foundation


                                            for Aids Research,

                                    Washington, DC, April 9, 2003.
     Hon. Gordon Smith,
     U.S. Senate,
     Washington, DC.
     Hon. Hillary Rodham Clinton,
     U.S. Senate,
     Washington, DC.
       Dear Senators Smith and Clinton: Thank you for your 
     sponsorship of the Early Treatment for HIV Act of 2003 
     (ETHA), which would allow states to extend Medicaid coverage 
     to low-income people living with HIV.
       Currently, Medicaid coverage is limited to people who meet 
     very strict income requirements and meet other 
     qualifications, such as being disabled. The disability 
     requirements for Medicaid are such that many low-income 
     uninsured people living with HIV are unable to qualify for 
     Medicaid until their disease has progressed to the point 
     where they are fully disabled by AIDS. Since individuals who 
     are HIV-positive generally do not qualify for Medicaid, many 
     do not have access to the early intervention and treatment 
     that can help slow the progression of HIV and prevent the 
     onset of opportunistic infections.
       There are many benefits to providing access to early 
     intervention and treatment to low-income HIV-positive people. 
     By delaying the progression from HIV to AIDS, savings in 
     treatment costs are realized. Most important, however, the 
     health and quality of life of individuals living with HIV is 
     greatly improved.
       The Early Treatment for HIV Act would provide states with 
     the option of extending Medicaid coverage to low-income, non-
     disabled people living with HIV. As a result, ETHA could help 
     provide early access to care for thousands of individuals 
     around the country.
       We thank you for your leadership and sponsorship of this 
     very important legislation.
           Sincerely,
                                                 Jerome J. Radwin,
     Chief Executive Officer.
                                  ____



                                        Human Rights Campaign,

                                    Washington, DC, April 7, 2003.
     Hon. Gordon Smith,
     U.S. Senate,
     Washington, DC.
     Hon. Hillary Rodham Clinton,
     U.S. Senate,
     Washington, DC.
       Dear Senators Smith and Clinton: Thank you, on behalf of 
     the more than 500,000 members of the Human Rights Campaign, 
     for your sponsorship of the Early Treatment for HIV Act of 
     2003.
       Currently, childless adults living with HIV generally only 
     qualify for Medicaid coverage once they become eligible for 
     Supplemental Security Income (SSI). Because an individual is 
     not eligible for SSI until they become disabled, a person 
     with asymptomatic HIV infection is not eligible for Medicaid 
     until he or she has progressed to full-blown AIDS. Since HIV-
     positive individuals do not qualify for Medicaid, many lack 
     the ability to receive medical care and medicine to help slow 
     the progression of the HIV and to prevent the onset of 
     opportunistic infections.
       Treating those who are HIV-positive early in the 
     progression of the disease provides numerous benefits. By 
     making therapeutics available earlier, treatment costs will 
     diminish, new HIV infections will decrease because of the 
     lower viral loads, the AIDS Drug Assistance Program will be 
     able to provide care to more individuals with HIV because of 
     savings, and most importantly, the quality of life for 
     countless HIV-positive individuals will be improved. Simply 
     put, providing coverage earlier rather than later is the 
     right thing to do.
       The Early Treatment for HIV Act would provide states with 
     the option of covering low-income HIV-infected individuals as 
     `categorically needy'. In this way, this legislation is very 
     similar to the successful effort in 2000 to provide states 
     with the option of providing Medicaid coverage to women 
     diagnosed, through a federally funded program, with breast or 
     cervical cancer.
       On behalf of the countless people whose lives will be 
     improved by enactment of this legislation, we thank you for 
     your leadership and your sponsoring this important 
     legislation.
           Sincerely,
                                               Winnie Stachelberg,
     Political Director.
                                  ____



                                    L.A. Gay & Lesbian Center,

                                   Los Angeles, CA, April 4, 2003.
     Hon. Gordon Smith,
     U.S. Senate,
     Washington, DC.
       Dear Senator Smith: On behalf of the L.A. Gay & Lesbian 
     Center, I am writing to thank you for agreeing to be the lead 
     sponsors of the Early Treatment For HIV Act (ETHA). We 
     wholeheartedly support your efforts to ensure that low-income 
     people with HIV have access to health care by allowing States 
     the option to expand Medicaid programs to cover non-disabling 
     HIV disease.
       ETHA represents a breakthrough in assuring early access to 
     care for thousands of low-income people living with HIV. 
     Current HIV treatments are successfully delaying the 
     progression from HIV infection to AIDS, improving the health 
     and quality of life for many people living with the disease. 
     However, without access to early intervention health care and 
     treatment, these advances remain out of reach for many non-
     disabled, low-income people with HIV.
       Research has shown that providing highly active 
     antiretroviral therapy produces significant cost-savings in 
     reduced hospital costs. By preserving the health of people 
     living with HIV, preventing opportunistic infections 
     associated with the disease, and slowing the progression to 
     AIDS, the Early Treatment for HIV Act could ultimately save 
     taxpayer dollars. Most importantly, should ETHA become law, 
     the United States will take an important step towards 
     ensuring that all people living with HIV can get the medical 
     care they need to stay healthy for as long as possible, 
     enabling individuals to lead productive lives.
       Increasing need as people with HIV live longer and the rise 
     in new infections demand additional resources to provide care 
     and treatment. It is unconscionable that low-income people 
     with HIV should not have access to care and treatment. The 
     demographics of the HIV epidemic have shifted into more 
     impoverished and marginalized communities. Rates of HIV 
     infection are staggeringly high in some communities, with one 
     in ten gay men infected and one in three African American gay 
     men living with HIV.
       In an era of constrained federal resources for health care 
     spending, we must aggressively fight for effective means to 
     finance care for people with HIV. This bill will begin to 
     address these challenges through a permanent funding 
     solution, allowing states to expand the safety net to cover 
     eligible persons with early-stage HIV disease.
       Thank you again for your leadership on behalf of people 
     living with HIV. Please let me know if there is anything I 
     can do to help secure passage of this important legislation.
           Sincerely,
                                                   Rebecca Isaacs,
     Interim Executive Director.
                                  ____



                                San Francisco AIDS Foundation,

                                 San Francisco, CA, April 8, 2003.
     Hon. Gordon Smith,
     U.S. Senate,
     Washington, DC.
     Hon. Hillary Rodham Clinton,
     U.S. Senate,
     Washington, DC.
       Dear Senators Smith and Clinton: The San Francisco AIDS 
     Foundation would like to thank you for your sponsorship of 
     the Early Treatment for HIV Act 2003.
       The Act would provide states with the option of covering 
     low-income people living with HIV as `categorically needy' 
     provide them with medical care and treatment, reduce long 
     term health care costs to states, and address a serious gap 
     in public health care access. Recent breakthroughs in medical 
     science and clinical practice have transformed the 
     possibilities in HIV/AIDS care in the United States. Today, 
     we know that early intervention with medical care and 
     treatment for HIV disease slows the progression of HIV and 
     prevents the onset of opportunistic infections. Application 
     of this knowledge lengthens the life expectancy and 
     dramatically improves the quality of life for many. These 
     changes in science and medical practice demand revisions in 
     the treatment of HIV disease under Medicaid.
       Currently Medicaid eligibility for childless adults is tied 
     to the Supplemental Security Income (SSI) eligibility. The 
     result of this determination is that people living with HIV 
     must wait for Medicaid access until their disease has 
     progressed to a disabling AIDS diagnosis. The cruel irony of 
     this practice is that individuals are forced to incur often-
     irreparable damage to their immune systems before receiving 
     treatments that could have delayed or avoided the damage. 
     This is counter to sound public health practices and all but 
     guarantees higher cost of care for thousands of affected 
     individuals. This serious anomaly in public health care 
     coverage must be rectified by the enactment of this 
     legislation.

[[Page S5087]]

       The AIDS Foundation thanks you both for your leadership and 
     sponsorship of this important legislation.
           Sincerely,
                                                   Ernest Hopkins,
     Director of Federal Affairs.
                                  ____

                                                  Treatment Access


                                            Expansion Project,

                                        Boston, MA, April 7, 2003.
     Hon. Gordon Smith,
     U.S. Senate,
     Washington, DC.
       Dear Senator: The Treatment Access Expansion Project (TAEP) 
     would like to thank you on behalf of our broad-based 
     coalition of members. Your leadership and support of the 
     Early Treatment For HIV Act (ETHA) and your commitment to 
     AIDS and to the HIV community are greatly appreciated.
       As you are well aware, ETHA would allow states to extend 
     Medicaid coverage to pre-disabled people living with HIV. 
     This breakthrough in assuring early access to care for 
     thousands of low-income people living with HIV is imperative. 
     Under current law, AIDS must disable most patients before 
     they can qualify for Medicaid coverage. Enacting ETHA into 
     law would represent an important step toward ensuring that 
     all people living with HIV could get the medical care 
     necessary to remain healthy for as long as possible.
       Current HIV treatments are successful in delaying the 
     progression from HIV infection to AIDS, and thus help improve 
     the health and quality of life for many people living with 
     the disease. By preserving the health of people living with 
     HIV, preventing opportunistic infections associated with the 
     disease, and slowing the progression to AIDS, the ETHA would 
     ultimately save taxpayer dollars.
       The members of TAEP fully endorse the Early Treatment for 
     HIV Act and thank you again for your dedication to the 
     passage of this important legislation.
           Sincerely,
                                                 Robert Greenwald,
                                                 Project Director.

  Endorsers of the Early Treatment for HIV Act, as of February 6, 2003


                               background

       The Early Treatment for HIV Act (ETHA) is currently pending 
     in Congress. ETHA would allow states to extend Medicaid 
     coverage to pre-disabled people living with HIV. It 
     represents a breakthrough in assuring early access to care 
     for thousands of low-income people living with HIV. 
     Currently, most individuals with HIV must become disabled by 
     AIDS in orders to receive Medicaid coverage.
       HIV/AIDS treatments are successfully delaying the 
     progression from HIV infection to full-blown AIDS. These 
     advancements have improved both the health and quality of 
     life for many people living with this disease. However, 
     without access to early intervention health care and 
     treatment, these advances remain out of reach for thousands 
     of non-disabled, low-income people living with HIV.
       By preserving the health of people living with HIV, 
     preventing opportunistic infections, and slowing the 
     progression to AIDS, ETHA could ultimately save taxpayer 
     dollars. Most importantly, if ETHA can garner the bipartisan 
     support needed to become law, the United States will take an 
     important step towards ensuring that all people living with 
     HIV can get the medical care they need to stay healthy for as 
     long as possible.


                              endorsements

       The following organizations support passage of the Early 
     Treatment for HIV Act:

     ACT UP Atlanta, Atlanta, GA
     ACT UP Philadelphia, Philadelphia, PA
     ADAP Working Group, Washington, D.C.
     AIDS Atlanta, Atlanta, GA
     AIDS Action, Washington, D.C.
     AIDS Action Baltimore, Baltimore, MD
     AIDS Alabama, Birmingham, AL
     AIDS Alliance for Children, Youth, and Families, Washington, 
         D.C.
     AIDS Foundation of Chicago, Chicago, IL
     AIDS Healthcare Foundation, Los Angeles, CA
     AIDS Project Los Angeles, Los Angeles, CA
     AIDS Project Rhode Island, Providence, RI
     AIDS Services Foundation Orange County, Irvine, CA
     AIDS Survival Project, Atlanta, GA
     AIDS Taskforce of Greater Cleveland, Cleveland, OH
     AIDS Treatment Data Network, New York, NY
     AIDS Vaccine Advocacy Coalition, New York, NY
     AIDS Volunteers of Northern Kentucky, Covington, KY
     Africa Eridge, Inc., West Linn, OR
     American Foundation for AIDS Research, Washington, D.C.
     American Society of Addiction Medicine, Chevy Chase, MD
     Association of Maternal and Child Health Programs, 
         Washington, D.C.
     Association of Reproductive Health Professionals, Washington, 
         D.C.
     AsUR Volunteer Services, Oakland, CA
     Beaver County AIDS Service Organization, Aliquippa, PA
     Center for AIDS: Hope & Remembrance Project, Houston, TX
     Center for Women Policy Studies, Washington, D.C.
     Community Advisory Board of the Miriam ACTG, Providence, RI
     Community Care Management, Johnstown, PA
     Council on AIDS In Rockland, Rockland, NY
     Critical Path AIDS Project, Philadelphia, PA
     District of Columbia Primary Care Association, Washington, 
         D.C.
     Elizabeth Glaser Pediatric AIDS Foundation, Washington, D.C.
     Florida AIDS Action, Tampa, FL
     Florida Keys HIV Community Planning Partnership, Key West, FL
     Foundation for Integrative AIDS Research, Brooklyn, NY
     Gay and Lesbian Medical Association, San Francisco, CA
     Gay Men's Health Crisis, New York, NY
     Georgia AIDS Coalition, Inc., Snellville, GA
     HIV/AIDS Alliance for Region Two, Inc. (HAART), Baton Rouge, 
         LA
     HIV/AIDS Dietetic Practice Group, American Dietetic 
         Association, Chicago, IL/Washington, D.C.
     HIV/AIDS Women's Caucus of Long Beach and South Bay, Long 
         Beach, CA
     HIV/Hepatitis C in Prison Committee/California Prison Focus, 
         San Francisco, CA
     HIV Medicine Association, Alexandria, VA
     HUG-M3 Program at Orlando Regional Healthcare, Orlando, FL
     Human Rights Campaign, Washington, D.C.
     International AIDS Empowerment, El Paso, TX
     Kitsap Human Rights Network, Silverdale, WA
     Lifelong AIDS Alliance, Seattle, WA
     Louisiana Lesbian and Gay Political Action Caucus, New 
         Orleans, LA
     Los Angeles Gay and Lesbian Center, Los Angeles, CA
     Matthew 25 AIDS Services, Inc., Henderson, KY
     Michigan Advocates Exchange, Ypsilanti, MI
     Michigan Persons Living With AIDS Task Force, Okemos, MI
     Montrose Clinic, Houston, TX
     National Alliance of State and Territorial AIDS Directors, 
         Washington, D.C.
     National Association of People With AIDS, Washington, D.C.
     National Association for Victims of Transfusion-Acquired 
         AIDS, Bethesda, MD
     National Coalition for LGBT Health, Washington, D.C.
     National Center on Poverty Law, Chicago, IL
     National Health Law Program, Los Angeles, CA
     National Minority AIDS Council, Washington, D.C.
     New York City AIDS Housing Network, New York, NY
     NO/AIDS Task Force, New Orleans, LA
     North Carolina Council for Positive Living, Raleigh, NC
     Northern Manhattan Women & Children HIV Project, Mailman 
         School of Public Health, Columbia University, New York, 
         NY
     Northland Cares, Flagstaff, AZ
     Okaloosa AIDS Support and Informational Services (OASIS), 
         Fort Walton Beach, FL
     Parents, Families and Friends of Lesbians and Gays (PFLAG), 
         Washington, D.C.
     Philadelphia FIGHT, Philadelphia, PA
     Pierce County AIDS Foundation, Tacoma, WA
     Presbyterian Church (U.S.A.) Washington Office, Washington, 
         D.C.
     Primary Health Care, Inc., Des Moines, IA
     Program for Wellness Restoration, Houston, TX
     Project Inform, San Francisco, CA
     Provincetown AIDS Support Group, Provincetown, MA
     Power of Love Foundation, San Diego, CA
     San Antonio AIDS Foundation, San Antonio, TX
     San Francisco AIDS Foundation, San Francisco, CA
     San Francisco Community Clinic Consortium, San Francisco, CA
     Shelter Resources, Inc. d.b.a. Belle Reve New Orleans, New 
         Orleans, LA
     STOP AIDS Project, San Francisco, CA
     Test Positive Aware Network, Chicago, IL
     Title II Community AIDS Action Network, Washington, D.C.
     Treatment Action Group, New York, NY
     United Communities AIDS Network, Olympia, WA
     University of IOWA HIV Program, Iowa City, IA
     Vermont People With AIDS Coalition, Montpelier, VT
     Visionary Health Concepts, New York, NY
     Whitmar Walker Clinic, Washington, D.C.
     Williamsburg/Greenpoint/Bushwick HIV CARE Network, Brooklyn, 
         NY
     Women Accepting Responsibility, Baltimore, MD
     Women's HIV Collaborative of New York, New York, NY.
                                  ____



                                                         ADAP,

                                    Washington, DC, April 4, 2003.
     Hon. Hillary Rodham Clinton,
     Hon. Gordon Smith,
     U.S. Senate,
     Washington, DC.

               RE: ETHA--The Early Treatment for HIV Act

       Dear Senator Clinton and Senator Smith: I write on behalf 
     of our membership to express our support and appreciation for 
     your bipartisan efforts in introducing the Early Treatment 
     for HIV Act.
       Passage of this act into law is a priority for this 
     coalition and we believe ETHA can eventually be a major step 
     towards providing the medically desirable early access to 
     treatment, medical care, support services and prevention 
     education for Americans with HIV disease.

[[Page S5088]]

       While we recognize that budgetary resources are constrained 
     we also recognize the cost effectiveness potential ETHA would 
     present to state government resources. Naturally we also 
     realize the extreme health importance of insuring proper 
     medical attention and access to care at the earliest possible 
     moment for HIV + patients.
       Thank you for your leadership in this very important effort 
     to deliver health care to HIV + positive Americans who 
     otherwise are likely to have to wait until diagnosed with 
     full blown AIDS before receiving access to Medicare which 
     would then be able to provide them with the care and 
     treatment which could prevent them from progressing to full 
     blown AIDS--in the first place.
       Our membership intends to devote time and every towards 
     passing ETHA into law as this session of Congress proceeds. 
     We are aware of hundreds of other organizations that are 
     equally committed to the passage of ETHA. We look forward to 
     actively supporting your efforts and to a final passage of 
     ETHA during the 108th Congress.
           Sincerely,
                                                William E. Arnold,
     Director.
                                  ____



                                        Whitman-Walker Clinic,

                                                    April 8, 2003.
     The Hon. Gordon Smith,
     U.S. Senate,
     Washington, DC.
     The Hon. Hilary Rodham Clinton,
     U.S. Senate,
     Washington, DC.
       Dear Senators Smith and Clinton: On behalf of the thousands 
     of men and women with HIV served by Whitman-Walker Clinic, 
     the board of directors, staff and volunteers thank you for 
     introducing the Early Treatment For HIV Act (ETHA). We 
     strongly support the goals of this legislation and are 
     grateful for your leadership.
       As you know, ETHA would allow states to extend Medicaid 
     coverage to pre-disabled people living with HIV. It 
     represents a breakthrough in assuring early access to care 
     for thousands of low-income people living with HIV. Current 
     HIV treatments are successfully delaying the progression from 
     HIV infection to AIDS, as well as improving the health and 
     quality of life for many people living with the disease. 
     However, without access to early intervention, health care 
     and treatment, these advances remain out of reach for many 
     non-disabled, low-income people with HIV.
       By preserving the health of people living with HIV, 
     preventing opportunistic infections associated with the 
     disease, and slowing the progression to AIDS, the Early 
     Treatment for HIV Act could ultimately save taxpayer dollars. 
     Most importantly, should ETHA become law, the United States 
     will take an important step towards ensuring that all people 
     living with HIV can get the medical care they need to stay 
     healthy for as long as possible.
       Whitman-Walker Clinic provides a broad range of services 
     including HIV testing and counseling, medical and dental 
     care, substance abuse and mental health services and housing. 
     Yet maintaining access to these services for those in need is 
     increasingly difficult.
       Despite nearly two decades of success in HIV prevention and 
     care which has kept tens of thousands alive and healthy in 
     our community, Washington, DC has a rate of AIDS ten times 
     the national average. And, our region, including Northern 
     Virginia and Suburban Maryland, ranks 5th in reported number 
     of cases.
       Thank you again for your leadership on behalf of people 
     living with HIV. We look forward to working with you to 
     secure passage of this important legislation.
           Sincerely,
     Mark M. Levin,
       Board Chair.
     A. Cornelius Baker,
       Executive Director.
                                  ____

                                                National Coalition


                                              for LGBT Health,

                                    Washington, DC, April 9, 2003.
     Hon. Gordon Smith,
     U.S. Senate,
     Washington, DC.

     Hon. Hillary Rodham Clinton,
     U.S. Senate,
     Washington, DC.
       Dear Senators Smith and Clinton: Thank you, on behalf of 
     the more than 75 organizations of the National Coalition for 
     Lesbian, Gay, Bisexual, and Transgender Health, for your 
     sponsorship of the Early Treatment for HIV Act of 2003.
       Currently, childless adults living with HIV generally only 
     qualify for Medicaid coverage once they become eligible for 
     Supplemental Security Income (SSI). Because an individual is 
     not eligible for SSI until they become disabled, a person 
     with a symptomatic HIV infection is not eligible for Medicaid 
     until he or she has progressed to AIDS. Since HIV-positive 
     individuals do not qualify for Medicaid, many lack the 
     ability to receive medical care and medicine to help slow the 
     progression of the HIV and to prevent the onset of 
     opportunistic infections.
       Treating those who are HIV-positive early in the 
     progression of the disease provides numerous benefits. By 
     making therapeutics available earlier, treatment costs will 
     diminish, due to cost savings the AIDS Drug Assistance 
     Program will be able to provide care to more individuals with 
     HIV, and most importantly, the quality of life for countless 
     HIV-positive individuals will be improved. Simply put, 
     providing coverage earlier rather than later improved lives 
     and reduces cost for all.
       The Early Treatment for HIV Act would provide states with 
     the option of covering low-income HIV-infected individuals as 
     ``categorically needy.'' In this way, this legislation is 
     very similar to the successful effort in 2000 to provide 
     states with the option of providing Medicaid coverage to 
     women diagnosed, through a federally funded program, with 
     breast or cervical cancer.
       On behalf of the countless people whose lives will be 
     improved by enactment of this legislation, we thank you for 
     your leadership and your sponsoring this important 
     legislation.
           Very truly yours,
     A. Cornelius Baker,
       Co-Chair, Executive Committee.
     Eugenia Handler,
       Co-Chair, Executive Committee.
                                  ____



                            Gay & Lesbian Medical Association,

                                 San Francisco, CA, April 7, 2003.
     Hon. Gordon Smith,
     Hon. Hillary Rodham Clinton,
     U.S. Senate,
     Washington, DC.
       Dear Senators Smith and Clinton: Thank you, on behalf of 
     the more than 1,500 members of the Gay & Lesbian Medical 
     Association, for your sponsorship of the Early Treatment for 
     HIV Act of 2003.
       Currently, childless adults living with HIV generally only 
     qualified for Medicaid coverage once they become eligible for 
     Supplemental Security Income (SSI). Because an individual is 
     not eligible for SSI until they become disabled, a person 
     with asymptomatic HIV infection is not eligible for Medicaid 
     until he or she has progressed to full-blown AIDS. Since HIV-
     positive individuals do not quality for Medicaid, many lack 
     the ability to receive medical care and medicine to help slow 
     the progression of the HIV and to prevent the onset of 
     opportunistic infections.
       Treating those who are HIV-positive early in the 
     progression of the disease provides numerous benefits. By 
     making therapeutics available earlier, treatment costs will 
     diminish, new HIV infections will decrease because of the 
     lower viral loads, the AIDS Drug Assistance Program will be 
     able to provide care to more individuals with HIV because of 
     savings, and most importantly, the quality of life for 
     countless HIV-positive individuals will be improved. Simply 
     put, providing coverage earlier rather than later is the 
     right thing to do.
       The Early Treatment for HIV Act would provide states with 
     the option of covering low-income HIV-infected individuals as 
     `categorically needy'. In this way, this legislation is very 
     similar to the successful effort in 2000 to provide states 
     with the option of providing Medicaid coverage, through a 
     federally funded program, to women diagnosed with breast or 
     cervical cancer.
       On behalf of the countless people whose lives will be 
     improved by enactment of this legislation, we thank you for 
     your leadership and your sponsoring this important 
     legislation.
           Sincerely,
                                               Kenneth Haller Jr.,
     President.
                                  ____



                                        Vermont PWA Coalition,

                                    Montpelier, VT, April 8, 2003.
     Hon. Gordon Smith,
     U.S. Senate,
     Washington, DC.
       Dear Senator Smith: On behalf of the Vermont People with 
     AIDS Coalition, I am writing to thank you for agreeing to be 
     the lead sponsor of the Early Treatment For HIV Act (ETHA). 
     We strongly support this legislation and are greatful for 
     your leadership.
       As you know, ETHA would allow states to extend Medicaid 
     coverage to pre-disabled people living with HIV. It 
     represents a breakthrough in assuring early access to care 
     for thousands of low-income people living with HIV. Current 
     HIV treatments are successfully delaying the progression from 
     HIV infection to AIDS, improving the health and quality of 
     life for many people living with the disease. However, 
     without access to early intervention health care and 
     treatment, these advances remain out of reach for many non-
     disabled, low-income people with HIV.
       Access to health care is an important issue for all 
     Vermonters. Any program that will give people who are HIV+ 
     early access to medical care gets our enthusiastic support. 
     In the long run, early treatment will save money and, more 
     importantly, keep people healthy and productive.
       By preserving the health of people living with HIV, 
     preventing opportunistic infections associated with the 
     disease, and slowing the progression to AIDS, the Early 
     Treatment for HIV Act could ultimately save taxpayer dollars. 
     Most importantly, should ETHA become law, the United States 
     will take an important step towards ensuring that all people 
     living with HIV can get the medical care they need to stay 
     healthy for as long as possible.
       Thank you again for your leadership on behalf of people 
     living with HIV. Please let me know if there is anything I 
     can do to help secure passage of this important legislation.
           Sincerely,
                                                  Kathy Kilcourse,
                                            Program Administrator.

[[Page S5089]]

     
                                  ____
                                                Beaver County AIDS


                                         Service Organization,

                                     Aliquippa, PA, April 7, 2003.
     Hon. Gordon Smith,
     U.S. Senate,
     Washington, DC.
       Dear Senator Smith: On behalf of the Beaver County AIDS 
     Service Organization (BCASO), I am writing to thank you for 
     agreeing to be the lead sponsors of the Early Treatment for 
     HIV Act (ETHA). We strongly support this legislation and are 
     grateful for your leadership.
       As you know, ETHA would allow states to extend Medicaid 
     coverage to pre-disabled people living with HIV. It 
     represents a breakthrough in assuring early access to care 
     for thousands of low-income people living with HIV. Current 
     HIV treatments are successfully delaying the progression from 
     HIV infection to AIDS, improving the health and quality of 
     life for many people living with the disease. However, 
     without access to early intervention health care and 
     treatment, these advances remain out of reach for many non-
     disabled, low-income people with HIV.
       By preserving the health of people living with HIV, 
     preventing opportunistic infections associated with the 
     disease, and slowing the progression to AIDS, the Early 
     Treatment for HIV Act could ultimately save taxpayer dollars. 
     Most importantly, should ETHA become law, the United States 
     will take an important step towards ensuring that all people 
     living with HIV can get the medical care they need to stay 
     healthy for as long as possible.
       Thank you again for your leadership on behalf of people 
     living with HIV. Please let me know if there is anything I 
     can do to help secure passage of this important legislation.
           Sincerely,
                                                     David Adkins,
     Program Coordinator.
                                  ____

                                                      AIDS Council


                                     of Northeastern New York,

                                        Albany, NY, April 8, 2003.
     Hon. Gordon Smith,
     U.S. Senate,
     Washington, DC.
       Dear Senator Gordon: On behalf of the AIDS Council of 
     Northeastern New York, I am writing to thank you for agreeing 
     to be the lead sponsors of the Early Treatment for HIV Act 
     (ETHA). We strongly support this legislation and are grateful 
     for your leadership.
       As you know, ETHA would allow states to extend Medicaid 
     coverage to pre-disabled people living with HIV. It 
     represents a breakthrough in assuring early access to care 
     for thousands of low-income people living with HIV. Current 
     HIV treatments are successfully delaying the progression from 
     HIV infection to AIDS, improving the health and quality of 
     life for many people living with the disease. However, 
     without access to early intervention health care and 
     treatment, these advances remain out of reach for many non-
     disabled, low-income people with HIV.
       By preserving the health of people living with HIV, 
     preventing opportunistic infections associated with the 
     disease, and slowing the progression to AIDS, the Early 
     Treatment for HIV Act could ultimately save taxpayer dollars. 
     Most importantly, should ETHA become law, the United States 
     will take an important step towards ensuring that all people 
     living with HIV can get the medical care they need to stay 
     healthy for as long as possible.
       Thank you again for your leadership on behalf of people 
     living with HIV. Please let me know if there is anything I 
     can do to help secure passage of this important legislation.
           Sincerely,
                                                  Julie M. Harris,
     Deputy Executive Director.
                                  ____



                                              Morrison Center,

                                      Portland, OR, April 8, 2003.
     Hon. Gordon Smith,
     U.S. Senate,
     Washington, DC.
       Dear Senator Smith: On behalf of the thousands of parents 
     and children served by Parents Anonymous' of 
     Oregon, I wish to thank you for the support you have provided 
     to the Parents Anonymous' Programs in your State. 
     These vital federal funds and support from Parents 
     Anonymous' Inc. allow us to meet the ever 
     increasing demand and ensure that the proven effective, child 
     abuse prevention programs of Parents Anonymous' 
     are available to strengthen families here at home.
       For over twenty-five years, Parents Anonymous' 
     of Oregon (PAO) has been dedicated to the prevention of child 
     abuse and neglect by strengthening families in our community. 
     Currently we provide 14 free weekly Parent Support Groups and 
     Children's Programs to parents experiencing challenges and 
     stress in their family and who have the courage to seek help. 
     PAO is committed to providing services to anyone in parenting 
     role, but particularly to at risk populations, including low 
     income Latino families, women transitioning from federal 
     prison and women in residential treatment for substance 
     abuse.
       I respectfully request your support and advocacy for two 
     funding initiatives for Parents Anonymous' Inc. 
     for fiscal year 2004.
       $4 million in the current level of appropriations under the 
     Commerce-Justice-State (``CJS'') appropriations bill, for 
     strengthening and expanding nationwide services to families 
     in local communities to prevent child abuse, neglect, and 
     juvenile delinquency.
       $3 million under the Labor-Health and Human Services 
     (``LHHS'') appropriations bill for establishing, operating, 
     and maintaining a national parent helpline.
       Research demonstrates that child abuse and neglect is often 
     a precursor to delinquent and adult criminal behavior and 
     that children who are abused or neglected are 40% more likely 
     to engage in delinquency or adult criminal behavior. In fact, 
     being abused or neglected as a child increases the likelihood 
     of an arrest as a juvenile by 59%, as an adult by 28%, and 
     for a violent crime by 30%. The requested CJS funding will 
     enable us to continue Parents Anonymous' Programs 
     and address the needs of at-risk populations. In addition, 
     this funding will help, in the long run, to reduce 
     expenditures in other Department of Justice programs.
       The requested LHHS funding for a national parent helpline 
     run by Parents Anonymous' Inc. will enable parents 
     throughout the country, in all states, on reservations, in 
     urban and rural areas, to obtain immediate support and help, 
     24 hours a day, 7 days a week. Currently, thee is no national 
     toll-free telephone system aimed at providing immediate 
     support to parents seeking help with their child-raising 
     crises and connecting them with effective community-based 
     programs for assistance--the first cry for help needs to be 
     answered in order to prevent child abuse and neglect.
       Given your strong commitment and leadership to addressing 
     the needs of families in your State, we wish to thank you in 
     advance for championing these two FY 04 funding initiatives.
           Very truly yours,

                                                  Ruth Taylor,

                                                 Program Director,
     Parents Anonymous' of Oregon.
                                  ____

                                     Metropolitan Community Church


                                                   of Portland

                                     Portlands, OR, April 9, 2003.
     Hon. Gordon Smith,
     U.S. Senate, Washington DC.
     Hon. Hillary Rodham Clinton,
     U.S. Senate, Washington, DC.
       Dear Senators Smith and Clinton, I want to take this 
     opportunity to thank you for your sponsorship of the Early 
     Treatment for HIV Act of 2003. Esther's Pantry has been a 
     food bank for individuals living with AIDS since 1985. As 
     funding for AIDS programs such as ours continue to decline 
     and disappear, it very important that individuals diagnosed 
     with HIV receive medical benefits as soon as possible so they 
     may maintain some level of health and be able to provide for 
     themselves long term. We have learned so much about HIV/AIDS 
     over the past several years and the most important lesson has 
     been early detection and treatment. Your bill will address 
     that further piece of the solution by providing some 
     resources to enable those infected to follow through.
       At Esther's Pantry, we regularly provide individually 
     shopped food boxes to approximately 150 clients every month 
     for a total annual population of clients numbering 250. We 
     recently lost Ryan White Title 1 funding and now provide our 
     service through local donation and grant funding from a 
     variety of sources. All clients must have AIDS and be at less 
     than twice the federal poverty level. We are a provider for 
     these clients who are struggling to cope with increased 
     medical costs. Earlier treatment of all these clients would 
     have helped to maintain their health, and enable them to 
     expend their resources for other life necessities. Failure to 
     do this has only created a dire situation.
       This is certainly a bill that takes the necessary steps to 
     improve the situation for so many men, women and children 
     suffering from this disease. Thank you for your continuing 
     efforts.
           In Gratitude,
                                                 David R. Beckley,
     Executive Director.
                                  ____

                                  Parents, Families and Friends of


                                            Lesbians and Gays,

                                    Washington, DC, April 7, 2003.
     Hon. Gordon Smith,
     U.S. Senate,
     Washington, DC.
     Hon. Hillary Rodham Clinton,
     U.S. Senate,
     Washington, DC.
     Re: Early Treatment for HIV Act of 2003
       Dear Senators Smith and Clinton: I am the executive 
     director of Parents, Families and Friends of Lesbians and 
     Gays (PFLAG), the nation's foremost family organization 
     dedicated to fair treatment for gay, lesbian, bisexual and 
     transgender (GLBT) persons. Founded in 1973 by heterosexual 
     parents who were brought together by their deep desire to 
     understand and accept their GLBT loved ones, PFLAG consists 
     of almost 500 chapters and represents over 250,000 members 
     and supporters--Republicans and Democrats--throughout the 
     country. On behalf of our national membership, I write to 
     thank you for your sponsorship of the Early Treatment for HIV 
     Act of 2003.
       As a national organization whose mission focuses on the 
     health and well-being of GLBT persons, PFLAG strongly 
     believes that treating those who are HIV-positive early in 
     the progression of the disease provides numerous benefits. By 
     making therapeutics available earlier, treatment costs will 
     diminish, new HIV infections will decrease because of the 
     lower viral loads, the AIDS Drug Assistance Program will be 
     able to provide care to more individuals with HIV because of 
     savings, and most importantly,

[[Page S5090]]

     the quality of life for countless HIV-positive individuals 
     will be improved. Simply put, providing coverage earlier 
     rather than later is the right thing to do.
       The Early Treatment for HIV Act would provide states with 
     the option of covering low-income HIV-infected individuals as 
     ``categorically needy''. In this way, this legislation is 
     very similar to the successful effort in 2000 to provide 
     states with the option of providing Medicaid coverage to 
     women diagnosed, through a federally funded program, with 
     breast or cervical cancer.
       PFLAG is proud to support you in calling for these critical 
     steps to be taken in our national fight against AIDS/HIV, and 
     we applaud you for your leadership in this important battle 
     we must all win.
           Sincerely,
                                                      David Tseng,
     Executive Director.
                                  ____

                                        Elizabeth Glaser Pediatric


                                              Aids Foundation,

                                    Washington, DC, April 8, 2003.
     Hon. Gordon Smith,
     U.S. Senate,
     Washington, DC.
     Hon. Hillary Rodham Clinton,
     U.S. Senate,
     Washington, DC.
       Dear Senators Smith and Clinton: On behalf of the Elizabeth 
     Glaser Pediatric AIDS Foundation, I would like to express my 
     strong support for the Early Treatment for HIV Act of 2003. 
     We applaud your efforts to give states the option to extend 
     critical Medicaid benefits to low-income HIV-infested 
     individuals.
       For children and adults infected with HIV the recent 
     dramatic advances in treatment offer great hope for living 
     long and healthy lives. Unfortunately, for too many low-
     income and uninsured individuals the cost of these live-
     saving medications is out of reach. A ``catch-22'' in the 
     current Medicaid rules requires that they must be disabled by 
     AIDS before Medicaid will begin to cover the drugs that would 
     have prevented or delayed their becoming disabled in the 
     first place.
       Improving the access of HIV-positive individuals to 
     treatment early in the progression of the disease is not only 
     humane, but also cost-effective. Early treatment lowers the 
     need for expensive medical interventions and, by decreasing 
     viral loads, reduces the likelihood of new infections. Just 
     as importantly, by preserving the ability of HIV-infected 
     individuals to be productive and healthy workers, parents and 
     citizens, early treatment also reduces the attendant social 
     costs of AIDS.
       Thank you for your leadership and commitment to this issue. 
     We look forward to working with you toward passage of the 
     Early Treatment for HIV Act.
           Sincerely,

                                                   Mark Isaac,

                                   Vice President for Governmental
     and Public Affairs.
                                  ____

         National Alliance of State and Territorial AIDS 
           Directors,
                                    Washington, DC, April 8, 2003.
     Hon. Gordon Smith,
     Russell Senate Office Building,
     Washington, DC.
       Dear Senator Smith: On behalf of the National Alliance of 
     State and Territorial AIDS Directors (NASTAD), I am writing 
     to offer our support for the ``Early Treatment for HIV Act.'' 
     NASTAD represents the nation's chief state and territorial 
     health agency staff who are responsible for HIV/AIDS 
     prevention, care and treatment programs funded by state and 
     federal governments. This legislation would give states an 
     important option in providing care and treatment services to 
     low-income Americans living with HIV.
       The Early Treatment for HIV Act (ETHA) would allow states 
     to expand their Medicaid programs to cover HIV positive 
     individuals, before they become disabled, without having to 
     receive a waiver. NASTAD believes this legislation would 
     allow HIV positive individuals to access the medical care 
     that is widely recommended, can postpone or avoid the onset 
     of AIDS, and can enormously increase the quality of life for 
     people living with HIV.
       State AIDS directors continue to develop innovative and 
     cost-effective HIV/AIDS programs in the face of devastating 
     state budget cuts and federal contributions that fail to keep 
     up with need. ETHA provides a solution to states by 
     increasing health care access for those living with HIV/AIDS. 
     ETHA will also save states money in the long-run by treating 
     HIV positive individuals earlier in the disease's progression 
     and providing states with a federal match for the millions of 
     dollars they are presently spending on HIV/AIDS care.
       Thank you very much for your continued commitment to 
     persons living with HIV/AIDS. I look forward to working with 
     you to gain support for this important piece of legislation.
           Sincerely,
                                                Julie M. Scofield,
     Executive Director.
                                  ____

                                               Southern California


                                       HIV Advocacy Coalition,

                                                    April 7, 2003.
     Hon. Gordon Smith,
     U.S. Senate,
     Washington, DC.
       Dear Senator Smith: on behalf of the Southern California 
     HIV Advocacy Coalition, I am writing to thank you for 
     agreeing to be the lead sponsors of the Early Treatment For 
     HIV Act (ETHA). We strongly support this legislation and are 
     grateful for your leadership.
       As you know, ETHA would allow states to extend Medicaid 
     coverage to pre-disabled people living with HIV. It 
     represents a breakthrough in assuring early access to care 
     for thousands of low-income people living with HIV. Current 
     HIV treatments are successfully delaying the progression from 
     HIV infection to AIDS, improving the health and quality of 
     life for many people living with the disease. However, 
     without access to early intervention health care and 
     treatment, these advances remain out of reach for many non-
     disabled, low-income people with HIV. The delay in getting 
     individuals into a system of care is having a huge 
     detrimental impact on the HIV delivery system and the entire 
     health safety net in the Southern California area.
       By preserving the health of people living with HIV, 
     preventing opportunistic infections associated with the 
     disease, and slowing the progression to AIDS, the Early 
     Treatment for HIV Act could ultimately save taxpayer dollars. 
     Most importantly, should ETHA become law, the United States 
     will take an important step towards ensuring that all people 
     living with HIV can get the medical care they need to stay 
     healthy for as long as possible.
       In an era of constrained federal resources for health care 
     spending, we must aggressively fight for effective means to 
     finance care for people with HIV. This bill will begin to 
     address these challenges through a permanent funding 
     solution, allowing states to expand the safety net to cover 
     eligible persons with early-stage HIV disease.
       Thank you again for your leadership on behalf of people 
     living with HIV. Please let me know if there is anything I 
     can do to help secure passage of this important legislation.
           Sincerely,
                                                     Tom Peterson,
     Co-Chair, Southern California HIV Advocacy Coalition.
                                  ____

                                              The Center for Aids,
                                       Houston, Tx, April 4, 2003.
     Hon. Gordon Smith,
     U.S. Senate,
     Washington, DC.
       Dear Senator Smith: on behalf of The Center for AIDS: Hope 
     & Remembrance Project (CFA), I am writing to thank you for 
     agreeing to be the lead sponsors of the Early Treatment For 
     HIV Act (ETHA). We strongly support this legislation and are 
     grateful for your leadership.
       As you know, ETHA would allow states to extend Medicaid 
     coverage to pre-disabled people living with HIV. It 
     represents a breakthrough in assuring early access to care 
     for thousands of low-income people living with HIV. Current 
     HIV treatments are successfully delaying the progression from 
     HIV infection to AIDS, improving the health and quality of 
     life for many people living with the disease. However, 
     without access to early intervention health care and 
     treatment, these advances remain out of reach for many non-
     disabled, low-income people with HIV. Moreover, without these 
     treatments to stave off disease progression, hospitalizations 
     and associated costs would unnecessarily add millions of 
     dollars in burdens to the U.S. health care system.
       The CFA has the largest collection HIV/AIDS-specific 
     treatment information in the southwestern U.S. The CFA 
     specializes in research/treatment information and advocacy. 
     The proposed ETHA legislation will help The CFA's clients--
     those affected by HIV/AIDS both locally in Houston and 
     nationally--stay healthier and lead productive lives in 
     society.
       By preserving the health of people living with HIV, 
     preventing opportunistic infections associated with the 
     disease, and slowing the progression to AIDS, ETHA could 
     ultimately save taxpayer dollars. Most importantly, should 
     ETHA become law, the United States will take an important 
     step towards ensuring that all people living with HIV can get 
     the medical care they need to stay healthy for as long as 
     possible.
       Thank you again for your leadership on behalf of people 
     living with HIV. Please let me know if there is anything I 
     can do to help secure passage of this important legislation.
           Sincerely,
                                                    Thomas Gegeny,
     MS, ELS, Editor & Interim Director.
                                  ____

                                           Association of Maternal


                                        Child Health Programs,

                                    Washington, DC, April 4, 2003.
     Hon. Gordon Smith,
     U.S. Senate,
     Washington, DC.
       Dear Senator Smith: on behalf of the Association of 
     Maternal and Child Health Programs (AMCHP), I am writing to 
     thank you for agreeing to be a lead sponsor of the Early 
     Treatment For HIV Act (ETHA). We strongly support this 
     legislation and are grateful for your leadership.
       As you know, ETHA would allow states to extend Medicaid 
     coverage to pre-disabled people living with HIV. It 
     represents a breakthrough in assuring early access to care 
     for thousands of low-income people living with HIV. Current 
     HIV treatments are successfully delaying the progression from 
     HIV infection to AIDS, improving the health and quality of 
     life for many people living with the disease. However, 
     without access to early intervention health care and 
     treatment, these advances remain out of reach for

[[Page S5091]]

     many non-disabled, low-income people with HIV.
       AMCHP represents the directors and staff of state public 
     health programs for maternal and child health (funded by the 
     Federal Maternal and Child Health Services Block Grant), 
     including children with special health care needs. These 
     programs provided services to over 27 million Americans in FY 
     1999, including 18 million children between the ages of 1 and 
     22, 16% of whom had no known source of health insurance.
       With this legislation, the United States will take an 
     important step towards ensuring that all people living with 
     HIV can get the medical care they need to stay healthy for as 
     long as possible.
       Thank you again for your leadership on this issue. Please 
     let me know how I can help support your efforts to secure 
     passage of this important legislation.
           Sincerely,
                                                 Deborah Dietrich,
     Acting Executive Director.
                                  ____

                                                     San Francisco


                                              AIDS Foundation,

                                 San Francisco, CA, April 8, 2003.
     Hon. Gordon Smith,
     U.S. Senate,
     Washington, DC.
     Hon. Hillary Rodham Clinton,
     U.S. Senate,
     Washington, DC.
       Dear Senators Smith and Clinton: the San Francisco AIDS 
     Foundation would like to thank you for your sponsorship of 
     the Early Treatment for HIV Act 2003.
       The Act would provide states with the option of covering 
     low-income people living with HIV as `categorically needy' 
     provide them with medical care and treatment, reduce long 
     term health care costs to states, and address a serious gap 
     in public health care access. Recent breakthroughs in medical 
     science and clinical practice have transformed the 
     possibilities in HIV/AIDS care in the United States. Today, 
     we know that early intervention with medical care and 
     treatment for HIV disease slows the progression of HIV and 
     prevents the onset of opportunistic infections. Application 
     of this knowledge lengthens the life expectancy and 
     dramatically improves the quality of life for many. These 
     changes in science and medical practice demand revisions in 
     the treatment of HIV disease under Medicaid.
       Currently Medicaid eligibility for childless adults is tied 
     to Supplemental Security Income (SSI) eligibility. The result 
     of this determination is that people living with HIV must 
     wait for Medicaid access until their disease has progressed 
     to a disabling AIDS diagnosis. The cruel irony of this 
     practice is that individuals are forced to incur often-
     irreparable damage to their immune systems before receiving 
     treatments that could have delayed or avoided the damage. 
     This is counter to sound public health practices and all but 
     guarantees higher cost of care for thousands of affected 
     individuals. This serious anomaly in public health care 
     coverage must be rectified by the enactment of this 
     legislation.
       The AIDS Foundation thanks you both for your leadership and 
     sponsorship of this important legislation.
           Sincerely,
                                                   Ernest Hopkins,
                                      Director of Federal Affairs.

  Mr. President, I ask unanimous consent that a copy of the Early 
Treatment for HIV Act of 2003 be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 847

       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 2003''.

     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 (XVII);
       (B) by adding ``or'' at the end of subclause (XVIII); and
       (C) by adding at the end the following:

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

       (2) by adding at the end the following:
       ``(cc) 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) Enhanced Match.--The first sentence of section 1905(b) 
     of the Social Security Act (42 U.S.C. 1396d(b)) is amended by 
     striking ``section 1902(a)(10)(A)(ii)(XVIII)'' and inserting 
     ``subclause (XVIII) or (XIX) of section 1902(a)(10)(A)(ii)''.
       (c) 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 (xii);
       (2) by adding ``or'' at the end of clause (xiii); and
       (3) by inserting after clause (xiii) the following:
       ``(xiv) individuals described in section 1902(cc);''.
       (d) 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(cc) who are only 
     eligible for such assistance on the basis of section 
     1902(a)(10)(A)(ii)(XIX).''.
       (e) 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.
                                 ______