[Congressional Record (Bound Edition), Volume 153 (2007), Part 16]
[Extensions of Remarks]
[Page 22962]
[From the U.S. Government Publishing Office, www.gpo.gov]




            INTRODUCTION OF THE EARLY TREATMENT FOR HIV ACT

                                 ______
                                 

                          HON. ELIOT L. ENGEL

                              of new york

                    in the house of representatives

                        Thursday, August 2, 2007

  Mr. ENGEL. Madam Speaker, today is an exciting day as I join with you 
and Representative Ros-Lehtinen and over 50 bipartisan co-sponsors--27 
Democrats and 27 Republicans to re-introduce the Early Treatment for 
HIV Act.
  Today is just one day in a long journey to promoting common sense 
health care in the Medicaid program. Medicaid coverage for people 
living with HIV is contingent on two factors; qualifying as low income 
and meeting the Social Security definition of disability. What this 
means for uninsured HIV Positive people is that outside of the Ryan 
White CARE ACT, HIV positive people must wait for their health status 
to be compromised beyond repair, to deteriorate to full blown AIDS 
before they can get healthcare coverage under Medicaid. This defies 
logic as current Federal guidelines call for early access to medical 
care and treatment including the use of combination antiretroviral 
therapy.
  The Early Treatment for HIV Act, ETHA, gives states the OPTION of 
amending their Medicaid eligibility requirements to include uninsured, 
pre-disabled low-income people living with HIV. ETHA is modeled after 
the successful Breast and Cervical Cancer Prevention and Treatment Act, 
BCCA, that allows States to provide early access to Medicaid to women 
with cancer. As with the BCCA, participating States would receive an 
enhanced Federal matching rate, the same that is provided through the 
breast and cervical cancer Medicaid project and SCHIP.
  Earlier access to health care for people with HIV/AIDS is cost 
effective. It improves both the health and quality of life of many 
people living with HIV. By keeping people healthy, the government saves 
money on expensive medical interventions, such as emergency care or 
hospitalizations. Furthermore, new medications now allow people with 
HIV to remain in the workforce longer, and reduces the need for support 
from government income subsidy programs like SSI and SSDI.
  Will the cost-savings be immediate? No. But after a number of years, 
when early, effective treatment will limit the number of people whose 
health status progresses to full-blown AIDS, health care costs will be 
minimized, and best of all there will be a 50 percent decrease in lives 
lost to this terrible disease.
  As all of you know, I have been advocating for improving access to 
quality healthcare for those with HIV/AIDS for my entire career in 
public service.
  I was deeply troubled 2 years ago when the Energy and Commerce 
Committee ``reformed'' Medicaid during the Deficit Reduction Act. I 
offered ETHA as an amendment during that mark up and secured the first 
ever vote on that bill. As I said to then Chairman Joe Barton ``if our 
committee is sincere about Medicaid reform outside of this budget 
driven reconciliation process, than we should seriously consider the 
huge improvements in health outcomes and long term cost-savings that 
will be realized over time through the Early Treatment to HIV.'' 
Unfortunately, the amendment was not agreed to.
  In the past Congress, I was deeply involved in the negotiations of 
the Ryan White Care Act. Those initially writing the Reauthorization 
shifted huge numbers in funding away from the epicenters of the AIDS 
epidemic to other emerging communities and added language that would 
make it harder for providers to serve those most in need. A common 
sense approach would have been to just fund the bill at higher levels 
to keep states from being pit against each other for scarce funding. We 
righted some of the wrongs in that bill though, and will continue to 
work to strengthen the Ryan White program.
  Madam Speaker, today is a new day though and a new Congress. With an 
equal number of Democrats and Republicans pushing for Early Treatment 
for HIV in the Medicaid program today, we have a new opportunity to 
enact common sense, life-saving treatment.

                          ____________________