  
Massachusetts expands insurance coverage for people with HIV
Last Updated: 2001-04-05 16:05:45 EDT (Reuters Health)
By Karen Pallarito
WESTPORT, CT (Reuters Health) - In a landmark shift in policy, Massachusetts said today that it is enrolling low- and moderate-income residents infected with HIV into MassHealth, its Medicaid program.
It becomes the first state in the nation to extend Medicaid benefits to people who have yet to develop AIDS. Advocates for people with HIV infection and AIDS lauded the move, which they said aligns state health policy with nationally accepted HIV treatment protocol.
As of April 1, HIV-positive residents under 65 may qualify for direct coverage or health insurance premium assistance under MassHealth. Benefits are available to people whose incomes are at or below 200% of the federal poverty--about $17,184 for a single person.
In January, Massachusetts received a waiver from the US Department of Health and Human Services allowing it to expand coverage to people with HIV infection. A handful of other states also have applied for or received federal waivers, sources told Reuters Health.
The new benefit provides hope for HIV-infected individuals and their families by reaching people in the early stages of disease and slowing the progression of AIDS, according to William O'Leary, the commonwealth's secretary of Health and Human Services.
Massachusetts also expects to save money by avoiding costly hospitalizations and nursing home care.
Patient advocates began talking with the state's Division of Medical Assistance about expanding Medicaid to people with HIV infection almost 4 years ago, said Larry Kessler, executive director of the AIDS Action Committee of Massachusetts, New England's oldest and largest AIDS organization.
"When you're talking about expanding Medicaid to any new group...it does take time, but it's really worth the effort," Kessler told Reuters Health.
Robert Greenwald, who now directs the health law project at Harvard Law School, was one of those early advocates for expanding coverage for people with HIV infection. It all began "the day that the first protease inhibitor came online," he told Reuters Health. "Up until that moment, all of the treatment options had been oriented to dealing with opportunistic infections and other symptoms related to AIDS."
"Now," said Greenwald, "from the moment you're HIV positive...you're covered under Medicaid." This, he said, "brings healthcare access in line with the recommended standard of care for people with HIV."
About 1000 people are expected to qualify for coverage under the program at an annualized cost of $10 million, including federal matching funds, said Richard McGreal, a spokesman for the Division of Medical Assistance.
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