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The life-threatening budget cuts

Posted on March 18, 2010March 18, 2010 by Staff

CHRIS FITZSIMON

The state budget crisis has turned into a matter of life and death for more than 200 people in North Carolina living with HIV/AIDS. The state’s AIDS Drug Assistance Program (ADAP), which provides lifesaving drugs for people living with the disease, is now closed to new applicants.

People who qualify for the program are now put on a waiting list, not a drug regimen. The medication that people with HIV need to stay alive can cost as much as $5,000 month, impossible to afford for people without insurance coverage.

The budget passed by the General Assembly last summer cut more than $3 million from ADAP. The program stopped taking new applicants in January and the waiting list has been growing steadily since, topping 200 last week.

State officials have expressed concern, but so far seem to be resigned to wait for the General Assembly to address the problem in the next fiscal year, which begins July 1, and even then expect lower financial eligibility levels for the program.

July is too late. Gov. Beverly Perdue needs to step in and find the money now to pay for the medication for people who need it. Perdue already is holding back 5 percent of the budget of most state agencies to prepare for next year’s budget shortfall, and there is money in the state’s savings account.

The crisis comes after the state has made significant progress in battling the AIDS epidemic. Not too long ago, the state’s HIV/AIDS policies were an embarrassment in the medical and public-health world, primarily because of the eligibility restrictions for ADAP. North Carolina denied access to the program to people making more than 125 percent of the national poverty level, which is roughly $13,000 a year and was even less a few years ago. The national average is 300 percent of poverty.

One powerful legislator said he didn’t want to do anything to help “those people,” and for years the woeful appropriation for AIDS prevention and treatment reflected that sentiment.

But a few years ago, the General Assembly increased the income eligibility for ADAP to 250 percent of poverty and then it was increased to the national average of 300 percent, which is roughly $30,000 a year.

That is still far too low when you consider that the drugs can cost $24,000 to $30,000 for a 12-month supply, but it was dramatic progress and seemed to signify an important shift in the state’s commitment to help people with HIV/AIDS. That progress is now being threatened.

More than 35,000 people in the state are living with the disease and almost 2,000 new cases are diagnosed every year. Many people whose medication was covered by health insurance at their workplace have lost jobs in the economic downturn and lost the ability to afford the needed medication.

The waiting list for help is only going to get longer unless Perdue does something about it. This is not a matter of an inconvenience that can be addressed when lawmakers return to town in May.

There should not be a waiting list to stay alive.

Chris Fitzsimon is executive director of N.C. Policy Watch.

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