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ADAP in Texas: Cuts may be ahead for AIDS program
  July 2 2010
By ROBERT T. GARRETT / The Dallas Morning News

AUSTIN - While some states cut a program that helps provide life-sustaining drugs to low-income people with HIV or AIDS, Texas has avoided trims - so far. "We don't have any firm plans at this time to make reductions," said Department of State Health Services spokeswoman Carrie Williams on Thursday. "It's something that we may need to talk about as we go through the legislative appropriations request process."
The state faces a budget shortfall of up to $18 billion next session. Advocates see hard times ahead for the program - known nationally as AIDS Drug Assistance, and in Texas as HIV Medication. As enrollees live longer and the recession makes more people eligible, it could be forced to halt admissions or trim the number of drugs offered.
More than 63,000 Texans had HIV or AIDS in 2008, according to the department's website.
Paid for with state and federal dollars, the nearly $100 million-a-year program supplies drugs to more than 14,000 uninsured Texans who earn less than twice the federal poverty level. A single person can make up to $21,660 and qualify. Randall Ellis, government relations director at Legacy Community Health Services, which operates three neighborhood health clinics in Houston, said the department told advocates in March that it expects a shortfall of $20 million to $30 million in the next two-year budget cycle.
"When the state's facing an $18 billion hole, having to go before the Legislature and ask for additional funding of that amount is extremely difficult," he said.
Eleven states have shut off new enrollees, most recently Florida, which has the nation's third-largest population of people with HIV, The New York Times reported Thursday. Three other states have tightened eligibility, and two of them - Arkansas and Utah - have dropped scores of people from the program. Ten states' programs dropped coverage of drugs that do not directly combat HIV or opportunistic infections, such as medications for nausea and high blood pressure.
Ellis, a former legislative budget aide, said the last time Texas' program faced a shortfall - in 2003 - supporters mustered enough political support to stave off cuts. But he said that year's compromise resulted in an edict that the department must create a waiting list or reduce drug offerings any time funds run short in the future.
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