Where is the Federal Commitment to ADAPs?

The AIDS Drug Assistance Programs (ADAPs) are authorized under Title II of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. Ryan White provides medical care assistance to those with low-incomes and little or no insurance. Approximately $1 billion dollars annually goes toward comprehensive care programs, which include health care, support services and drug assistance programs. Most of the funding is made available for ADAPs to provide anti-retroviral therapy, as well as to purchase health insurance for eligible clients.

For the last several years, ADAPs increasingly faced funding shortfalls that have placed more and more HIVers on waiting lists. As of last year, waiting lists routinely jeopardized the health, well-being and lives of hundreds of Americans living with HIV/AIDS. In fact, clients even died in South Carolina, West Virginia and elsewhere.

President Bush and Congress have attempted to address the problem with small increases, including a $38 million increase in 2005, $35 million in 2006, and $10 million in 2007. In addition, in June 2004 the President also released an emergency $20 million dollars to help provide services to those on the waiting lists. But never have these increases kept pace with the actual need.

There is also a financial rational for fully funding ADAPs. In advocating for additional funding, supporters of ADAPs point to the cost-effective nature of the program. The annual per-patient cost under ADAP last year was only $12,500, as compared to over $40,000 for treating a person with AIDS by Medicaid.

The likelihood of the cash-strapped ADAPs receiving additional federal funding is questionable with Congress embroiled in partisan differences over next year’s budget priorities. At present, proposed increases for the program are relatively small and far from the $135+ million needed to adequately address the waiting lists.

This raises the question about the federal commitment to fully funding ADAPs? What should AIDS advocates do about this problem?