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Early Treatment for HIV Act

The Problem

Currently, childless adults living with HIV generally only qualify for Medicaid coverage once they become eligible for Supplemental Security Income (SSI).  Because an individual is not eligible for SSI until they become disabled, a person with asymptomatic HIV infection is not eligible for Medicaid until he or she has progressed to full-blown AIDS.  Without access to Medicaid, many low-income, HIV-positive individuals lack the ability to receive medical care that would help to slow the progression of the disease and prevent the onset of opportunistic infections.
 

What is the Early Treatment for HIV Act?

The Early Treatment for HIV Act (ETHA) would permit state Medicaid programs to provide HIV treatment to individuals before they develop AIDS.  The Act would amend Title XIX of the Social Security Act to provide states with the option of covering low-income, HIV-positive people as “categorically needy.”  States taking advantage of this option would be provided with an enhanced federal Medicaid match. 
 

Critical Treatment and Taxpayer Savings

Treating those who are HIV-positive early in the progression of the disease provides numerous benefits.  Providing therapy earlier keeps individual viral loads suppressed and delays the onset of opportunistic infections.  Lower viral loads decrease the transmissibility of the disease and thereby reduce new infections.  Most importantly, early treatment improves the quality of life for countless HIV-positive individuals.

In providing this critical treatment, ETHA would also create significant savings for taxpayers.  Because early treatment for HIV-positive individuals would delay both the need for more expensive forms of treatment and the time at which individuals would become medically disabled, enacting ETHA could reduce demands on the SSI, Social Security Disability Insurance Savings, and Medicaid and Medicare programs.  Additionally, ETHA would lessen the strain on other federal HIV/AIDS programs, such as those funded by the Ryan White CARE Act.
 

Action in the 112th Congress

ETHA was introduced in the 112th Congress by Representatives Eliot Engel (D-NY)  on June 21, 2012 (H.R. 6006).  A three-year ETHA program was a part of the House passed health reform bill.  It was not included in the final reform legislation.
 

What is the Current Status of the Bill?

ETHA is expected to soon be reintroduced in the 113th Congress.

 

For more information, please contact legislation@hrc.org. Read about other Federal Legislation pertinent to the LGBT community here.

Last Updated: April 24, 2013