Issue:  Vol. 48 / No. 3 / 18 January 2018

AIDS advocates worry
drug program will be cut


Jason Villalobos speaks of his dependence on medications provided through ADAP at a rally demanding that Governor Arnold Schwarzenegger fully fund the AIDS Drug Assistance Program. Photo: Rick Gerharter
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Local AIDS advocates, worried there's a lack of funding for the state's AIDS Drug Assistance Program next year, are calling for help for what they say is a life-saving program.

Dana Van Gorder, executive director of Project Inform, told about 80 people gathered outside San Francisco City Hall on Monday, November 30, that there could be a shortfall as large as $100 million for ADAP next year. The program helps provide medication to thousands of Californians living with HIV/AIDS.

At the rally – held the day before World AIDS Day – Van Gorder said that the financial collapse has resulted in "a life and death crisis" where thousands of people "may literally have the pills they depend upon to survive HIV taken out of their mouths."

He said that the state Office of AIDS could remove from the program as many as 8,500 people who earn more than $20,600 a year, among other changes. That would be a quarter of the 34,000 people that Van Gorder said are in the program.

The state health department, which includes the state Office of AIDS, did not confirm data on ADAP by press time.

Prescriptions for the drugs can cost $1,000 or more.

Jason Villalobos is an ADAP recipient who was diagnosed with AIDS five years ago.

"I will not lie down and die quietly because our state went over budget," said Villalobos, 30, at the rally. "... I will die without ADAP."

Several people held signs referring to Republican Governor Arnold Schwarzenegger like, "Arnie Do you Want Blood on Your Hands?" That sign featured red handprints.

This summer, Schwarzenegger used his line-item veto power to slash $52.1 million in general fund support to AIDS programs, including totally eliminating state funding for HIV prevention and testing efforts, on top of more than $30 million lawmakers had agreed to cut from the state Office of AIDS budget.

In a phone interview, Van Gorder said that Schwarzenegger would release his proposal for the 2010-11 state budget on January 10. He said that advocates are trying to persuade him to include $100 million to cover the shortfall they're predicting.

H.D. Palmer, deputy director of the state Department of Finance, said that Schwarzenegger hasn't made any decisions, "either on a final or preliminary basis," on funding levels for ADAP or other public health programs.

"We're in the process of finalizing our economic and revenue forecasts, which will determine the size of the budget gap that we have to close, and we will be sitting down with the governor over the next several weeks to make those decisions," said Palmer.

The state appears to already be in trouble ahead of next year. The legislative analyst's office said last week that "the state must address a General Fund budget problem of $20.7 billion" before the Legislature enacts a 2010-11 budget plan.

Van Gorder said that this year the state will use $255 million of its ADAP reserve fund – "virtually all of it," he said. That fund comes from rebates that pharmaceutical companies pay on the purchase of drugs, in addition to discounting the cost of medications for ADAP, according to Van Gorder.

He said the state has used so much of the rebate revenue that the only way to maintain the program next fiscal year is to get more money from the state general fund, the federal government, or the pharmaceutical companies. Each is a source for ADAP, which this year is $415 million.

"We will be working on trying to accomplish all three of those things," said Van Gorder.

He said that there are legislators, such as openly gay state Senator Mark Leno (D-San Francisco), "who realize how great the damage is that's being done here."

Leno said, "Without a doubt, we'll have a big battle in the coming year. I can assure you that the Democratic Caucus of both houses of the Legislature are fully committed to keeping ADAP funding intact, but we've seen what the governor's already done with his line item veto, and our strength in communicating with him will be in our coalition."

He explained, "This is not just an issue for the LGBT legislative caucus," it's also a "top issue" for the women, African American, and Latino caucuses.

Van Gorder said that the situation "simply has to be addressed by all of our elected officials," and he called for help at the federal level.

It's "just completely incongruous as the Congress and president attempt to adopt some system of national health care reform, the underlying principle of which is that all Americans should have access to care and treatment, not just for HIV, but for everything else," he said.

Shin Inouye, President Barack Obama's director of specialty media, wrote in an e-mail, "Ensuring adequate support for HIV/AIDS care and treatment is a critical priority for [the president]. That is why he signed the reauthorization of the Ryan White HIV/AIDS program and why his FY 2010 budget proposed increased funding, including an increase for ADAP funding."

However, he also wrote, "the federal government cannot be expected to step in and fill in for all of the gaps in services resulting from state budget cuts." That's why Obama's "working so hard to enact comprehensive health insurance reform ...," he said in the e-mail.

Van Gorder also said that advocates would be appealing to California's two Democratic senators, Barbara Boxer and Dianne Feinstein, and House Speaker Nancy Pelosi (D-San Francisco) "to say whether as part of national health care reform or some other means, you have to identify dollars that will create a bridge in ADAP funding until we hopefully see national health care reform adopted."

Drew Hammill, a spokesman for Pelosi, wrote in an e-mail, "The speaker has a long history of support for ADAP increases," including when she was a member of the Labor-Health and Human Services-Education Appropriations Subcommittee. 

"She continues to advocate for strong increases to ensure access to the lifesaving medications provided by this program," he wrote. "A $20 million increase for ADAP is included in both the House and Senate versions of the pending fiscal year 2010 Labor-HHS-Education appropriations bill."

Hammill added that the "House health reform bill includes provisions to significantly expand access to HIV medications under Medicare Part D and to dramatically expand access to Medicaid, which includes access to prescription drug coverage in all 50 states."

Feinstein and Boxer's offices did not provide comment.

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