Early Intervention Program Saves Washington Money
Medication and Insurance Assistance for People Living with HIV/AIDS
An HIV diagnosis opens the door to a complicated world of medical terms, drub regimens, insurance rules, and personal change. If the newly diagnosed person isn’t already in a low-income category, HIV likely puts them on the road to it. The cost of care can be financially debilitating. HIV will preclude someone from gaining private insurance if they don’t already have it. The drugs required to treat HIV can cost between $1,500 and $4,500 every month.
Washington employs a treatment entry point for people called the Early Intervention Program. Whether a person has HIV or has already progressed to AIDS, they start at EIP. The program covers health services and medications for HIV-positive people who have low to moderate income and who are not already on Medicaid or covered through Veterans Affairs. It also helps enrollees pay their insurance premiums for COBRA or the Washington State High-Risk Insurance Pool creating large savings for the state.
At a time of record enrollment, the Governor proposes to reduce EIP funding by $3M, or 13.2%. A record number of the state's residents, between 11,000 and 12,000, are now living with HIV. While the majority of these individuals are not dependent on state-funded programs, a worsening economy is bound to change that dynamic putting more stress on the lifeline of EIP. 3,377 people are currently enrolled in EIP, and 170 additional persons turn to EIP for help annually. Unrestored, the $3M cut will inevitably cost Washington millions more.
Every dollar spent on HIV care saves money and prevents new infections:
1. EIP is a lifeline, ensuring uninterrupted access to life-saving medications
For a disease that requires at least 95 percent adherence to prevent developing a resistance, taking medicine consistently is key. Research has shown that HIV-positive people who take breaks from their drug regimens are more likely to die prematurely. Source: Inflammatory and Coagulation Biomarkers and Mortality in Patients with HIV Infection, 2008 Oct 20
2. Providing access to care and medications avoids more costly ailments later
By maintaining an individual’s health through steady access to medical care, the cost of HIV/AIDS care can be greatly reduced. The annual cost of medical care for a person with early-stage HIV disease is $14,000 per year, in comparison to $37,000 per year for those with late-stage AIDS. EIP helps ensure such access to care, allowing clients to remain healthy, and in many cases, to return to work and contribute to our economy. Source: Distribution of health care expenditures for HIV-infected patients. 2006 Apr 1
3. Access to care and medications is an important component of HIV prevention
There is clear data that treating people with HIV significantly decreases their likelihood of transmitting HIV, helping curb down infection rates in our state.
Lifelong AIDS Alliance, and AIDS Service Organizations across Washington, Urge the State Legislature to Restore $3M for EIP. During these devastating times, holding the line on EIP funding is, in effect, a cut to a program barely coping with record demand.
EIP PROGRAM OVERVIEW
Early Intervention Program (EIP) is an assistance program helping eligible HIV positive people in Washington get health care to help with their HIV-related medical costs.
1. Services Provided:
Prescription medications
Limited HIV-related provider visits and tests
Limited dental care
Helps eligible clients get medical insurance
Aids in paying for insurance and premiums
2. Eligibility Requirements: Family income at or below 300% FPL
3. Enrollment: 3,377 clients
4. Race of clients served
· White 61.27%
· African American/Black 13.05%
· Multi-Racial 5.22%
· Asian 1.95%
· Amer. Indian/AK Native 1.56%
· Nat. Hawaiian/PI 0.64%
5. Gender of clients served: 86% male, 13.5 % female
6. Socio-economic status of clients served: 74.74% Less than 200% FPL 2,451
o 1,350 clients per month received medication
o 560 paid a monthly cost share
7. Funding
o Washington State budget allocated approximately $22.75 million annually to EIP last biennium, comprising 38% of EIP’s budget
o In 2008 additional revenue sources included: Federal 40%, Prescription Drug Rebates 21%
8. Costs of Services/Programs:
Rx Drugs 50%
Insurance 33%
Med/Lab 7%
Spenddown 6%
Administration 7%
Source: HIV Client Services Update EIP Brochure, November 2008.
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