Speaker Pelosi praises H.R. 3962 that will improve Medicaid access to HIV/AIDS-affected people

December 20, 2015

The bill's expanded access to Medicaid begins in January 2013, when the new Health Insurance Exchange begins operation. In the interim, H.R. 3962 further ensures early access to care and treatment for people living with HIV by giving states the option of an enhanced federal match if they choose to cover people with HIV in their existing Medicaid programs. In participating states, people with HIV infection would qualify for coverage using the same eligibility standards that currently apply for disabled adults.

In addition, H.R. 3962 also finally allows medications provided through the AIDS Drug Assistance Program (ADAP) to count toward out-of-pocket costs in the Medicare Part D 'donut hole'. Prior to this change, ADAP beneficiaries would enter the "donut hole" coverage gap and then never leave it because their drug costs weren't being counted.

Now, ADAP beneficiaries will exit the "donut hole" more quickly, giving them access to the full range of medications covered under Medicare Part D. This is important because ADAP programs generally have a more limited formulary than the typical Medicare Part D plan.

SOURCE Office of the Speaker of the House