Anthem Blue Cross, California’s largest health insurer, was just sued for discriminating against patients with HIV and AIDS. The company instituted a policy prohibiting these patients from filling their prescriptions at local or specialty drug stores, instead requiring the use of a mail-order pharmacy. These limitations outraged many Californians.
Ensuring improved access to healthcare has been at the center of our country’s health debate for decades. Providing access to the uninsured was the foundation of President Obama’s successful push to overhaul our healthcare system through the Affordable Care Act. This legislation was long overdue. Many of its provisions will remove the barriers to care that have kept people from achieving improved health outcomes.
However, after a closer look at our new healthcare system, advocates are starting to voice concerns about areas that can diminish access to care. One such issue is the Independent Payment Advisory Board (IPAB), which has the power to limit care for those who need it most.
IPAB is a powerful new board charged with controlling Medicare spending, limiting Medicare’s growth to the rate of GDP growth plus half of a percentage point. While this may sound like an effective way to control spending, IPAB’s cost-controlling authority is severely flawed.
IPAB only authority is to cut government reimbursement rates to doctors who treat Medicare patients. These rates are already dangerously low, resulting in doctors turning away patients. Between 2004 and 2009, the number of doctors refusing new Medicare patients more than doubled, according to the American Academy of Family Physicians.
Here in California, finding a doctor is already more difficult than just about anywhere else in the country. A recent series of studies by California HealthCare Foundation documented acute doctor shortages across the Golden State. Los Angeles is one of California’s counties that don’t meet the federal government’s recommended supply of primary care physicians. In 2008, there were just 58 per 100,000 people.
IPAB’s unencumbered authority will only exacerbate this problem.
This is of particular concern to those of us at the Wall Las Memorias Project – an organization that works with Latino populations in California affected by HIV/AIDS. Our fear is that IPAB will dramatically reduce the number of doctors that accept Medicare patients. This will limit access to healthcare, particularly for patients with chronic diseases like HIV/AIDS.
HIV/AIDS may not seem like a health care issue for seniors, but according to the Centers for Disease Control, more than half of HIV positive Americans over 65 develop AIDS. These patients account for 35 percent of all AIDS-related deaths.
Currently the number of HIV positive Medicare enrollees is rising. Approximately one fifth of infected Americans receive their treatments through Medicare. If IPAB is allowed to implement Medicare cuts, care will become increasingly challenging to access for seniors with HIV/AIDS.
Fortunately, our representatives are recognizing that IPAB will do more harm than good. In January, a bipartisan group of lawmakers introduced the “Protecting Seniors’ Access to Medicare Act” – a bill to repeal IPAB. Democratic Representative Linda Sanchez of California’s 38th district is one of the bill’s co-sponsors.
At The Wall Las Memorias Project, we’ve seen the tragic consequences when people who desperately need healthcare are denied access. We applaud Rep. Linda Sanchez for her work to ensure Californians living with HIV/AIDs get the treatment they need.
Americans know that Medicare needs a fiscal overhaul; the program is careening towards bankruptcy, while driving a large portion of our nation’s debt. But IPAB’s proposed solution will only weaken our healthcare safety net.
Other lawmakers in Washington, from California and across the country, should follow Rep. Sanchez’s lead and support her efforts to repeal IPAB.
Richard Zaldivar, Executive Director/President & Founder of The Wall Las Memorias Project, an organization dedicated to promoting wellness and preventing illness among Latino populations affected by HIV/AIDS.
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