Medicaid expansion update.

Proposals have been made to expand Medicaid to ensure that uninsured or underinsured people living with HIV are receiving the medical benefits they need. Medicaid is an assistance program designed to provide health care benefits to those eligible through a certain income level and disability. An HIV-positive person currently cannot be eligible for Medicaid until he or she is already sick, thereby delaying treatment which could have prevented the sickness from progressing. In 1997 it was proposed to expand Medicaid to include people living with HIV to facilitate early treatment and to save money. Medicaid expansion at the Federal level was stymied because of a need to increase the budget to accomplish the changes. At the State level, however, the expansion can proceed as long as it meets Federal requirements and is accepted by the Health Care Financing Administration (HCFA). Maine, Massachusetts, Florida, Wisconsin, Colorado, and Texas are considering the expansion, including issues such as eligibility, benefits, and service delivery. A study addressing the costs and benefits of expanding Medicaid showed these changes would save lives and be cost effective.