WASHINGTONThe Clinton administration has decided not to extend Medicaid coverage to all low-income people infected with HIV. Currently, HIV-positive patients who have developed AIDS can receive Medicaid benefits even if they are not poor enough to qualify under normal Medicaid guidelines.
The administration had speculated that extending the AIDS exception would be cost effective by allowing HIV-positive patients to receive the newer HIV drug combinations that may prevent progression to AIDS.
However, Victor Zonana, a spokesman for the Department of Health and Human Services, said that none of the proposals for the expansion analyzed by the government yielded a revenue-neutral plan, that is, one that would not increase spending over a 5-year period.
Although the administration has declined to make the change nationwide, individual states have the option of developing and submitting their own proposals for such a change, if they can be shown not to increase costs. According to Mr. Zonana, at least three statesMaine, Massachusetts, and Floridahave expressed an interest in doing so.