State Policies and the Financing of AIDS Care

Treating illness related to human immunodeficiency virus (HIV) may cost the United States $50 billion during the 1990s. Deciding how to distribute that cost burden over federal, state, and local government; employers; third-party payers; and patients poses major problems for our society. Significant initiatives must be taken quickly to organize adequate data to make informed policy choices on AIDS (acquired immune deficiency syndrome) treatment finance. To that end, this Note reports the results of a telephone survey of officials in all 50 states and the District of Columbia between the fall of 1987 and the fall of 1988. The survey material was organized to answer questions about the state of the epidemic and about four policy domains as they affect HIV/AIDS patients — eligibility for Medicaid, services reimbursed under Medicaid, guarantees of access to private health coverage, and regulations of benefits offered under private policies. The Note describes the survey in detail, presents the findings, and attempts to explain them. It includes a section on state-by-state statistics regarding HIV infection, AIDS caseload, and care expenditure; sections on Medicaid and private health insurance as they relate to HIV infection and AIDS; and a section on statistical tests of the relationship among Medicaid and private insurance and state background variables as explanatory factors.