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Utah legislators delay action on federal HIV grant due to reform concerns

Medication money in limbo do to questions on reform

Published: Wednesday, April 7 2010 12:00 a.m. MDT

SALT LAKE CITY — Utah GOP legislative leaders' animosity toward any federal health care reform has put in limbo a longtime federal grant that helps pay for drugs and other services for Utahns who are extremely ill or terminal with HIV/AIDS.

An annual post-session review of federal grants that require approval of the Legislature's Executive Appropriations Committee took an unexpected turn and got political in tone when Senate President Michael Waddoups, R-Taylorsville, and other top GOP leaders started asking about a routine federal grant that provides "life and death" drugs to Utahns who have HIV/AIDS-related health problems.

The grant program is named after Ryan White, a teenage hemophiliac who died from AIDS complications in the 1980s after contracting the HIV virus during a transfusion to treat the blood disorder.

"Doesn't Obamacare pay for this?" asked Waddoups, referring to the new health insurance reform package passed by Democrats in Congress and signed two weeks ago by President Barack Obama without a single Republican vote.

Waddoups said he would not vote for the grant, which has never been questioned in previous years, until all his questions were answered. Waddoups noted that voicing his concerns should not be read as intending harm or preventing necessary medications from being delivered to Utahns who receive them under the grant. The earliest the grant will be considered is at the committee's next scheduled meeting in May.

State Department of Health administrators did their best to answer the questions, noting that they had received no prior notice that lawmakers would be asking questions about that grant or any others on the list. The inaction puts the health department, already pinched by two years of budget cutbacks, in the position of finding the $420,000 from other areas in agency programs to cover the cost of providing the services through April.

Democratic members of the committee balked at putting off action, noting that doing so puts the health department in a more precarious financial circumstance should the committee decide not to approve the grant.

Health department administrators said the program saves lives every month, has been approved by the Legislature's Health Department budget review committee and never has been opposed before by the appropriations committee members.

Each year, the state puts up nearly $2 million, while the federal government puts up nearly $4 million, and needy, sick people get anti-HIV drugs and are placed in a long-term health-risk pool.

"In the five years I've been here, we've never missed this (grant approval) deadline," said Utah Department of Health executive director Dr. David Sundwall.

It is a question of life and death, he said, as the "few people who need these drugs, really need them." They may not die if they don't get the drugs for one month, but they likely would suffer, he said.

Waddoups and other Republicans questioned why "Obamacare" wouldn't pay for the drugs.

One health official said that when the law fully kicks in, in 2014, such payments will be covered by the new federal program. But until then — or at least for the current year — the Ryan White program must do, and the state needs to kick in its share to get the federal money.

At one point, Rep. Jennifer Seelig, D-Salt Lake, sighed audibly as GOP members kept asking what harm would come by waiting until May to consider the grant, which would allow staff time to provide answers to their concerns as well as background information about the program.

"I'm really troubled" by the GOP questions, said Rep. Carol Spackman Moss, D-Holladay, noting that it was unclear to her if her fellow committee members were troubled about the grant's implication in their minds of health or lifestyle of homosexuals or if it was just motivated by an anti-reform stance.

"Let's make a common-sense decision," said Sen. Luz Robles, D-Salt Lake.

"If this is a life-and-death decision, no one on this committee wants to vote against this," said House Budget chairman Ron Bigelow, R-West Valley. He said it's clear no one will die because the Executive Appropriations Committee did not approve the federal Ryan White grant now.

But the process was not followed properly, Bigelow added, and the grant's deadline — no money for April for the drugs — should not be brought to the attention of legislative leaders with just "a couple of minutes' notice."

No other Health Department programs will be harmed by waiting a month, Bigelow said.

GOP members of Congress and the Utah Legislature are dead-set against any kind of national health care reform and haven't been shy in acting like it. Utah lawmakers, the vast majority of whom are Republicans, approved a bill and a joint resolution in March telling Congress and the Obama administration that the state would delay any reform changes Washington imposed for at least a year, and that they would, in effect, defy any regulations Utah deemed to be counter to its own health care reform effort or thought to be violations of state sovereignty.

e-mail: bbjr@desnews.com; jthalman@desnews.com

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