Opinion: Budget a Death Sentence for New Jerseyans with AIDS

R. William Potter | July 20, 2010
Cuts put proven drugs out of reach for sufferers, yet save the state next to nothing

More than 900 New Jerseyans received a bipartisan death sentence at the end of June.

That’s when Democrats and Republicans, voting together to balance the budget without a tax increase, tightened eligibility for persons with AIDS who can’t afford costly antiretroviral drugs that can stave off the ravages of a disease that has taken 35,000 New Jersey lives since data were first collected.

How did this happen? The budget law cut eligibility for the successful AIDS Drug Assistance Program (ADAP) from 500% of the federal poverty level ($10,000) to 350%. In other words, someone with AIDS who earned up to $50,000 a year was eligible for ADAP, but now the cutoff is reduced to $35,000.

To some, that may sound generous. After all, earning $35,000 seems almost middleclass these days, not an amount typically associated with recipients of public charity, especially in tough economic times.

But consider: The costs of these AIDS drugs — like those keeping basketball legend and millionaire Magic Johnson healthy, not wasting away in the corridor of a public hospital — can exceed $25,000 a year. The result is that an estimated 957 registered ADAP recipients are too wealthy for ADAP, but too poor to obtain access to these life-saving meds.

Thus while it might seem mean-spirited to call this budget-cutting measure a death sentence in slow motion, it’s no exaggeration. And as their illness grows worse, sufferers’ incomes fall or they become jobless, qualifying them for the full array of welfare and Medicaid treatment. Now you’re talking real money, as the costs of drugs for just one AIDS patient exceeds an average of $600,000 lifetime, assuming (optimistically) the victim survives for 24 years.

But what about those state budget savings, which legislators worked so hard to find? They amount to a whopping $7 million. While even $1 million is no one’s idea of chump change, $7 million — compared to overall state funding of $29.5 billion — is a rounding error of two-hundredths of 1% of state spending for the year. Broken down further, that’s a cool two hours of state spending. Not much money saved, and it comes at the cost of lives shattered or lost, along with far greater taxpayer expense in the longer term.

So what is the state doing to prevent more AIDS infections, the ultimate budget-balancing and life-saving initiative? Precious little. Only three years ago, New Jersey ended its mindless holdout as the only state preventing clean needle exchange programs (NEPs) that contain HIV caused by intravenous drug users who share needles contaminated with the virus. Every study of NEP in other states has concluded that allowing addicts to exchange dirty needles for clean ones saves lives, prevents HIV in sexual partners and their children, and induces IV drug users to seek treatment for their addiction. And at 10 cents per clean needle or syringe, the benefit-to-cost ratio is staggering.

But cash-strapped New Jersey is not allowing any expansion of its NEP, which remains the most restrictive in the nation. The state limits the NEP to just six cities in a “pilot program” that has had to limp along on private donations. State law prohibits any public funds for needle exchange, despite an estimated 8,000 active IV drug users who need help most and can’t get it.

What all this adds up to is an inexplicable lack of common sense — never mind compassion — among Democrats and Republicans in the Statehouse. Why vote to “save” $7 million by tightening the ADAP eligibility, when doing so could hasten the deaths of more than 900 residents or drive them into poverty where taxpayers will bear the full costs of their healthcare at an estimated $600,000 per AIDS patient? Why not invest in NEPs to prevent more HIV infections that can lead to full-blown AIDS and costly public dependence?

And what of the people who face these life-or-death decisions even as I write this? What of their orphaned children who may become wards of the state?

We all want to see more bipartisanship in Trenton. But not when it comes at such a high price — for all New Jerseyans.

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