Medicare Part D: Implementation, Impact and HIV/AIDS Policy

Philip Curtis, AIDS Project Los Angeles

Enacted by Congress in 2003, the Medicare Prescription Drug Improvement and Modernization Act was intended to be the largest expansion of public health benefits in the United States in 40 years. It provides millions of Medicare-eligible senior citizens and disabled people with complete or partial coverage for prescription medications for the f~st time. Whether Medicare Part D prescription drug benefit amounts to an expansion or a constriction of public health benefits for Californians disabled with HIVIAIDS remains a question, especially for people living with HIVIAIDS who are dually eligible for both Medicare and California's Medi-Cal program. AIDS Project Los Angeles (APLA) is proposing to conduct research in collaboration with California State University at Dominguez Hills (CSUDH) that will: 1) Explore the impact that Medicare Part D may have on dually eligible people living with HIVIAIDS with a focus on their access to care, treatment and drugs; and 2) Explore policy implications and responses to the impact of Part D on the target population. Specifically, APLA and CSUDH plan to conduct qualitative (n=40) and quantitative (n=200) interviews with APLA clients throughout Los Angeles County, and key informant interviews (n=12) with stakeholders throughout California. To explore the impact of Medicare Part D, information from both the client and key informant interviews will be used to document and identify the range of impacts and to examine factors associated with social, economic, and health outcomes. Key informant interviews with stakeholders will be used to further explore intended and unintended consequences of Medicare Part D among people living with HIVIAIDS. Following these interviews, APLA will sponsor a think tank (n=10) that will help the research team analyze and interpret fmdings from the study. Findings from the study will constitute the subject matter for a policy document - co-authored by members of the think tank - that will contain a description of the study, its findings and recommendations for policy responses. The findings from the proposed study will be used to inform a larger study of the impact of changes in Medicare on various populations throughout the state of California.