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Medicaid AIDS coverage unfair; not likely to change.


 Two recent studies conclude that many state Medicaid programs should modify limitations on health care coverage for AIDS patients. A study sponsored by the Agency for Health Care Policy and Research found that fixed payment programs offered by many state programs can discourage hospitals from admitting Medicaid recipients needing expensive care. However, a payment system that adjusts payments according to a patient's diagnosis-related group (DRG) is more likely to meet the needs of specific patients. In a study conducted at the University of Illinois at Urbana, researchers found that, in 1992, 12 of 42 responding states had some form of annual utilization limit on inpatient hospital care for Medicaid patients. Nine states limited the number of hospital days to 15 to 45. These studies come at a time when Congress is proposing to fund Medicaid through block grants, which probably means a cut in Medicaid funding for most states. In addition, Congress proposes to cap increased spending on Medicaid to four percent annually (vs. ten percent currently). States will then have to either cut back coverage or reduce enrollment of new patients.
