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Left out of the budget

AS LAUDABLE as it was for legislators to have a budget on the governor's desk before the start of the fiscal year, there is still unfinished business that justifies a supplemental budget.

Unless more funds are put into the HIV-AIDS Drugs Assistance Program, for example, the state might have to put patients on a waiting list for these life-saving medications. More money is also needed for substance abuse services lest the state forfeit $9.1 million in federal matching funds, according to the Executive Office of Human Services. Legislators should give priority to these appropriations over more controversial ones that could get in the way of speedy approval during an informal session.

The drugs program, which is partially funded by the federal government, is for AIDS patients who earn too much to qualify for Medicaid but are not privately insured. Demand has grown as more individuals become infected and those with the disease live longer. The increase in the ranks of the uninsured also adds to the number seeking this assistance. The cost of the drugs purchased increases as patients with viral strains resistant to first-line drugs have had to switch to more-expensive second-line medications. The average per patient outlay now is $15,600 per year.

The drugs program was under particular pressure this year because the state had unwisely lowered the eligibility cap for AIDS patients seeking Medicaid assistance from those earning 200 percent of the poverty level to 133 percent. Patients excluded from Medicaid as a result had to look to the drugs program. The budget for next year restores the 200 percent eligibility level, but officials estimate that there is still a gap of $2.4 million that must be filled to avoid waiting lists, which several other states have been forced to use.

Some of the $11.8 million in substance abuse funds sought by the Executive Office of Health and Human Services in the supplemental budget would go to the most basic step in addressing drug and alcohol abuse: detoxification. Because of budget cuts, the number of detox beds in the state is less than half what it was two years ago, says John Auerbach, executive director of the Boston Public Health Commission.

Detox facilities are just one of several public health functions that have not been adequately funded in the past two years. Prevention and screening efforts for a wide range of diseases have also been scaled back. A supplemental budget now cannot restore all those programs, but it can at least ensure that the state still supplies such basic services as AIDS drugs and assistance for those trying to break alcohol or drug addictions. Legislators can and should approve such a budget without taking sides in the broader dispute dividing the Romney administration and legislative leaders who take issue with the governor's rosier view of state finances. 

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