Elton John and Sen. Bill Nelson (D-FL) have an op-ed in Politico this morning urging Congress to increase funding for programs that provide access to HIV/AIDS drugs. “All 50 states now have assistance programs for people with low income, living with the disease. But, in an increasing number, the need for these medications is greater than federal and state funding,” the two warn, arguing that “these cuts will only lead to higher costs to taxpayers in the long run“:

First, patients who lose their assistance and are forced off HIV medications could develop drug-resistant strains of HIV — which may well be more difficult to manage.

Second, denying treatment to low-income, HIV-positive people will most likely result in increased transmission of the disease. A recent, groundbreaking study by the National Institutes of Health demonstrated that people living with HIV who receive effective drug treatment are 96 percent less likely to pass the virus on to their uninfected partners.

Third, while HIV/AIDS medications are expensive, the emergency room and hospital care required by people who do not receive them is far more costly.

While Congress debates funding levels for the next fiscal year — President Obama asked Congress to increase funding for AIDS medications to $940 million in the next fiscal year, but a Senate appropriations subcommittee has only approved $900 million — HHS has recently released $1.89 billion in grants through the Ryan White HIV/AIDS Program. Approximately $1.213 billion will be sent to states and territories under Part B of the Ryan White Program, with $813 million of that total designated specifically for the AIDS Drug Assistance Program (ADAP). ADAP is a national initiative funded by the federal and state governments and run by the states that provides prescription drug coverage for low-income people with HIV/AIDS. As of October, 7,409 individuals in 10 states were waiting to sign up for the program.

Meanwhile, health advocates continue to fight against cuts to health care programs that HIV/AIDS patients rely on. Earlier this week, House members from California met with CMS Administrator Donald Berwick and urged him to deny the state’s request to cut $1.4 billion from Medicaid, the single largest source of coverage for people with HIV.

Earlier this week, Sen. Orrin Hatch (R-UT) spoke about his efforts to repeal the Affordable Care Act before the conservative Heritage Foundation in Washington, DC. Hatch was introduced by Michael Franc the group’s vice president of government studies, who, in recalling the major provisions of the law, took a veiled swipe at the ongoing Occupy Wall Street movement.

Franc said that the health law’s provision permitting young adults to stay on their parents’ health insurance policies until age 26 was driving up health care premiums and suggested that its beneficiaries were slackers, akin to the Wall Street demonstrators:

FRANC: And that increase comes even as two coverage mandates are taking effect. One is to cover grown men and women up to age 26, many of whom are protesting at the Occupy Wall Street demonstrations, I might add. I was there this past weekend looking at it.

Watch it:

Hatch didn’t repudiate Franc’s characterization in his remarks, despite the fact that 1 million Americans have become insured as a result of the provision. Instead, the senator accused the demonstrators of possessing a “welfare mentality” that is “starting to pervade our country.”

Interestingly, while Hatch and Heritage now condemn health care reform, both Hatch and the Heritage Foundation had supported the individual mandate — a key provision of the law — before it was embraced by President Obama.

A coalition of hospitals is urging the super committee to avoid Obama administration-backed reductions to the Medicaid program, warning that a federal cut in funding would “simply shift existing and growing costs onto states, providers and beneficiaries, and damaging the nation’s already fragile economy.” In a latter sent to the committee last night, the coalition specifically singled out proposals to “blend” Medicaid reimbursement rates and limit states’ use of provider taxes — two proposals Obama included in his deficit reduction plan:

The nation’s hospital systems recognize that Medicaid costs are putting significant pressure on federal and state budgets as millions have lost their jobs and now need this critical safety net. We would like to work with you to find positive solutions to alleviate this pressure while maintaining a strong safety net. Sound policy changes would reduce the overall costs in the health care system—not simply shift existing and growing costs onto states, providers and beneficiaries, and damaging the nation’s already fragile economy. Two proposals likely under consideration by the Joint Select Committee, unfortunately, do not meet this test.

One proposal would combine the various Medicaid Federal Medical Assistance Percentages (FMAPs) provided to states into a single “blended rate” for all populations and services…A separate proposal would limit states’ use of provider taxes (also known as provider assessments) to help fund the non-federal share of Medicaid costs. Provider taxes, which are paid by health care providers, are tax revenues that are widely used by states to pay for the state share of Medicaid costs. Provider taxes allow states to maintain a functioning Medicaid program. Cutting state use of provider taxes limits states’ flexibility in financing their Medicaid program and will hurt patients.

All this sounds benevolent enough, but hospitals fear that a drop in Medicaid funding will result in an increase in uncompensated care and force providers to offer emergency treatments to a growing uninsured population. They’re also lobbying the committee to raise the Medicare eligibility age and move younger seniors into private policies, which typically pay higher reimbursements to providers. What we’re seeing is concern about the bottom line.

But this minor outrage over “blended rates” and provider taxes is just a small preview of the kind of resistance Republicans will face from hospitals, doctors, and their lobbyists if they ever make a serious push to block grant the Medicaid program and significantly reduce federal health care funding to the states.

On Tuesday, Sen. Orrin Hatch (R-UT) told Inside Health Policy’s Sahil Kapur that the Democratically-backed idea of extending Medicaid drug rebates to beneficiaries in Medicare Part D was “a very important area,” and said he “expect[s] it to be under consideration” in the deficit reduction talks. “We’re going to have to try and go through it line by line, every part of that, and see what we can do with it on a bipartisan basis,” Hatch told Kapur.

But the morning after, drug lobbyists — who are the senator’s top campaign contributors — “were frantic,” Kapur’s sources claim, and, “Hatch’s office sent an email to IHP emphasizing the lawmaker’s opposition to Part D rebates and seeking a clarification in the article.” The senator’s staff even released a memo to journalists and lobbyists “saying the reporting of his comments ‘completely mischaracterizes’ the lawmaker’s position on the issue”:

In the meantime, industry sources said, Hatch’s office went into damage control efforts with the drug industry, which loathes the rebate proposal. In one email to the industry’s top lobbying group, the Pharmaceutical Research and Manufacturers of America (PhRMA), obtained by IHP, Hatch’s office insisted the notion that he supports changes to rebates “of course is false.” He promised them he is not asking the super committee to take up the policy and declared that the Part D program is “working so well.” PhRMA excerpted from the email in a note to its members. [...]

In an email exchange with IHP Wednesday (Oct. 12) morning, Hatch spokeswoman Julia Lawless said the lawmaker meant that he would go through the proposal on a line-by-line basis to see how to prevent government price controls. “This can be done on a bipartisan basis, given that some Democrats are against government price controls as well,” is what Hatch intended to say, according to Lawless.

Indeed, extending Medicaid drug rebates to Medicare patients has long been a Democratic priority that is typically opposed by Republicans. Back in 2003, the GOP-backed Medicare Part D legislation moved the 6 million Americans who were eligible for both Medicare and Medicaid into the Medicare Part D program, creating a windfall for the industry. Whereas Medicaid delivered an average discount of about 34 percent from pharmaceutical companies that participated in the Medicaid program, “the average discount obtained by the Part D plans was 14 percent,” according to a report issued by Rep. Henry Waxman (D-CA). As he put it, “The drug companies are making the same drugs. They are being used by the same beneficiaries. Yet because the drugs are being bought through Medicare Part D instead of Medicaid, the prices paid by the taxpayers have ballooned by billions of dollars.” CBO estimates that if drug manufacturers provided the Medicare Part D program with the same prices that Medicaid receives, the government could save $112 billion over 10 years.

According to Open Secrets, pharmaceuticals is Hatch’s top career contributor, funneling some $1,705,597 to the senator since 1989.