Though certain new drugs are already showing great promise in life-saving battles against AIDS, health maintenance organizations and state distribution systems insist on severe limits to what they'll spend for each patient's welfare.

Typical allowances for drugs add up to little more than $3,000 per year, though costs for the drug combinations deemed most effective cost at least $10,000 annually. The new drugs appear to dramatically improve many patients' health and are raising hopes in individuals who have had little expectation they'd live even a year longer.

Low income patients have previously been given state assistance, particularly if they're not covered by private health insurance or government programs like Medicaid. Though the Clinton administration has arranged to provide as much as 85% of the $300 million spent each fiscal year to shore up states' drug assistance programs, officials in various states now say funds are dwindling rapidly and that they are currently faced with major shortages causing them to set strict limits on who gets what when it comes to supplying the highly effective AIDS drugs.

Thus, in Missouri, for example, only 132 persons are eligible for protease inhibitors. A cap of $10,000 has been placed on what any of these recipients receive. Oregon, South Dakota, Nevada, and Arkansas are poised to spend nothing on protease inhibitors. In Florida, a state which has maintained 3rd place in U.S. locales hardest hit by the epidemic, even the $24 million supplied this year by the federal government will not be sufficient for the state's needs. "We anticipate needing many more dollars," insists David W. Poole, chief of AIDS patient care at the Florida Health Department.

The limits imposed by HMO's on drug availability at pharmacies are not for AIDS patients specifically, though its believed AIDS patients are affected most. A policy analyst at Gay Men's Health Crisis in New York, says that "pre-authorization requirements and caps on prescription drugs are becoming a significant problem" for men and women with AIDS. The most distressing fact is that people with AIDS must continuously seek ways to stay covered by one insurance program or another. The search becomes, literally, a full-time occupation.

Patients tell of desperate financial struggles endured while they've suffered extreme wasting and energy loss. "The worrisome pressures that fall on such people have more than just negative effects on their psyches," says one AIDS caseload worker. "There are those who go into deep depressions and sometimes its difficult to save them."

AIDS activist Warren D. Adkins says there are once again reasons to "act up." "Drug companies, states, and insurance providers must once again be given brash notices," he says, "loud and clear notices."