South Carolina is once again making really bad news on HIV/AIDS: People living with HIV are rallying against a budget plan that will end funding for a program that helps low-income people living with HIV/AIDS buy meds. More than 2,000 people would lose their insurance and potentially have to end treatment. It’s an unfortunately timely reminder of how poorly our current national health care system works. South Carolina has been among a batch of largely southern states that have struggled chronically to maintain their AIDS Drug Assistance Programs, which are jointly funded by the feds and state governments. The programs patch up a huge hole in the health care safety net, by offering coverage to thousands of working Americans who don’t qualify for Medicaid but can’t afford the hefty price tag of HIV drugs. Like Medicaid, however, ADAPs have long created budget problems – particularly in southern states, where the epidemic has grown most quickly. South Carolina’s program has stood out as a problem. In 2005, four people died while lingering on a waiting list for entering the program. But South Carolina isn’t alone. Throughout the Bush era, several states developed ADAP waiting lists, and as of March 5, 662 people were on waiting lists in 10 states. Check out the blog of Housing Works, a New York City-based AIDS group, for a solid round up of the budget pressures nationally. Advocates are petitioning President Obama to make an emergency allocation of $126 million to keep ADAPs around the country afloat this year. But the bigger picture, of course, is health care reform. ADAPs are a disturbingly fitting example of our problem: The programs exist only because our larger system has so utterly failed, leaving tens of thousands of people neither covered by Medicaid nor able to participate in the private market. ADAPs were a patch, but even the patches to our health care system have worn through.