The 2005 ADAP Report published by the National Alliance of State and Territorial AIDS Directors (NASTAD) shows that Texas is among "ADAP's with other cost containment strategies (instituted din April 1, 2004). That strategy would be "capped enrollment for Fuzeon access with 82 individuals on Fuzeon waiting list." The report also shows Texas to be among those "ADAP's anticipating new/additional cost-containment measures (before March 31, 2006)." There's no hint what that measure might be, but, by rule, it would include the institution of medical criteria for eligibility for the program.
Given that THMP was already pursuing this strategy to some degree with through the advice being given by its medical director (now, unfortunately, in the Army and not where we need him in Texas), it's hard to see how much further this measure can be pushed before the next level of cost containment (eliminating spend down) is instituted.
[I decided that I didn't want the "picture," but can't get rid of it now that it's here. That's my punishment for playing with the tools.]