By the end of 1987, the Centers for Disease Control reported about 50,000 cumulative cases of acquired immune deficiency syndrome (AIDS) since 1981. The extent of the problem for states varies with the number and types of cases. States have responded to the AIDS epidemic with varied policy initiatives: states support treatment of those with AIDS, develop traditional public health measures, regulate insurance companies, and enforce antidiscrimination laws. The degree and content of each states responses appear to be linked most significantly to the incidence of AIDS. Nevertheless, states with strong social conservative power and a competitive party system have lower per case expenditures for AIDS.