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Medicaid Expansion

Health insurance increases access to important HIV/AIDS services. In 2010, the Patient Protection and Affordable Care Act (ACA) expanded access to health insurance, so more Americans, including those at risk for and living with HIV/AIDS, have access to health insurance.

This is particularly important for people living with HIV because the ACA ensures health insurance coverage for people with preexisting conditions (meaning they cannot be denied or dropped from health insurance). A Kaiser Family Foundation study found that people with HIV who gained coverage through the ACA were able to navigate health insurance and benefited from coverage, though health insurance literacy was a challenge.

A major provision of the ACA was to expand Medicaid to all people with incomes at or below 138% of the federal poverty level. The June 2012, the Supreme Court ruled that states could choose whether or not to expand Medicaid. By January 2016, 19 states had chosen not to expand their Medicaid programs.

Medicaid expansion is specifically important for a number of reasons to people living with or at high risk for HIV/AIDS. Prior to ACA implementation, only 17% of people living with HIV/AIDS had health insurance. By establishing a new minimum income eligibility level for Medicaid, more people living with HIV/AIDS are eligible to enroll in Medicaid.

Additionally, individuals living with HIV/AIDS historically have had difficulty accessing insurance because of screening for preexisting conditions, which is no longer allowable under the ACA. An estimated 60,000 people living with HIV/AIDS who are uninsured and have low incomes live in states that are not expanding Medicaid.

Resources to Learn More

The ACA and People with HIV: An Update
Document
Issue brief discussing how implementation of the Affordable Care Act (ACA) has helped provide health insurance to many people living with HIV. Provides an update on how people across the country have been impacted by this new legislation. Compares focus groups conducted in 2014 and 2016 to better understand the direct impact of the ACA.
Organization(s): Kaiser Family Foundation
Date: 5/2016

The Affordable Care Act and HIV/AIDS
Document
Reviews how the ACA improves healthcare access and coverage for people living with HIV/AIDS, as well as providing links to additional resources to learn more about the impact of the ACA and resources for people living with HIV/AIDS.
Organization(s): U.S. Department of Health & Human Services
Date: 2/2016

Implementation of the ACA for People with HIV
Video/Multimedia
Video of a policy briefing discussing what the implementation of the Affordable Care Act (ACA) means for people living with HIV. Includes testimony by John Carlo, CEO of AIDS Arms Dallas; Laura Cheever, Associate Administrator, HIV/AIDS Bureau, the Health Resources and Services Administration; Shandora Lane, a Ryan White client from Atlanta, Ga., who lives with HIV; and Tim Westmoreland, Professor from Practice, Georgetown University Law Center.
Organization(s): Kaiser Family Foundation
Date: 5/2016