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The ACA and People with HIV: An Update

Executive Summary
  1. Heather Bradley, et al. Centers for Disease Control and Prevention. “Vital Signs: HIV Diagnosis, Care, and Treatment Among Persons Living with HIV — United States, 2011.” Morbidity and Mortality Weekly Report.63(47);1113-1117. November 28, 2014

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  2. Myron S. Cohen, et al. “Prevention of HIV-1 Infection with Early Antiretroviral Therapy.” New England Journal of Medicine. 365(2011):493-505.

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Introduction
  1. Prior to the ACA, Medicaid eligibility for low income childless adults was quite limited and under pre-ACA Medicaid eligibility rules, to qualify for the program, one had to meet financial eligibility criteria and belong to a group that is “categorically eligible” for Medicaid (such as children, parents with dependent children, pregnant women, and individuals with disabilities). Federal law categorically excluded non-disabled adults without dependent children, unless a state obtained a waiver or uses state-only dollars to cover them. These Medicaid eligibility rules presented a “catch-22” for many low-income people with HIV who could not qualify for Medicaid until they were already quite sick and disabled (usually having progressed to an AIDS diagnosis).

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  2. Myron S. Cohen, et al. “Prevention of HIV-1 Infection with Early Antiretroviral Therapy.” New England Journal of Medicine. 365(2011):493-505.

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  3. J. Kates, L. Dawson, T. Undem, and K. Perry. The Kaiser Family Foundation. Health Insurance Coverage for People with HIV Under the Affordable Care Act: Experiences in Five States. 2014. Available at: https://www.kff.org/hivaids/issue-brief/health-insurance-coverage-for-people-with-hiv-under-the-affordable-care-act-experiences-in-five-states/view/footnotes/

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  4. Centers for Disease Control and Prevention. “Diagnoses of HIV Infection in the United States and Dependent Areas, 2012.” HIV Surveillance Report, 2012. vol. 24. November 2014.

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Findings
  1. The Essential Plan is New York’s Basic Health Program (BHP). New York adopted the BHP option available under the ACA to provide coverage to those with incomes between 138-200% FPL that is more affordable than the coverage they would have otherwise purchased in the Marketplace.

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Appendix
  1. Centers for Disease Control and Prevention. “Diagnoses of HIV Infection in the United States and Dependent Areas, 2012.” HIV Surveillance Report, 2012. vol. 24. November 2014.

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