The ACA and People with HIV: Profiles from the Field

Introduction
  1. Kates, J, Dawson, L., Undem, T., and Perry, K. Kaiser Family Foundation. 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/

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Background
  1. 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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  2. Department of Health and Human Services, Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in HIV-1-infected Adults and Adolescents. April 8, 2015;. Accessed 5/4/15. at: http://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-treatment-guidelines/0.

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  3. 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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  4. For a discussion of the role The Ryan White Program plays in insurance purchasing see: Cite insurance purchasing brief

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HIV Profiles
  1. Marketplace plans are grouped into different metal levels- platinum, gold, silver and bronze- each is associated with an actuarial value (a percentage representing the share of costs a plan would cover for a typical enrollee). Typically platinum offer the most generous coverage and bronze the least, with gold and silver plans falling in between.

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  2. Marketplace plans are those health plans sold on the health insurance marketplaces set up by the federal government and some states. Most individual non-marketplace plans now have the same protections as marketplace plans but only those plans selected through the marketplaces afford access to the health insurance subsidies available to those 100-400% of the federal poverty level.

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  3. There is no waiting period for enrolling in Medicaid through an SSI pathway but there is two year waiting period for those enrolling in Medicare based on SSDI eligibility. This information was provided to the respondent after the interview.

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