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An Update on Insurance Coverage Among People with HIV in the United States

Key Facts
  1. Kates, J and Dawson, L. Insurance Coverage Changes for People with HIV Under the ACA. Kaiser Family Foundation. 2017. https://www.kff.org/health-reform/issue-brief/insurance-coverage-changes-for-people-with-hiv-under-the-aca/

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  2. Kates, J and Dawson, L. Insurance Coverage Changes for People with HIV Under the ACA. Kaiser Family Foundation. 2017. https://www.kff.org/health-reform/issue-brief/insurance-coverage-changes-for-people-with-hiv-under-the-aca/

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  3. Kates, J and Dawson, L. Insurance Coverage Changes for People with HIV Under the ACA. Kaiser Family Foundation. 2017. https://www.kff.org/health-reform/issue-brief/insurance-coverage-changes-for-people-with-hiv-under-the-aca/; Bradley, et al. “Health Care Coverage And Viral Suppression Pre- And Post-ACA Implementation.” Conference on Retroviruses and Opportunistic Infections (CROI) March 4–7, 2019.

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  4. Kates, J and Dawson, L. Insurance Coverage Changes for People with HIV Under the ACA. Kaiser Family Foundation. 2017. https://www.kff.org/health-reform/issue-brief/insurance-coverage-changes-for-people-with-hiv-under-the-aca/

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  5. See description of MMP sampling in methods and the CDC Surveillance Report: https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-special-report-number-20.pdf

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  6. U.S. Dept. of Health and Human Services (HHS). “Ending the HIV Epidemic: A Plan for America.” [Press release.] February 5, 2019. https://www.hhs.gov/blog/2019/02/05/ending-the-hiv-epidemic-a-plan-for-america.html

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FIndings
  1. A difference that was not statically significant overall but was significant in expansion states sampled

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  2. Kates, J and Dawson, L. Insurance Coverage Changes for People with HIV Under the ACA. Kaiser Family Foundation. 2017. https://www.kff.org/health-reform/issue-brief/insurance-coverage-changes-for-people-with-hiv-under-the-aca/

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  3. 2015 data are not directly comparable to 2012 and 2014 data due to a methodological change in data collection.

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  4. Throughout this data note, the Medicaid category includes those dually eligible for both Medicaid and Medicare.

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  5. Kates, J and Dawson, L. Insurance Coverage Changes for People with HIV Under the ACA. Kaiser Family Foundation. 2017. https://www.kff.org/health-reform/issue-brief/insurance-coverage-changes-for-people-with-hiv-under-the-aca/

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  6. U.S. Department of Health and Human Services. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV. Available at http://www.aidsinfo.nih.gov/ContentFiles/ AdultandAdolescentGL.pdf.; Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med 2011;365:493-505.; Cohen MS, Chen YQ, McCauley M, et al. Antiretroviral therapy for the prevention of HIV-1 transmission. N Engl J Med 2016;375:830-9.;CDC. HIV Treatment as Prevention; updated November 2017. https://www.cdc.gov/hiv/risk/art/index.html; INSIGHT START Study Group. Initiation of antiretroviral therapy in early asymptomatic HIV infection. N Engl J Med. Jul 20 2015.; Rodger, A., et al. Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study. The Lancet. May 2, 2019.

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Methods
  1. U.S. Department of Health and Human Services. Center for Medicare and Medicaid Services. June 30, 2015: Effectuated Enrollment Snapshot. September 2019. https://www.cms.gov/newsroom/fact-sheets/june-30-2015-effectuated-enrollment-snapshot

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  2. U.S. Department of Health and Human Services. Center for Medicare and Medicaid Services. 2015 Marketplace Open Enrollment Period Public Use Files. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Marketplace-Products/2015_Open_Enrollment.html

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  3. A total of 23 areas were funded to conduct data collection for the 2015 cycle: California (including the separately funded jurisdictions of Los Angeles County and San Francisco), Delaware, Florida, Georgia, Illinois (including the separately funded jurisdiction of Chicago), Indiana, Michigan, Mississippi, New Jersey, New York (including the separately funded jurisdiction of New York City), North Carolina, Oregon, Pennsylvania (including the separately funded jurisdiction of Philadelphia), Puerto Rico, Texas (including the separately funded jurisdiction of Houston), Virginia, and Washington.

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