There are numerous aspects of the Affordable Care Act that will be important for people with HIV in the U.S., -- however, it is unlikely that these changes will address all the needs of people with HIV. The Ryan White HIV/AIDS Program will thus remain crucial for the provision of adequate health care to HIV-infected individuals, but it will need to change. Changes in the Ryan White Program’s role will depend largely on state decisions on Medicaid expansion and health care marketplaces. This article, published in the September/October issue of Topics in Antiviral Medicine, summarizes a presentation by Jennifer Kates of the Kaiser Family Foundation at the IAS–USA continuing education program held in New York, New York, in April 2013.