How should we evaluate ACA impact on HIV?

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  1. Allow me to refer you to the Kaiser Family Foundation website that has conducted some research on the topic.

    Ryan White HIV/AIDS Program & Affordable Care Act

    Research has demonstrated that the Ryan White Program remains a critical component of the nation’s response to HIV in the ACA era.16 The program continues to fill gaps for those with traditional insurance – such as private coverage, Medicare and Medicaid – by providing support services like case management, transportation, and nutritional support, which are critical to engaging people with HIV in care. In fact, recent Ryan White program data shows that client insurance coverage through Medicaid and private insurance increased in the ACA era while the rate of uninsurance declined.17 Additionally, its role in insurance purchasing assistance has become increasingly important under the ACA as thousands of clients gained insurance through the private market. The number of ADAP clients that received insurance purchasing assistance to help defray the cost of coverage increased by 1162% between 2002 and 2015.18 Finally, while thousands of people with HIV gained coverage under the ACA, many are still without coverage and, for them, the Ryan White HIV/AIDS Program will remain a critical safety net, providing life-saving care and treatment.
    Key Issues

    The Ryan White HIV/AIDS Program, first enacted as an emergency measure, has grown to become a central component of HIV care in the U.S., playing a critical role in the lives of low and moderate-income people with HIV who have little or no access through other sources. Looking ahead, there are several key issues facing the program:

    As a federal grant program, its funding depends on annual appropriations by Congress, and funding levels do not necessarily correspond to actual need including the number of people who need services or the costs of services. As a result, historically, not all states and communities have been able to meet the needs of their jurisdictions. For these reasons, monitoring appropriations allocations and any cuts enacted by Congress will be important going forward.
    It will be critical to assess how future reauthorization impact structure and financing of the program.
    If the ACA is repealed, or repealed and replaced – a policy option currently on the table – it will have significant implications for the health coverage of people with HIV, many of whom have gained coverage through the Medicaid expansion and the marketplaces, and for the Ryan White Program. In particular, it will be important to assess whether the program is able to meet the HIV care and treatment needs of those losing coverage in such an environment.

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