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MOPE631 - Poster Exhibition
How will US healthcare reform help achieve the treatment goals of the National HIV/AIDS Strategy?
J. Peller1, R. Greenwald2
1AIDS Foundation of Chicago, Chicago, United States, 2Legal Services Center of Harvard Law School, Cambridge, United States
Background: The U.S. National HIV/AIDS Strategy (NHAS), released by President
Obama in July 2010, established four main goals: reduce new HIV infections,
increase access to care and improve health outcomes for people with HIV, reduce
HIV-related health disparities, and achieve a more coordinated national
response to the U.S. HIV epidemic. Without significant structural change in
healthcare delivery, however, achieving these goals would be challenging at
best. The Affordable Care Act (ACA) may provide the change necessary to reach
the Strategy's goals.
Methods: We examine how full implementation of the ACA will
be essential to reach the goals of the NHAS, and also how the Act could
negatively impact services for people living with HIV/AIDS.
Results: The NHAS goals of reducing HIV-related health disparities and
increasing access to care cannot be met without significant expansion of health
insurance coverage. Today, fewer than 13% of people with HIV have private
insurance coverage, compared to 54% of the general population. Over 24% are
uninsured compared to 14% in the general population, leading to an inability to
access comprehensive medical care. The
ACA will dramatically increase coverage for people with HIV by expanding
Medicaid and access to private insurance through the health insurance
exchanges.
As important as it will be, however, the impact of the ACA on the
NHAS may not be entirely positive. ACA implementation may result in reduced
funding for the Ryan White Program, which currently provides essential healthcare
and supportive social services for thousands of uninsured or underinsured
people with HIV/AIDS.
Conclusions: The ACA is essential to reaching the NHAS goals, but some services
for people with HIV could be adversely impacted by the ACA. The advocacy and treatment communities must understand
the potential of the ACA as it relates to NHAS implementation and HIV-related
service and advocacy infrastructure in the U.S.
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