XIX International AIDS Conference

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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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