A new analysis from the Kaiser Family Foundation reveals that, under the Affordable Care Act (ACA), Medicaid expansion drove a nationwide increase in health coverage for people living with HIV. This analysis provides the first national estimates of changes in health coverage for people with HIV since the law was implemented. More importantly, as Congress moves to repeal the Affordable Care Act, the report finds that rolling back the law’s Medicaid expansion could significantly impact coverage for people with HIV.
According to the issue brief, Medicaid coverage for people with HIV in care rose 6 percentage points nationwide between 2012 to 2014, when ACA coverage expansions took effect. That increase was largely driven by states that expanded Medicaid, where Medicaid coverage rose by 12 percentage points over the same period. Those in Medicaid expansion states also saw the share of people with HIV who are uninsured drop from 13 percent to 7 percent. States that did not expand Medicaid saw no significant changes in coverage for people with HIV during this time.
The analysis also finds that an increasing share of people with HIV in care rely on the Ryan White HIV/AIDS Program, rising from 42 percent in 2012 to 48 percent in 2014. Ryan White reliance for those with private insurance increased by 15 percentage points, and by 7 percentage points for those with Medicaid, demonstrating the ongoing role of the program in the ACA era.