Reform Law’s Medicaid Expansion Could Boost HIV Care, Advocates Say

Advocates attending this week's International AIDS Conference in Washington, D.C., say that the Medicaid expansion in the federal health reform law could help identify and treat many individuals with HIV, Politico reports.

How Expansion Could Boost Access to HIV Treatment

About 1.1 million U.S. residents have HIV, and about 20% of those are unaware of the infection. Advocates say the Medicaid expansion would pay for at-risk individuals to get tested and help low-income individuals with HIV who currently have limited access to care receive comprehensive treatment.

Julie Scofield, executive director of the National Alliance of State and Territorial AIDS Directors, said the expansion is "the single-biggest thing that can be done to push the National HIV/AIDS Strategy forward." HIV activists will be lobbying alongside hospitals in favor of state Medicaid expansions, according to Politico.

State Opt Outs Could Hinder Progress

Progress in identifying and treating individuals with HIV could be limited by large states, such as Texas and Florida, vowing to opt out of the expansion, Politico reports. Advocates say such opt outs could limit the chances of achieving the national strategy's goals, including:

• Reducing the number of new infections by 25%, from the current annual rate of 50,000;
• Ensuring that individuals are aware of infection; and
• Increasing the percentage of infected individuals who get care within three months of diagnosis to 85% from 65%.

In states that choose to participate in the expansion, many individuals with HIV will be covered under Medicaid for some treatments they currently receive through the Ryan White AIDS Drug Assistance Program. ADAP still will provide supplementary services, including food assistance, transportation and help navigating medical systems (Norman, Politico, 7/25).