States’ Medicaid Expansion Decisions Affect Those With HIV/AIDS

About 60,000 U.S. residents with HIV/AIDS likely will remain uninsured in states that choose not to expand Medicaid under the Affordable Care Act, according to a study conducted by researchers from California and other areas, Kaiser Health News' "Capsules" reports.

Background

According to "Capsules," about 30% of individuals with HIV/AIDS are uninsured.

In 2010, just 17% of individuals with HIV/AIDS had health insurance, compared with 65% of the general population nationwide.

Currently, individuals with HIV/AIDS can use the Ryan White Program for health services, which administers federal grants. However, the program is not comprehensive health insurance and does not include inpatient care (Gold, "Capsules," Kaiser Health News, 3/4).

Details of Study

The study, which was published in Health Affairs, was conducted by researchers from:

• AbbVie;
• Bristol-Myers Squibb;
• Precision Health Economics, in Los Angeles; and the
• University of Southern California (Health Affairs, March 2014).

Researchers studied data from the National Health Interview Survey and national HIV surveillance data.

Study Findings

The report found that about 70% of individuals with HIV/AIDS living in states not expanding Medicaid have incomes too low to qualify for federally subsidized health coverage under the ACA.

It found that if every state expanded its Medicaid program, about 115,000 individuals with HIV/AIDS would gain coverage.

More than 50% of the 60,000 individuals with HIV/AIDS who live in states that are not expanding their Medicaid programs reside in Florida, Georgia or Texas.

Lead study author Julia Thornton Snider, a senior economist at Precision, said expanding Medicaid in such states would be economical.

Thornton Snider said, "It costs money to run Medicaid, and you have to weigh that against the benefits." However, she added, "Because anti-retroviral therapy is so effective in reducing disability, extending life and improving quality of life, if people with HIV/AIDS don't have access to it up front, there will be costs down the line" ("Capsules," Kaiser Health News, 3/4).