The Affordable Care Act May Increase The Number Of People Getting Tested For HIV By Nearly 500,000 By 2017

Abstract

People are much less likely to engage in risky sexual behavior if they know that they are HIV-positive. Unfortunately, more than 18 percent of people living with HIV/AIDS in the United States are unaware of their HIV status, and about half of new HIV infections are transmitted from that "HIV unaware" population. For these reasons, HIV testing is at the forefront of HIV prevention strategies in the United States. The Affordable Care Act (ACA) may support these strategies, since gaining coverage increases the likelihood of being tested for HIV. We modeled the impact of the ACA on HIV testing, diagnoses, and awareness of being HIV-positive, assuming that only the eighteen states (and the District of Columbia) that had committed to expand Medicaid as of July 2013 did expand the program. We found that the ACA will result in an additional 466,153 people's being tested for HIV and 2,598 new diagnoses of HIV by 2017. Among people living with HIV/AIDS who gain insurance through the ACA, the share of the HIV unaware will decline by 22 percent. The impact on both HIV testing and new diagnoses would be nearly 30 percent larger if all fifty states expanded Medicaid. Policy makers should consider such epidemiological benefits when analyzing insurance expansion policies.

Surge in Newly Identified Diabetes Among Medicaid Patients in 2014 Within Medicaid Expansion States Under the Affordable Care Act

“…Beyond diabetes, the trends we observed in the current study are likely to affect diagnosis of other chronic medical conditions such as hypertension, hypercholesterolemia, and chronic kidney disease. Such a pattern has already been reported for the diagnosis of HIV (11), where diagnosis occurred at an earlier stage among Medicaid patients in expansion states. Improved access and use of medical services may in turn lead to earlier diagnosis of associated diseases and permit earlier intervention to reduce long-term complications (12).…”

Implementation and Operational Research: Affordable Care Act Implementation in a California Health Care System Leads to Growth in HIV-Positive Patient Enrollment and Changes in Patient Characteristics

“…The increase was expected because of increased post-ACA coverage for HIV-positive patients owing to implementation of the exchanges, removal of pre-existing condition exclusions, Medicaid expansion, and potentially broader HIV testing. 39 Growth also is consistent with the increased number of HIV-positive individuals in the population due to reduced mortality.…”

HIV Care Providers’ Attitudes regarding Mobile Phone Applications and Web-Based Dashboards to support Patient Self-Management and Care Coordination: Results from a Qualitative Feasibility Study

“…HIV care provides a case example with challenging co-morbidities and behavioral factors, and which is being integrated into primary health care in the United States, along with mental health, and drug abuse treatment, as supported by the Affordable Care Act [13–15]. Coinciding with the shift in medical homes and care coordination associated with the ACA, the Los Angeles County (LAC) Department of Public Health, Division of HIV and STD Programs, recently funded HIV Medical Care Coordination (MCC) programs throughout LAC.…”