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The ACA and the Ryan White HIV/AIDS Program

“I’ve talked to Kentuckians who have never had insurance before who have literally cried on my shoulder thanking me because they now have insurance and they’re not scared to go to the doctor.”

—Karen Sams, HIV/AIDS Program Branch Chief
Ryan White Part B Division of Epidemiology, Kentucky Department of Public Health

Transcript for The ACA and the Ryan White HIV/AIDS Program video

The Affordable Care Act (ACA) is a historic opportunity for people living with HIV (PLWH), including those currently receiving services through the Ryan White HIV/AIDS Program. It increases access to health insurance coverage and health services for all Americans, including PLWH, through a number of private market reforms, an expansion of Medicaid eligibility, and the establishment of health insurance marketplaces. The federal government, states, insurers, and consumers have a number of roles and responsibilities to help with implementation.

The ACA includes a number of private health insurance reforms that will benefit PLWH. For example, PLWH cannot be prevented from purchasing most private health insurance plans — from which they historically have been excluded — based on having HIV/AIDS as a pre-existing condition. Other reforms include:

  • Guaranteed availability of coverage, which prevents insurers from denying coverage to individuals based on pre-existing conditions.

  • Fair health insurance premiums, which prohibits discriminatory premium rates by preventing insurers from charging more for individuals based on pre-existing conditions.

  • Prohibition of pre-existing condition exclusions or other discrimination based on health status.

  • Prohibitions against imposing annual dollar limits on essential health benefits.

  • Dependent coverage extension (up to age 26).

  • Coverage of specified preventive health services without cost-sharing.1, 2

Visit to learn more about ACA and to enroll in a marketplace exchange. Visit to view ACA implementation tools for Ryan White HIV/AIDS Program grantees.

Delivery of comprehensive care is a hallmark of the Ryan White HIV/AIDS Program. This video shares stories from grantees in Missouri and Kentucky, highlighting how the ACA is assisting them in providing seamless support for their patients and showcasing the work they are doing to facilitate enrollment.

Having consistent insurance is extremely important. “You can’t just treat HIV in a vacuum,” says Dr. Erika Hayes, of the St. Louis Barnes-Jewish Children’s Hospital, a featured grantee in the video. “You have to focus on that patient being completely healthy and having access to all the physicians they may need,” she explains.

Over the years, HRSA’s Ryan White HIV/AIDS Program has done an “amazing job of realizing all those aspects that [people] need to be successful in care,” says Dr. Hayes. The ACA expands that reach, assisting patients in finding a secure source of insurance. The combined effect is helping more PLWH engage and remain in care, which can lead to reduced viral loads. As more individuals reduce their viral loads, communities become healthier too. That’s important for everyone.