ACA (AFFORDABLE CARE ACT)
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The Affordable Care Act (ACA) provides Americans—including those with and at risk for HIV—better access to health care coverage and morehealth insurance options .
Health insurance gives people with HIV access to appropriate HIV medical care, particularly antiretroviral therapy (ART), which helps people with HIV stay healthy and Prevent transmitting HIV to others.Here are just some of the ways the ACA has improved access to coverage for people with or at risk for HIV.
Coverage for people with pre-existing conditions.
Thanks to the ACA, no American can ever again be dropped or denied coverage because of a pre-existing health condition, like asthma, cancer, or HIV. Insurers also are prohibited from cancelling or rescinding coverage because of mistakes made on an application, and can no longer impose lifetime caps on insurance benefits. These changes are significant because prior to the ACA, many people living with HIV or other chronic health conditions experienced obstacles in getting health coverage, were dropped from coverage, or avoided seeking coverage for fear of being denied. Now they can get covered and get the care they need.
More affordable coverage
The ACA requires most Americans to have qualifying health insurance. To help people access quality, affordable coverage, the ACA created the (and some state-run Marketplaces sometimes called “exchanges”) that help consumers compare different health plans and determine what savings they may qualify for. The ACA also provides financial assistance for people with low and middle incomes in the form oftax credits that lower the cost of their monthly premiums and lower their out-of-pocket costs. These tax credits depend on a family’s household size and income. In addition, Americans can apply for free or low-cost coverage through Medicaid and CHIP at any time, all year. If you qualify, coverage can begin immediately.
Coordinated care for those with chronic health conditions.
The law recognizes the value of patient-centered medical homes as an effective way to strengthen the quality of care, especially for people with complex chronic conditions such as HIV. The patient-centered medical home model of care can foster greater patient retention and higher quality HIV care because of its focus on treating the many needs of the patient at once and better coordination across medical specialties and support services. The Ryan White HIV/AIDS Program has been a pioneer in the development of this model in the HIV health care system. The ACA also authorized an optional Medicaid State Plan benefit for states to establish Health Homes to coordinate care for Medicaid beneficiaries with certain chronic health conditions. HIV/AIDS is one of the chronic health conditions that states may request approval to cover.
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