March 20, 2012
As the Supreme Court hears arguments in the case challenging the nation's health care reform law, there is much more at stake than a legal case. The Patient Protection and Affordable Care Act, signed into law two years ago, will help expand access to lifesaving HIV care and treatment for low-income adults who need it but lack private insurance and do not qualify for Medicaid. Some are already being helped by the law, and in the years ahead, many more people living with HIV will receive the care they need as the law is fully implemented. Striking down key components of the law critical to enacting landmark health insurance expansion that will significantly improve access to lifesaving care for people living with HIV will set us back just as we are starting to turn the tide against this pandemic.
The scientific evidence is increasingly clear, as the results of the groundbreaking HPTN 052 clinical trial showed just last year: Treating those infected with HIV not only improves the health of the person infected, but also dramatically reduces the likelihood of disease transmission. With about 1.1 million people currently living with HIV infection in the U.S., and more than 50,000 new cases occurring annually, now is a critical time to put science into clinical practice, expand access to HIV prevention and care, and improve our patients' health and the country's public health.
When the health reform bill became law, only 17 percent of Americans with HIV/AIDS had private health insurance. Nearly 30 percent were uninsured and without access to either private health coverage or coverage through a publicly-funded program, such as Medicaid, which provides a lifesaving safety net for low-income adults that qualify. The insurance coverage requirement that is being challenged is critical to ending the discrimination that currently allows private insurers to close the door to health coverage for so many people living with HIV.
The Medicaid coverage expansion also being examined in this case will eliminate the cruel policy of delaying access to health care under Medicaid for most people with HIV until they become sick and disabled. Many of our patients with HIV are poor, and nearly half of all those living with HIV and in care rely on Medicaid coverage. The health care reform law will expand Medicaid eligibility to all low-income individuals regardless of health or family status and will allow many more low-income adults living with HIV to get the care they need but cannot afford.
In our fight against HIV/AIDS in this country, nothing is more urgent than fixing our nation's broken health care system. For the first time in 30 years, thanks to advances in HIV prevention and treatment research, we can realistically envision the end of the greatest pandemic of our time. To reach this goal, we cannot afford to take any steps backwards.
Judith A. Aberg, M.D., F.I.D.S.A., is the HIV Medicine Association chair.