June 28, 2012
The Supreme Court ruling today upholding the Affordable Care Act (ACA) as the law of the land is a significant victory for people with HIV infection and the public health of our nation. The ACA corrects the injustices of our current health system, which often denies health insurance coverage to those who need it the most. Too many of our patients have died prematurely despite the availability of effective HIV treatment due to late diagnosis and poor access to health care services.
Early and reliable access to HIV care and treatment not only saves the life of the HIV-infected individual but significantly reduces HIV transmission risk. With 1.2 million people living with HIV infection in the U.S. -- at least 20 percent of them not knowing they are infected -- and around 50,000 new infections occurring annually, the ACA offers unprecedented opportunity to make significant headway against the HIV epidemic.
Today, fewer than 15 percent of people with HIV have private insurance coverage and at least a quarter are uninsured. The ACA creates a level playing field for them and others with serious and chronic conditions by expanding Medicaid to all low income individuals and creating regulated state-based exchanges for purchasing insurance. These provisions are made possible by the individual mandate and the other policies upheld today that are vital to offering the more than 50 percent of people with HIV not in care the opportunity to benefit from lifesaving HIV care and treatment.
During the last three decades, HIV infection has rooted itself in too many poor and vulnerable communities across the country. We urge Congress and state policymakers to help us end the HIV public health crisis by recognizing the ACA as the law of the land by fully implementing the Medicaid expansion and supporting the law with full funding. The nearly 50 million uninsured Americans, including many people with HIV infection, deserve no less.
Judith A. Aberg, M.D., F.I.D.S.A., is the HIV Medicine Association chair.