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Opinion

What We Could Lose: Thanks to the ACA, Medicaid Covers 12% More HIV-Positive Folks in Expansion States

February 23, 2017

Tim Murphy

Tim Murphy (Credit: Edwin Pabon)

As a Republican-led Congress proposes drastically slashing federal funding for Medicaid, a new analysis finds that the number of people with HIV covered by Medicaid rose 6% between 2012 and 2014, the first two years during which Medicaid expansion occurred under the Affordable Care Act (aka Obamacare).

The analysis by Kaiser Family Foundation (KFF), based on data from the Centers for Disease Control Prevention (CDC), also shows that, in the more than two dozen states that chose to expand Medicaid coverage under Obamacare, the percentage of HIV-positive folks covered by Medicaid rose by 12%.

Medicaid expansion under Obamacare has been crucial because it raised the annual income ceiling for individual eligibility from about $11,000 to about $15,500 and removed the requirement that someone must be pregnant or disabled to apply, which often meant that HIV-positive folks had to deteriorate to an AIDS diagnosis before becoming eligible.

According to the report press release: "Those in Medicaid expansion states also saw the share of people with HIV who are uninsured drop from 13 percent to 7 percent. States that did not expand Medicaid saw no significant changes in coverage for people with HIV during this time."


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All That, Plus Louisiana

In addition, Kenyon Farrow of Treatment Action Group explained to me over email that this KFF analysis preceded Medicaid expansion in Louisiana last June. "Given that New Orleans and Baton Rouge usually fall in the top four cities with the highest new HIV diagnoses, the impact of Medicaid expansion there is probably going to skew this data even more toward greater Medicaid coverage of people with HIV," he says.

And there's one more important point: Farrow has been hearing from experts that, in many states, those who benefited substantially from Medicaid expansion were gay black men, who are at high risk for HIV. "That data needs to be published," he says.

All of which is to say: Expanded Medicaid is a good thing.


Step Up: Tell Congress How Losing Coverage Would Harm You

But, it's under attack by Republicans in Congress. I've said it before, and I'll say it again: Now is the time for us HIV-positive folks to step up and tell our representatives (especially the Republican ones) how we've benefited -- and how we'll be harmed if we lose that coverage. So, call your congressmember(s) and your senators now to demand that they not repeal or slash the programs.

But, don't stop there! Join an Indivisible group near you to be part of a national movement of citizens putting pressure on elected leaders to resist the destructive Trump/GOP agenda in Washington! We can stop this -- but only if we all throw ourselves into the fight!

Tim Murphy has been living with HIV since 2000 and writing about HIV activism, science and treatment since 1994. He writes for and has been a staffer at POZ, and writes for the New York Times, New York Magazine, Out Magazine, The Advocate, Details and many other publications. He is also the author of the NYC AIDS-era novel Christodora.


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