In Virginia, the Affordable Care Act is changing how the HIV-positive community keeps the virus under control. But not everyone can qualify for these new insurance plans. How can those people access the healthcare they need?
AIDS was first discovered in the U.S. in the early-1980s, and the disease rapidly became an epidemic, decimating communities and causing panic until health breakthroughs and preventative initiatives helped curb its spread. But even though we now know more about AIDS and HIV, the virus that causes it, the disease still affects many Americans — in 2012, around 13,700 people with an AIDS diagnosis died in the U.S., according to the CDC.
Today, there are more than 1.2 million HIV-positive Americans living around the country, several thousand of whom call Virginia home, according to County Health Rankings. Fortunately, thanks to advances in medical care, people can live with the infection — but that requires extensive and expensive measures to manage the effects of the virus, measures that are out of reach for many insurance policies. So how do HIV-positive people handle their condition in Virginia?
Viral in Virginia
When the Affordable Care Act (ACA) became the law of the land, Virginia was one of the 20 states that decided to forego expanding Medicaid coverage, according to Science Daily. The decision presented a tricky situation for low-income residents: many remain ineligible for Medicaid, but are still in dire need of access to care.
The system usually turns a blind eye, as these patients cannot pay for medications or insurance. Fortunately, the state’s AIDS Drug Assistance Program (ADAP) offers care to those lost in the so-called “Medicaid gap.”
The program started in 1996, when the ADAP Advisory Committee was created. Supported by a federal grant, ADAP supplies low-income residents with access to medications that treat HIV and other related illnesses. By providing medication or helping out with insurance premiums and medication copayments, the grant cuts costs for low-income patients who need the support.
Studying HIV and ACA
Recently, a study from the University of Virginia examined how HIV patients receive care within the state. Over the course of two years, researchers focused on almost 4,000 Virginia ADAP patients who were able to shift to an ACA health plan in 2014. The study revealed that low-income HIV patients who enrolled in the new plans were more likely to have high rates of viral suppression, which, according to Medical News Today, meant they were receiving better care.
The lead author of the study, Dr. Kathleen McManus, explains, “[w]e found patients fared better under ACA health plans, possibly due to broader access to medical care and medications beyond those that target HIV. Additionally, this approach allows the state to cover the largest number of patients in the most cost-effective way. ACA plans provide more comprehensive care for the same or less money.”
As the study in Virginia showed, patients with access to more options received better medical care overall. But not everyone can qualify for or afford the plans offered by the ACA and the ADAPs, which currently provide medication to one-third of U.S. residents with HIV. The two-thirds of HIV-positive Americans unable to get these plans need to find another way to receive care.
Stepping up to fill that void is SingleCare. The service can help uninsured or underinsured members find the doctors to give them the care they need, and it’s free to join. With prescription discounts, SingleCare can help people living with HIV find ways to afford their critically important medication, no matter the kind of insurance coverage they have.
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