The ACA and People with HIV: Profiles from the Field

The Affordable Care Act (ACA), signed into law in 2010, has provided millions of individuals with new health insurance coverage, including thousands of people with HIV. To explore what new ACA era coverage opportunities have meant for this population, we examined the coverage and enrollment experiences of people with HIV, by conducting focus groups with HIV positive individuals in five states (California, Florida, Georgia, New York, and Texas).¹ These focus groups were conducted after the end of the first open enrollment period and consisted of participants who enrolled in or attempted to enroll in private coverage through the marketplaces, those who enrolled in Medicaid as part of the expansion population, and those who remained uninsured, largely because they lived in a state that elected not to expand its Medicaid program.

In this brief, we report on findings from follow-up, one-on-one interviews conducted with a subset of twelve individuals from the focus groups to provide an in-depth look at how the ACA has affected them. The interviews that inform these profiles took place after the second round of open-enrollment, which ended in February 2015, to see how participants were faring with respect to their health and insurance coverage after two enrollment periods. Participants came from both states expanding their Medicaid programs and from states that have elected not to expand. Similarly, participants were from states relying on the federally facilitated marketplace as well as those running their own marketplaces. During the interviews, which lasted about one hour each, participants were asked to discuss their enrollment and coverage experiences, including whether they got new coverage, and how their HIV care was affected. Participants were also asked to describe the role that the Ryan White HIV/AIDS Program, the nation’s safety net for people with HIV who are uninsured and underinsured, played in their care.