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 The report comes as Republican lawmakers and President Donald Trump
discuss ways to repeal the health insurance law, also known as
Obamacare, which expanded insurance coverage to 20 million people.
The study was based on data from the U.S. Centers for Disease
Control and Prevention's Medical Monitoring Project, which gathers
nationally representative information about people who have or are
being treated for HIV infections - but not all people with HIV. It
excluded the undiagnosed or those diagnosed but not being treated.
According to the report, much of the increase in coverage came from
the 31 states and the District of Columbia that expanded access to
the federal Medicaid program for the poor and disabled.
Nationwide, Medicaid coverage of people being treated for HIV rose
to 42 percent in 2014, up from 36 percent in 2012, the year before
the law went into effect, according to the report by the Kaiser
Family Foundation.
In the Medicaid expansion states sampled, Medicaid coverage rose to
51 percent in 2014, up from 39 percent in 2012, and the share of
uninsured fell to 7 percent from 13 percent.
"It basically demonstrates that the Medicaid expansion made a
significant difference in the lives of people with HIV in providing
new and expanded coverage," Kaiser health policy analyst Jennifer
Kates, one of the report's authors, said in a telephone interview.
The findings underscore some of the difficulties lawmakers face as
they go about repealing and replacing Obamacare.
Under the Affordable Care Act (ACA), states received funding to
expand Medicaid eligibility to nearly all individuals with incomes
at or below 138 percent of the official poverty level. The law also
did away with other eligibility requirements, such as disability or
being pregnant, that prevented many poor adults with HIV from
gaining Medicaid coverage.
The ACA also banned the insurance industry practice of denying
private insurance coverage to people with pre-existing conditions.
And it included provisions that prevented insurance companies from
setting significantly higher rates for people with HIV, or imposing
annual or lifetime coverage limits.
These changes may have helped some people with HIV gain access to
private insurance, but the biggest impact came from Medicaid
expansion.
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"The main takeaway is that for a population that faced a pretty
significant barrier to Medicaid before the ACA, expansion of
Medicaid made a big difference," she said.
If efforts to repeal the ACA result in the elimination of Medicaid
expansion, the study said, "most people with HIV who gained coverage
would likely lose it unless states adopt alternative approaches to
retaining the newly covered population in the program."
Disruptions in care pose significant challenges to people with HIV
because they can increase the chance that the virus will become drug
resistant.
Studies have shown that taking drugs to suppress the virus
dramatically reduces the risk of spreading HIV to others.
New figures released by the CDC earlier on Tuesday show the number
of annual HIV infections in the United States fell 18 percent
between 2008 and 2014, from an estimated 45,700 to 37,600.
CDC researchers said they believe the declines in annual HIV
infections are due, in large part, to efforts to increase the number
of people living with HIV who know their HIV status and are virally
suppressed — meaning their HIV infection is under control through
effective treatment.
"This is a top public health priority," CDC said in a statement.
(Reporting by Julie Steenhuysen; Editing by Tom Brown)
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