The Impact of ACA and Medicaid Expansion on Progress Toward UNAIDS 90-90-90 Goals

  title={The Impact of ACA and Medicaid Expansion on Progress Toward UNAIDS 90-90-90 Goals},
  author={Blythe J. S. Adamson and Lauren Lipira and Aaron B. Katz},
  journal={Current HIV/AIDS Reports},
Purpose of ReviewPassage of the Affordable Care Act (ACA) in 2010 and subsequent Medicaid expansion has influenced access to HIV treatment and care in the USA. This review aims to evaluate whether the implementation of these policies has impacted progress toward UNAIDS 90-90-90 goals.Recent FindingsPreliminary evidence has emerged suggesting that the ACA and Medicaid expansion has increased the likelihood of HIV testing and diagnosis, reduced the number of people unaware of HIV infection, and… 
Nonadherence to Any Prescribed Medication Due to Costs Among Adults with HIV Infection — United States, 2016–2017
Reducing barriers to ADAP and Medicaid coverage, in addition to reducing medication costs for persons with private insurance, might help to decrease nonadherence due to cost concerns and, thus contribute to improved viral suppression rates and other health outcomes among persons with HIV infection.
HIV Care Outcomes in Relation to Racial Redlining and Structural Factors Affecting Medical Care Access Among Black and White Persons with Diagnosed HIV—United States, 2017
Analysis of HIV care outcomes among Black and White persons with diagnosed HIV in relation to three structural factors: racial redlining, Medicaid expansion, and Ryan White HIV/AIDS Program use found a lower proportion of Black PWDH were linked to HIV care within 1 month after diagnosis and were virally suppressed in 2018.
Impact of Therapeutic Drug Monitoring of Antiretroviral Drugs in Routine Clinical Management of People Living with HIV: a narrative review.
The authors discuss the potential added value of TDM in the optimal management of people living with HIV (PLWH) in selected real-life clinical scenarios based on data collected over 10 years by their TDM service.
Facilitators for retaining men who have sex with men in pre-exposure prophylaxis care in real world clinic settings within the United States
Persistence in PrEP care was associated with structural and social supports as well as a high level of perceived internal control over protecting their health by taking PrEP.


Demographic, Insurance, and Health Characteristics of Newly Enrolled HIV-Positive Patients After Implementation of the Affordable Care Act in California.
Examination of changes in HIV-positive patient enrollment in a large health care delivery system before and after key Affordable Care Act provisions went into effect in 2014 found more men, higher deductibles, and better HIV viral control characterize newly enrolled HIV- positive patients after the ACA.
Three-Year Impacts Of The Affordable Care Act: Improved Medical Care And Health Among Low-Income Adults.
Assessment of changes in health care use and self-reported health after three years of the ACA's coverage expansion in three states found improvements in affordability of care, regular care for those conditions, medication adherence, and self -reported health.
The Oregon experiment--effects of Medicaid on clinical outcomes.
This randomized, controlled study showed that Medicaid coverage generated no significant improvements in measured physical health outcomes in the first 2 years, but it did increase use of health care services, raise rates of diabetes detection and management, lower rates of depression, and reduce financial strain.
Nearly 60,000 uninsured and low-income people with HIV/AIDS live in states that are not expanding Medicaid.
Using national HIV surveillance data and data from the National Health Interview Survey, it is estimated that nearly 115,000 uninsured, low-income people living with HIV/AIDS would be eligible for Medicaid if all states adopted the expansion of Medicaid.
Mind the Gap: The Impact of the ACA Medicaid Expansion on Health Outcomes in the United States
A significant improvement in these outcomes in expansion states relative to non-expansion states is found when focusing on low-income non-elderly adults, in particular health access and preventative care.
Impact of the Affordable Care Act on the HIV Care Continuum
This study could lead to positive social change as PLWHA are made more aware of the benefits of comprehensive health care coverage and increase healthcare utilization, leading to improved health for those infected and less transmission of the virus.
The Affordable Care Act may increase the number of people getting tested for HIV by nearly 500,000 by 2017.
It is found that the ACA will result in an additional 466,153 people's being tested for HIV and 2,598 new diagnoses of HIV by 2017, and among people living with HIV/AIDS who gain insurance through the ACA, the share of the HIV unaware will decline by 22 percent.
Insurance status of HIV-infected adults in the post-HAART era: evidence from the United States.
It is found that public insurance is the predominant source of coverage for those in care for HIV, and that coverage increases as disease progresses, suggesting that reforms allowing HIV positive (+) patients to maintain public coverage while returning to work could increase employment and earnings significantly.
Editorial Commentary: Affordable Care Act, Medicaid Expansion … or Not: Ryan White Care Act Remains Essential for Access and Equity.
  • Ellen F. Eaton, M. Mugavero
  • Medicine
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2016
The Patient Protection and Affordable Care Act (ACA) has the potential to improve healthcare for hundreds of thousands of persons living with human immunodeficiency virus (HIV) (PLWH) in the United
Current and (Potential) Future Effects of the Affordable Care Act on HIV Prevention
Opportunities to expand access to high-impact HIV prevention interventions under the ACA are summarized, whether available evidence indicates that these opportunities are being realized are examined, and potential challenges to further gains for HIV prevention in an era of health reform are considered.