This report examines the Affordable Care Act’s (ACA) effects on people living with HIV in California, Florida, New York, Georgia, and Texas, using focus groups conducted with people insured under the ACA in California and New York and people who remain uninsured, largely because they fall into the coverage gap, in Florida, Georgia, and Texas.
Residents of New York and California insured under the ACA report increasing comfort with the system, expressing satisfaction with their plan, and even those who admit they don’t understand the complexities of the ACA are aware New York and California offer better health care options than other states, with one participant having moved from Georgia to New York to receive better HIV care under the ACA. Many insured residents of New York and California express fear of losing their insurance, and many require outside help to navigate the system.
Participants living in Florida, Texas, and Georgia, all state which chose not to expand Medicaid services to low-income families, largely remain uninsured due to the coverage gap. Although programs like Ryan White are generally sufficient in providing their HIV care, they express disappointment in their state for not expanding Medicaid, and many say they would enroll if expanded Medicaid were available.
The uninsured rely heavily on the Ryan White program. Some feared that becoming insured may mean they lose Ryan White services, and both the insured and uninsured groups were unclear of exactly what role Ryan White plays in the lives of the insured.