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HIV Policy 2012 Planning in a time of uncertainty and change
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HIV Policy 2012
Planning in a time of uncertainty and change
HIV in the 21st Century National HIV/AIDS Strategy Ryan White Program Health Reform ‘Medical Model’ Clinical Care Team ‘Treatment as Prevention’ Test and Treat Strategy High Impact HIV Prevention Prevention with Positives Enhanced Comprehensive HIV Prevention
Planning
HIV Programs in US Ryan White Program Medicaid Medicare Housing Opportunities for People With AIDS -
HOPWA Centers for Disease Control and Prevention-
CDC AIDS Drugs Assistance Program - ADAP Substance Abuse and Mental Health Services
Administration - SAMHSA Veterans Administration - VA
Ryan White Reauthorization 2013
Medicaid Expansion 2014
Elections November 2012
Essential
Health
Benefits
Uncertainty
Affordable Care Act
Expansion of Medicaid
No discrimination by insurance companies
Essential health
benefits
Subsidies for premiums and cost-sharing
No $ limits
Coordination of care
Ryan White and Medicaid Expansion
51% Medicaid
(disability)
Medicaid Expansion to cover
133% FPL
~90%+ Ryan White clients
Medicaid eligible in 2014
78%
13%
6%
4%
Ryan White Clients Income, 2009
<100% FPL 100-199%200-299% >300%
Private17%
Medicare13%
Medicaid51%
Other Public
1%None17%
Unknown1%
Ryan White Clients In-surance Status, 2009
Estimated Changes to Insurance Status for Philadelphia EMA Ryan White Clients Following the Full Implementation of the ACA
Basel
ine
RW
2014
Ave
rage
Par
ticip
atio
n
2014
Enh
ance
d Pa
rticip
atio
n0
1000
2000
3000
4000
5000
6000
7000
8000
9000
6250
7942
8315
2,047 1,535
1,5352,071
891518
MedicaidESIUninsured
Health Reform and Ryan WhiteMedicaid Expansio
n??
75/25 rule??
Service definitions
System capacity
Payor of last resort
More people insured
Essential benefits
Health Reform and Ryan White Program
http://vimeo.com/46052691
National HIV AIDS Strategy
Coordinated response
Reduce HIV rate
Reduce HIV-related health inequalities
Increase access to care for people living with HIV and improve their
health outcomes
Ryan White Reauthorization 2013
Medicaid Expansion 2014
Elections November 2012
Essential
Health
Benefits
Uncertainty
resources HIVHealthReform.org Kaiser Family Foundation
www.kff.org Commonwealth Fund
www.commonwealthfund.org/ Office of HIV Planning
www.hivphilly.org
Nicole JohnsOffice of HIV Planning
215-574-6760 ext. [email protected]
