RomneyCare and HIV/AIDS A look at Massachusetts offers insight on national health care reform
an insurance program for low-income Americans with incomes up to $15,420 ($31,812 for a family of four), regardless of health status. Medicaid provider payment rates will also rise to match Medicare rates for a two-year period beginning in 2013, which should expand the number of medical providers willing to accept Medicaid coverage.
Medicare: Under the ACA, the so-called “donut hole” in Medicare prescription drug coverage shrinks over time. As a source of revenue to pay for its many new provisions, the ACA reduces incentives to health insurance companies to offer Medicare Advantage plans. The reduced incentives are not expected to affect Medicare benefits. The ACA is a lightning rod issue for many voters, both for and against. How might the law help people with and at risk of HIV, if fully implemented? Are we better off halting implementation and starting over with Romney’s plans for the nation? The answers to these questions are critical for everyone committed to the fight against HIV/AIDS as we head to the polls in November.
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current threshold amounts published in the 2012 HHS Poverty Guidelines. The Census Bureau updates poverty threshold amounts annually.
David Ernesto Munar is president/
CEO of the AIDS Foundation of Chicago (AFC) and an HIV-positive advocate. Working with other AIDS advocacy organizations across the country, AFC hosts HIVhealthreform.org, an educational website on health reform policy geared toward people affected by HIV/AIDS, their organizations and advocates. P os i t i ve lyAwar e .co m
Illustration @ Brandon Laufenberg
* Income eligibility amounts cited reflect
Long before health reform dominated national headlines, officials in Massachusetts were working on strategies to reduce the number of uninsured in the state. Here’s a quick recap.
allowing Medicaid expansion to non-disabled poor residents living with HIV. The state combined federal resources with state appropriations to offer a comprehensive benefit package to all uninsured state residents living with HIV at or below 200% of Federal Poverty Level (FPL). With health insurance provided by Medicaid to most HIV-positive uninsured residents, the state used federal Ryan White Program grants to provide wraparound support services to help connect and sustain people in care. The state’s AIDS Drug Assistance Program (ADAP) shifted its focus from dispensing HIV medication to predominately providing premium and co-pay assistance for people living with HIV.
2001: Massachusetts was the first state in
2006: Governor Romney signed reforms
the nation to implement a federal waiver
into law, including:
t’s hard to imagine how the
federal health reform law, known as the ACA, will work for people living with HIV/AIDS once it is fully implemented in 2014. Because the framework of the ACA is loosely based on health care reform in Massachusetts, a review of that state’s system can help HIV/AIDS advocates understand how the national law might affect people with HIV nationwide.
Massachusetts reforms
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