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HIV/AIDS Qualifies As a “Chronic Condition” Under the Affordable Care Act

, by Reilly O'Neal

Today the Obama administration announced that HIV/AIDS now qualifies as one of the chronic conditions eligible for enhanced federal reimbursements through Medicaid. This change helps guarantee that people with HIV can continue to access medical care from HIV specialists who, in turn, will receive enhanced reimbursements as the Affordable Care Act (ACA) is implemented in the coming years.

“Because of the ACA, a series of investments to help providers support patients with chronic disease like HIV/AIDS are available,” explained Health and Human Services Secretary Kathleen Sebelius in a statement released in advance of World AIDS Day. “Under the law, states can receive extra federal funding to support high-quality coordinated care through Health Homes for Medicaid beneficiaries with chronic health needs. The goal of a Health Home is to treat the whole person, coordinating all their care from primary and acute care to behavioral health and long-term services.”

“Today, I am proud to announce that we will be issuing a rule to explicitly include HIV/AIDS on the list of chronic conditions that every state may target in designing effective Health Homes,” continued Secretary Sebelius. “This will make it easier for states to provide coordinated care for people living with HIV/AIDS.”

“As we move forward with implementation of the Affordable Care Act, a major concern has been that people with HIV/AIDS and the specialty providers who care for them could get lost in the process as people transfer from the Ryan White program to Medicaid and reimbursement rates change,” said Neil Giuliano, CEO of San Francisco AIDS Foundation, in a press release. “Today our community can rest easier knowing that the program’s culturally competent, high-quality care will be sustained as we transition into implementing the Affordable Care Act.”

“Today’s announcement underscores the critical need for states across the country to expand their Medicaid programs under the Affordable Care Act to take advantage of this tremendous opportunity to offer comprehensive services for all people living with HIV and other chronic conditions,” noted Courtney Mulhern-Pearson, the foundation’s director of state and local affairs.

“We know that when someone living with HIV is properly engaged in care, they will lead healthier, more productive lives, and are also far less likely to spread the virus to others,” added Ernest Hopkins, director of legislative affairs at the foundation. “That’s why as we implement the Affordable Care Act, ensuring continuity of care for people with HIV/AIDS is paramount, and the administration today said they agree.”

Secretary Sebelius’ full statement is available here, and the San Francisco AIDS Foundation’s press release explaining the important Medicaid change is available at sfaf.org.

Want to learn more about the Affordable Care Act—and what it means for people with HIV? Check out Ari Ezra Waldman’s in-depth BETA article, “Ask a Lawyer: The Affordable Care Act Survives—What Now?”

Reilly O’Neal is a freelance writer and former editor of BETA.


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