How is the ACA Affecting HIV and AIDS Care Providers Funded by the Ryan White Program?
Before the Affordable Care Act was fully implemented in 2014, people with HIV and AIDS relied on a system for health care that was largely separate from the one accessed by Americans who could get traditional health insurance.
A significant part of that system of clinics, physicians, hospitals, labs, and other support was funded by the Ryan White HIV/AIDS Program, first authorized in 1990. In fiscal 2014, the program is allocating $2.3 billion, which makes it the third largest funder of HIV and AIDS care behind Medicare and Medicaid. More than 1,673 providers receive Ryan White funding and approximately 536,000 people of all ages receive care from them.
The Affordable Care Act now is allowing people with HIV and AIDS to access Medicaid and private health insurance, some for the first time in their lives. Therefore, it’s changing how many HIV-positive people can access care. Even with some states opting not to expand Medicaid, by some estimates this change affects up to 50,000 individuals.
Abt Associates – which has extensive experience in HIV and AIDS in the U.S. and internationally – is assessing how Ryan White-funded health professionals, hospitals, clinics, and others are adapting to this new landscape. The two-year contract, with the Health Resources and Services Administration (HRSA), began in October 2013 (HRSA, HIV/AIDS Bureau (HAB) administers the Ryan White program).
“Ryan White providers are in the process of figuring how best to navigate the new terrain created by the Affordable Care Act,” said Michael Costa, Abt Senior Associate and director of this assessment. Abt is conducting a mixed methods study that includes interviews with more than 30 Ryan White-funded provider sites to understand how the health care law is affecting care at these Ryan White care sites. Abt will also analyze Ryan White program- and client-level data to observe changes in insurance uptake and service utilization patterns.
“Ultimately, the assessment will help inform HRSA’s recommendations regarding the future direction of the Ryan White program,” Costa said.