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to Section One | to Arts & Entertainment
posted Friday, November 22 2013 - Volume 41 Issue 47
Why LGBTs should help Obamacare succeed
Section One
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Why LGBTs should help Obamacare succeed

by Paul Kawata - Special to the SGN

Three years ago, I asked, 'Are you ready?' With the passage of the Affordable Care Act (ACA), I understood that our organizations and clients were facing radical change. Little did I know the extent of this change. In addition to getting ready for ACA implementation, in the last two years we've also witnessed a scientific revolution, providing us a pathway to end the epidemic and hope for a cure. I moved from asking 'Are you ready?' to discussing ways that we can further the vision of ending the HIV/AIDS epidemic in America.

The latest domestic epidemiological profile of this disease in America showed the overwhelming impact this epidemic continues to have on marginalized populations, from IV drug users and sex workers to women of color and Gay men - especially young, Black, Gay men. These same populations are also the most likely to lack access to affordable insurance coverage.

According to CDC data:

o There were 47,300 new HIV infections in the U.S. in 2010;

o Approximately 1.1 million people are living with HIV in the U.S.;

o Since the beginning of the domestic epidemic, 658,992 people have died, including more than 16,000 in 2010;

o 18% of Americans living with HIV are unaware of their status; and

o Only 25% of Americans living with HIV/AIDS are virally suppressed.

We are nowhere close to hitting the necessary targets for any of our highly impacted populations. That's why it is so important that we continue to work to successfully implement the ACA. The Health Resources and Services Administration (HRSA) estimates that as many as 140,000 Americans living with HIV currently being served by the Ryan White Program will be newly eligible for private or public health insurance under the Affordable Care Act. That's a lot of people we need to enroll. And as we've seen, the rollout of the exchanges has been rocky so far.

As of last week, only about 160,000 people have signed up for private insurance plans under the federal or state exchanges - far short of the number needed to sustain them. But while some opponents of the ACA use this fact to claim that the law is fundamentally flawed, they ignore the more than one million Americans who have signed up to compare insurance plans via the state and federal exchanges. While many of them have not yet selected a plan, it is clear that the public has an appetite for affordable, quality coverage. It is our job to work with the administration and our local partners to ensure that they and our clients can access it.

CRUCIAL FOR HIV CARE
For the HIV/AIDS community, it's especially important to understand and educate our clients about the full range of benefits that come with specific plans. We've seen some state essential health benefits packages that do not cover all the drugs necessary to support the lives and health of people living with HIV. Some plans lack a 'grandfather' clause, meaning they might not cover a particular drug regimen even if you have already successfully reached viral suppression on that regimen. Additionally, some insurance companies still have not disclosed specifics about the HIV medications they will cover. While we continue to work with our coalition partners to address these issues, it is important that the community remain engaged and continue to review plans and policies closely before selecting them.

The Federal AIDS Policy Partnership and the HIV Health Care Access Working Group have been doing fantastic work on this front. Please go to www.hivhealthreform.org and get on their listserves for updates.

There's no doubt that it has been a rough month and a half since Obamacare's initial rollout. But we must remember that our nation spent decades trying to pass large-scale health care reform, and we can't expect it to be perfect or address all the challenges that our constituents face on day one. We're here for the long haul and will continue to work to address any shortfalls or gaps in the law. Nobody said transforming health care in America was going to be easy. We are being asked to transform our systems of HIV care while simultaneously facing budget cuts and a shifting prevention paradigm. But this is important work, essential to ending the AIDS epidemic. Successful implementation of the Affordable Care Act is central to that vision.

Paul Kawata is the executive director of the National Minority AIDS Council. a

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