Pumping up Medicaid
Pop quiz: What’s the single largest source of medical coverage for people living with HIV in the United States? Gold star if you guessed Medicaid. Provisions in the Affordable Care Act that aim to improve and expand state Medicaid programs will benefit people with HIV by providing better opportunities for high-quality care.
Remember that a key goal of the Affordable Care Act is to reduce the number of uninsured Americans by vastly expanding the Medicaid program. As of May 2012, 48 states and the District of Columbia have already taken steps to take advantage opportunities to provide more coverage to more people, including those living with HIV.
The federal government is offering many ways for states to bulk up their Medicaid programs, which the Kaiser Foundation has summarized here.
Two programs that will especially benefit people living with HIV are health homes and dual eligible programs.
Health Home Services. Many Medicaid beneficiaries – including those with HIV – are suffering from either multiple or severe chronic conditions, and could greatly benefit from more efficient coordination of care. More and more states are looking to health homes as a solution to fragmented care, and the Affordable Care Act has authorized a temporary 90% match for health home services. Some of these services include comprehensive care management, transitional care from inpatient to other settings, health promotion, referral to community support services and the use of health information technology to link services. Learn more about health home services here.
As of this April, Missouri, Rhode Island, New York and Oregon have been approved for health home programs. North Carolina, Washington state, Alabama, Iowa, Illinois, Ohio and Oklahoma also have plans in the works to implement health home programs.
Dual Eligible Programs. Numerous people living with HIV are among the nine million Americans who are living at the intersection of severe chronic illness and low-income status that make them eligible for both Medicare and Medicaid. Efforts to integrate financing and delivery of medical care for these “dual eligibles” has been limited thus far. Provisions in the Affordable Care Act have funded programs in 15 states to improve the quality, coordination and effectiveness of care for “dual eligibles” – often the poorest and sickest individuals who qualify for either program. These states include California, Colorado, Connecticut, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oklahoma, Oregon, South Carolina, Tennessee, Vermont, Washington state and Wisconsin.
To find out where your state stands on Medicaid expansion, check out Kaiser’s report here.
Category: HIVHealthReform.org Blog
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