Universal Health Insurance, Not Universal Health Care: Examining the Impact of the Affordable Care Act on People Living with HIV/AIDS in the United States

Abstract

This thesis centers around the study, “HIV Care Accessibility/Retention in HIV/AIDS Patients Under the ACA,” conducted during the summer of 2016. This research sought to answer the question, “how has the Affordable Care Act affected People Living With HIV/AIDS (PLWHA) and what are the prevailing barriers and challenges that inhibit PLWHA from accessing and staying in care?” Results revealed barriers to care, challenges, and forms of discrimination, which continue to prevent PLWHA from receiving the full health care that they need. Reviewed research found that more PLWHA have gained health insurance because of the ACA, however, the complexity of HIV/AIDS renders health insurance coverage, on its own, inadequate in serving this group. Instead, the most promising outcomes have been demonstrated by PLWHA who have health insurance coverage and assistance from the HIV/AIDS-specific Ryan White Program (RWP). To improve the success of these programs working in tandem with one another, the prevailing barriers and challenges need to be addressed. To this end, policy recommendations begin with maintaining both the ACA and the RWP, and continue with suggested anti-discrimination and cost containment measures in order to strengthen the ACA and the RWP’s ability to provide comprehensive care to PLWHA. Ultimately, universal health insurance does not always translate to universal health care, and achieving the former for PLWHA involves special protections and measures.