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HIV Policy 2012

HIV Policy 2012

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Planning in a time of uncertainty and change

This presentation was originally conducted at the Office of HIV Planning's Community Empowerment Workshop held at St. Luke's Church on October 16, 2012.

Planning in a time of uncertainty and change

This presentation was originally conducted at the Office of HIV Planning's Community Empowerment Workshop held at St. Luke's Church on October 16, 2012.

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HIV Policy 2012

  1. 1. HIV Policy 2012 Planning in a time of uncertainty and change
  2. 2. Let’s remember how far we have come http://youtu.be/haEPLCA_H2Y
  3. 3. HIV in the 21st Century  National HIV/AIDS Strategy  Ryan White Program  Health Reform  ‘Medical Model’  Clinical Care Team  ‘Treatment as Prevention’  Test and Treat Strategy  High Impact HIV Prevention  Prevention with Positives  Enhanced Comprehensive HIV Prevention Planning
  4. 4. HIV Programs in US  Ryan White Program  Medicaid  Medicare  Housing Opportunities for People With AIDS - HOPWA  Centers for Disease Control and Prevention- CDC  AIDS Drugs Assistance Program - ADAP  Substance Abuse and Mental Health Services Administration - SAMHSA  Veterans Administration - VA
  5. 5. Ryan White Medicaid Reauthorization Expansion 2014 2013 Uncertainty Elections Essential Health November 2012 Benefits
  6. 6. http://youtu.be/vmdbllWOOzs
  7. 7. Affordable Care Act Expansion of Medicaid No discrimination by insurance companies No $ limits Subsidies for Essential Coordination premiums and health benefits of care cost-sharing
  8. 8. Ryan White and Medicaid Expansion 51% Medicaid (disability) ~90%+ Ryan White clients Medicaid eligible in Medicaid 2014 Expansion to cover 133% FPL
  9. 9. Ryan White Clients Insurance Ryan White Clients Status, 2009 Income, 2009 Unknown 1% <100% FPL 100-199% 200-299% >300% Other None Private 4% 5% Public 17% 17% 1% 13% Medicare 13% Medicaid 78% 51%
  10. 10. Estimated Changes to Insurance Status for Philadelphia EMA Ryan White Clients Following the Full Implementation of the ACA 9000 8315 8000 7942 7000 6250 6000 5000 Medicaid 4000 ESI Uninsured 3000 2,047 1,535 2000 2,071 1,535 1000 891 518 0 Baseline RW 2014 Average 2014 Enhanced Participation Participation
  11. 11. Health Reform and Ryan White Medicaid 75/25 rule?? Expansion??
  12. 12. Health Reform and Ryan White Program http://vimeo.com/46052691
  13. 13. National HIV AIDS Strategy Reduce HIV rate Coordinate d response Increase access to care for people Reduce HIV- living with HIV and related health improve their inequalities health outcomes
  14. 14. Ryan White Medicaid Reauthorization Expansion 2014 2013 Uncertainty Elections Essential Health November 2012 Benefits
  15. 15. resources  HIVHealthReform.org  Kaiser Family Foundation  www.kff.org  Commonwealth Fund  www.commonwealthfund.org/  Office of HIV Planning  www.hivphilly.org Nicole Johns Office of HIV Planning 215-574-6760 ext. 108 Nicole.johns@gmail.com

Editor's Notes

  • the product of applying research done by the Kaiser Commission on Medicaid and the Uninsured to our EMA. These are estimates based on EMA data that has been noted as limited, due to duplications. OHP staff calculated the projections based on the data reported by AACO for insurance status for 2010, using the participation percentages in the Kaiser report. These participation estimates assumed that those with employer sponsored coverage would have similar participation regardless of outreach efforts (25%). However, the uninsured participation is expected to increase from 57% in the standard participation to 75% in the enhanced participation scenario. Individuals covered under other insurance types were not considered for this model. These projections result in 63% - 66% of Ryan White clients being Medicaid enrolled (this includes the individuals already enrolled in Medicaid). Between 4% - 7% of Ryan White clients will remain uninsured. However, those captured within that 4-7% uninsured may gain access to insurance through employers or through the state insurance exchanges. This Medicaid range is less than the estimate above that 75% of Ryan White clients will be Medicaid-eligible based on income alone, because the Kaiser projections are for enrollment, not just eligibility. There will be a number of individuals who do not enroll in Medicaid for any number of reasons, including lack of knowledge of eligibility, lack of the proper documentation of eligibility, and not wanting to participate.
  • 4:00-14:45

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