A cross-jurisdictional evaluation of insurance coverage among HIV care patients following the Affordable Care Act

Julia E. Hood*, Susan E. Buskin, Bridget J. Anderson, Alexandra Gagner, Jennifer Kienzle, David Maggio, Katie Markey, Jennifer Reuer, Nanette Benbow, Pascale Wortley

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


The impact of the Affordable Care Act (ACA) on HIV care patients, aged 18–64, was evaluated in three jurisdictions with Medicaid expansion (Chicago, New York State, and Washington) and three jurisdictions without Medicaid expansion (Georgia, Texas, and Virginia) using data from the Medical Monitoring Project. Multivariate regression models were used to evaluate insurance status that was reported pre- and post-ACA; self-reported impact of ACA on HIV care was explored with descriptive statistics. The likelihood of having insurance was significantly greater post-ACA compared to pre-ACA in Chicago (aRR = 1.33, 95%CI = 1.20, 1.47), Washington (aRR = 1.15, 95%CI = 1.08, 1.22), and Virginia (aRR = 1.14, 95%CI = 1.00, 1.29). In Washington and Chicago, the likelihood of being Medicaid-insured was greater post-ACA compared to pre-ACA implementation (Chicago: aRR = 1.25, 95%CI = 1.03,1.53; Washington: aRR = 1.66 95% CI = 1.30, 2.13). No other significant differences were observed. Only a subset of HIV care patients (range: 15–35%) reported a change in insurance that would have coincided with the implementation of ACA; and within this subset, a change in medical care costs was the most commonly noted issue. In conclusion, the influence of ACA on insurance coverage and other factors affecting HIV care likely varies by jurisdiction.

Original languageEnglish (US)
Pages (from-to)511-515
Number of pages5
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Issue number4
StatePublished - Apr 3 2017


  • Ryan White
  • health reform
  • insurance coverage

ASJC Scopus subject areas

  • Health(social science)
  • Social Psychology
  • Public Health, Environmental and Occupational Health


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