This new baseline provides a snapshot of access to care and coverage for people with HIV today and serves as marker for gauging changes going forward. It reflects coverage gains associated with the Affordable Care Act's (ACA) expansions as well as access through traditional insurance pathways and the Ryan White program. People with HIV saw significant gains in insurance coverage under the healthcare law, through Medicaid expansion, the creation of health insurance marketplaces, and the elimination of insurance barriers, including pre-existing condition exclusions. At the same time, many continue to rely on the traditional Medicaid program, as well as the Ryan White HIV/AIDS program, the nation's safety net for people with HIV who are underinsured and uninsured. In addition, even with the ACA's expansions, state decisions have resulted in significant variation in access to coverage across the nation. As debate over the future of the ACA continues, this baseline offers one tool for assessing changes made to the coverage landscape moving forward.
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