Story URL: http://news.medill.northwestern.edu/chicago/news.aspx?id=224633
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Christina Cala/MEDILL

HIV/AIDS medications can cost anywhere between $1,500-$2,000 a month.


People with HIV and AIDS advised to wait to sign up for Obamacare

by I. Christina Cala
Oct 09, 2013


HIVAIDS2

Ed Negron/AIDS Foundation of Chicago

AIDS Foundation of Chicago advocates periodically lobby in Springfield for better health care for people with HIV and AIDS.

AIDS care providers in Illinois such as the AIDS Foundation of Chicago are urging people to wait to enroll in the insurance plans offered through the Affordable Care Act.

Details about care and medications covered in different plans need to be clarified before people enroll, according to Ryan Singleton Communication Coordinator for the AFC.

“Oct. 1 is a great day when people aren’t discriminated against because of a preexisting health condition, but celebrate by waiting,” said Singleton.

Private insurance plans often denied coverage to those with preexisting conditions such as HIV and AIDS.

An estimated 36,000 people have been diagnosed and are living with HIV or AIDS in Illinois, according to HIV Care Connect. Roughly half of those are currently uninsured and only about 40 percent of people living with HIV have access to continuous care.

Singleton said Obamacare will change that, but urges people to wait for online exchanges to work out availability for HIV care providers and drug assistance programs.

The plans take effect Jan. 1 and people can enroll until Dec. 15.

To ease the transition, AFC will offer access to government certified counselors who can help clients navigate the exchange website. They will begin meeting with people in the next few weeks. Some organizations like the AIDS Legal Council of Chicago have already started scheduling appointments.

“We don’t want people to enroll in plan that can’t work for them,” Singleton said. When looking at health care exchange plans, that means making sure that HIV positive individuals can continue with their physicians, pharmacists and mental health providers as well as making sure their tailored medication regimen is covered.

“Continuity of care is so critical," said Ann Fisher, executive director of the AIDS Legal Council of Chicago. “If people go into their doctor and are told, 'Sorry we can’t help you because we’re not in that plan,' how long is to going to take before they’re hooked up with an HIV specialist. Will that plan have those, and will they be available?”

Beyond a level of comfort and trust with one’s doctor, this continuity of care is important because of how easily HIV mutates to develop a resistance if people stop taking their medications, according to Fisher.

Individuals who don’t have access to care may not be able to afford their required biannual doctor visits to test their viral loads either, which means that their resistance may not be caught and treated. Since the number of drug regimens to treat HIV is limited, there are only so many times resistances can be battled, she said.

 

HIV/AIDS medications can cost anywhere between $1,500-$2,000 a month, according to Fisher.

“It’s going to be life changing,” said Fisher. While about 60 percent of HIV positive people in the Ryan White HIV/AIDS Program in Illinois will be going into Medicaid, an easy transition because care organizations already know how the program functions, roughly 15-20 percent will be purchasing private insurance through the exchanges. Depending on income, private insurance may be subsidized, essentially lowering the premiums. The Affordable Care Act promises a wider array of options for care and the extension of health care past HIV related conditions.

“ACA is real insurance. You’ve got coverage not just for your HIV related conditions, but if you get hit by a bus, if you get some other condition, you get coverage for all of it,” Fisher said. “[But] we’ve got a lot of work to do to make sure that the promise of the Affordable Care Act actually comes through for people with HIV.”

Visit healthcare.gov or illinoishealthmatters.gov for more information.