Supporting HIV care through education and innovation

Affordable Care Act & the Ryan White HIV/AIDS Program

Affordable Care Act & the Ryan White HIV/AIDS Program

March 2014
TARGET Center
ACA and Ryan White Marketplace

The Patient Protection and Affordable Care Act (ACA) was developed to achieve better health outcomes in the United States by increasing the number of insured Americans, reducing care costs, and improving the overall American health care system. To achieve that, major changes are under way in both the health insurance marketplace (eg, reforms in insurance laws, expansion of Medicaid eligibility) and the health care delivery system (eg, through investigation of new ways to fund and deliver care). These changes will expand care options for everyone, including people living with HIV/AIDS who receive care from the Ryan White HIV/AIDS Program.

The following ACA Learning Modules both explain ACA and present implementation ideas for Ryan White agencies and consumers, which were generated from grantee presentations on health care reform at the 2012 Ryan White Grantee Meeting, HRSA/HAB leadership, and HIV/AIDS and health reform leaders. Complementing the Learning Modules are technical assistance tools in the TARGET Center's Health Care Reform topic page as well as HRSA's Ryan White and the Affordable Care Act: What You Need to Know and ACA and HRSA ProgramsGrantees and consumers are urged to share their implementation tools.

Learn about Reform

A basic understanding of ACA will help individuals and agencies understand what reform is all about--the importance of being insured, types of coverage options, and changes underway in health care delivery.

Participate in the Marketplace Process

Many decisions have been made about Marketplaces, like specific requirements for coverage and approval of health insurance plans. However, Marketplaces will be adjusted over time, presenting new opportunities for consumers and agencies to provide input.

Educate and Assist Your Clients

Under ACA, most individuals living with HIV/AIDS will be either eligible for Medicaid or able to purchase individual coverage in the Marketplace with access to tax credits/subsidies. Clients need to be educated (eg, about eligibility, costs, services, agencies they can go to for health care) so they can make wise decisions about their coverage. Staff (eg, benefits counselors, case managers, social workers, clinicians) need training and tools so that they can help educate clients.

Adjust Your Systems

Many health care providers will need to change their operations to adjust to the expanded third-party payer system and innovations in care delivery. Examples include enhanced third-party reimbursement systems, establishment of linkages with health insurance plans and provider networks in order to expand access to new payers, and restructuring of the agency and its services to improve care and reduce costs.

Key Websites

This page contains links to information about health care reform and ACA.

Updates

The TARGET Center's Health Care Reform topic page provides technical assistance tools and other resources for Ryan White agencies and consumers.

See our ever-growing collection of ACA Tools on Enrollment, Assessing Health Plans, Contracting with Health Plans, Billing, Planning, and more.

Got questions? Get answers from HealthCare.Gov.
How to Apply for Marketplace Coverage.
See tailored tools to help consumers decide on coverage, developed by states and agencies across the nation. 
See what's going on in your state.
 

 

 

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