Falling into another Living Affected Moment

The Affordable Care Act: An Update

Implementation of the Affordable Care Act (ACA) began October 1st amidst a flurry of (in)activity on Capitol Hill. Despite being the focal point of the legislative standstill that led to government shutdown, the Act’s very implementation on time is a victory for uninsured Americans. AIDS United Arkansas grantee, The Living Affected Corporation has been diligent in staying updated and engaged as the insurance mandate has rolled out in their state. Despite the challenges and barriers of the website, Healthcare.gov, the organization pivoted from the online problems by offering a "offline" solution through allowing possible clients enroll the old fashion way via paper applications. According to Chief Operating Officer, Cornelius Mabin, " we've learned that this entire project has been a working process that requires us to use all of capacity to meet the needs of the program and the clients we serve." He continued, " we've acknowledge that the online experience has not been the most productive but we felt that the next best move was to continue to educate and circulate the paper applications to our target LGBTQ audience and others that we encounter." Still, the Republicans in Congress who hope to delay as much of the ACA as possible continue to threaten not to pass a continuing resolution to fund the government or approve a debt ceiling increase to avoid an economic shutdown. Despite the fighting in Washington, the marketplaces opened last Tuesday to overwhelming interest. Health Resources and Services Administration (HRSA) reported 8.6 million unique visitors in the first 3 days. Interest was so great, in fact, that many of the new online marketplace websites faced expected glitches due to high demand . The government is working to fix these glitches, and expect them to be taken care of well before the deadline for getting insured. For the most part implementation has been a success so far, despite continued confusion for many Americans about what the Affordable Care Act is and is not. Plans also appear to be more affordable for most Americans, but for some a lack of understanding has led to questioning its affordability. For more information about what implementation of the Affordable Care Act looks like on the ground, click here for an interview with AIDS Alabama’s Director of Policy and Advocacy Lauren Banks. HIV advocates are particularly interested in reviewing the newly revealed marketplace insurance plans with a watchful eye on their formularies. Most importantly, advocates say that the plans must contain all antiretroviral medications necessary for the treatment of HIV including relatively new combination drugs that can be taken only once a day, this would be a great benefit to many people living with HIV. Finally, for a lighter take on ACA implementation, (or to ease ACA stress and worry) we rather enjoyed our visit to the Adorable Care Act. For more information about The Living Affected Corporation check out www.livingaffected.org.

AIDS Alabama's Lauren Banks Talks ACA

Since becoming law, the Affordable Care Act has directly helped many of AIDS United’s community-based stakeholder organizations to increase and improve services for the clients they serve. AIDS Alabama, for instance, an AIDS United grantee and Public Policy Committee (PPC) Member, was recently awarded a Patient Navigator Grant by the U.S. Department of Health and Human Services to help the uninsured in the community navigate Alabama’s new insurance marketplace, which, along with all of the insurance marketplaces around the country, launched on October 1. Lauren Banks, the organization’s Policy and Advocacy Director, spoke with us about its new program funded by its Patient Navigator Grant, the difficulties of implementing the Affordable Care Act in Alabama, and much more. As part of the grant, AIDS Alabama developed "Enroll Alabama", which includes forming partnerships with seven other sites and hiring 10 new staff members. Patient Navigators work to answers questions about the Affordable Care Act and guide uninsured individuals through the process of choosing a plan and enrolling in it. Eighty volunteer navigators also support the work of the 10 new staff members, evidence of a huge positive response from the community. “People in Alabama want this to succeed, they realize how important it is,” says Banks. To gain further support, Enroll Alabama will be attending numerous community events beginning in November, spreading the word about the benefits of the Affordable Care Act. It has been a little over a week since the insurance exchanges opened nationwide to a flurry of excitement, as well as a few glitches on the websites. Enroll Alabama expected some glitches and was prepared with solutions. For instance, staff and volunteers use paper applications when the website is having difficulties. An official “grand opening” launch of Enroll Alabama is planned for the first weekend of November, at which point all website issues are expected to be resolved. Despite the occasional glitch, news coverage and community response have been extremely positive. Enroll Alabama hopes to hit its goal of enrolling 5,000 uninsured individuals. As an AIDS Service Organization, AIDS Alabama is especially conscious of the HIV community in its approach to enrollment. The navigators at Enroll Alabama will help HIV positive clients make sure that plans cover their providers, their medications, and will educate them about which services will be available through insurance and which will be available through the Ryan White Program. Enroll Alabama will work with case managers to help people living with HIV make the decisions that ensure they have access to quality HIV treatment so that none fall out of care as they access the new care system(s) for which they are eligible. While Alabama residents will benefit from the insurance reform component of the Affordable Care Act, Alabama is one of many states that is not yet expanding Medicaid, denying many poor people the insurance that the Affordable Care Act was meant to provide. Alabama is the state with one of the lowest thresholds and strictest requirements for Medicaid qualification, and not expanding means that many of the most impoverished are going to be left out, according to Banks. Worse, she says, “a lot of them don’t know they’re going to be left out.” With this in mind Enroll Alabama’s message has been strategic, working to drum up excitement but not get people’s hopes up. The ”deep south” is bearing a disproportionate burden of new HIV cases in the United States, according to Banks. With the exception of Arkansas none of those states are expanding Medicaid, which will only serve to further increase the health disparities between the South and many other states. In Alabama, for instance, a whopping 75.7% of AIDS Drug Assistance Program (ADAP) clients would be eligible for Medicaid if the program was expanded. ADAP is part of the Ryan White Program, which is the payer of last resort for HIV positive individuals who are poor and need care and treatment. For people in those non-Medicaid expansion states living with HIV, Banks says it is critical to advocate for expansion. For residents of Alabama, AIDS Alabama will be hosting a series of advocacy workshops on different topics in the spring, including Medicaid expansion.

Announcements

Upcoming Awareness Days Don’t forget! National Latino AIDS Awareness Day, October 15, is quickly approaching. To learn more about this awareness day and several others, click here Syringe Access Fund Releases Eighth Grant Cycle Request for Proposals The Syringe Access Fund is a national grantmaking initiative that supports service providers and policy projects to reduce the risk of HIV, hepatitis C and other blood-borne pathogens among injection drug users and their sexual partners through expanded access to sterile syringes. Established in 2004, the Syringe Access Fund has been a collaborative effort of various private foundations, corporations and public charities that together have granted almost $10.4 million.  Currently, leading partners include the Elton John AIDS Foundation, Irene Diamond Fund, Levi Strauss Foundation, Open Society Foundation, and AIDS United.  The Round Eight Grant Cycle Request for Proposals has been released, and grantseekers can click here for more information on applying for a grant. Internship and Fellowship Opportunity with amfAR amfAR, The Foundation for AIDS Research is now accepting applications for The Allan Rosenfield Internship and Fellowship Program. This program is established for exceptional college undergraduates and graduates who aspire to become leaders in public health and in the fight against the HIV/AIDS epidemic. This program is based in Washington, DC. For more information visit amfAR’s website or email policyfellowship@amfar.org.