Vol 23, 2014 Annals of Health Law 31
THE ACA AND PEOPLE LIVING WITH HIV/AIDS
access to health care and ( 2) to make the nation’s health care system more
efficient and less costly. 21 PPACA was Congress’s answer to the
longstanding twin problems of access and cost that have plagued the
American health care system. 22 Recognizing that PLWHA have suffered
disproportionately from lack of health care access, Congress included a
number of consumer protections prohibiting health insurance providers
from denying PLWHA coverage. 23 For example, in the debate over
PPACA’s passage, the commonplace insurance industry practice of denying
people with pre-existing conditions desperately needed care was widely
criticized. 24 In order to build upon the framework laid by PPACA, the
Obama Administration also issued the National HIV/AIDS Strategy, which
calls upon both state and non-state actors to address the HIV epidemic. 25
(2011) (introducing PPACA as the U.S.’s “most sweeping reform of healthcare law and our
greatest expansion of healthcare access since the 1965 enactment of Medicare and
Medicaid,” and, in the words of Vice President Joe Biden, “a ‘big f—-ing deal.’”);
Health Law Advocates, National Health Care Reform Initiative, http://www.healthlaw
advocates.org/priority-areas?id=0018 (last visited Nov. 21, 2013) (noting that the passage of
PPACA brought “decades of efforts to enact national health care reform . . . to a successful
conclusion”); see also Nat’l Fed’n of Indep. Bus. v. Sebelius, 132 S. Ct. 2566, 2609 (2012)
(Ginsburg, J., concurring in part and dissenting in part) (noting that in passing the PPACA,
Congress “comprehensively reformed the national market for health-care products and
services” and that “[b]y any measure, that market is immense”); CONG. BUDGET OFF.,
ESTIMATES FOR THE INSURANCE COVERAGE PROVISIONS OF THE AFFORDABLE CARE ACT
UPDATED FOR THE RECENT SUPREME COURT DECISION 13 (2012), available at
Estimates.pdf (estimating by taking into account the effects of National Federation that
PPACA will result in an additional twenty-nine to thirty million people gaining health
insurance by 2019).
21. See Nat’l Fed’n of Indep. Bus., 132 S. Ct. at 2571 (describing PPACA as an effort by
Congress to “increase the number of Americans covered by health insurance and decrease
the cost of health care”).
22. See Kaiser Family Found., Health Care Costs A Primer: Key Information on Health
Care Costs and Their Impact 1 (May 2012), http://kaiserfamilyfoundation.files.
wordpress.com/2013/01/7670-03.pdf (noting that “[h]ealth care accounts for a remarkably
large slice of the U.S. economic pie”); Kaiser Family Found., Kaiser Commission on
Medicaid and the Uninsured Key Facts: The Uninsured and the Difference Health Insurance
Makes 1 (2012), http://kaiserfamilyfoundation.files.wordpress.com/2013/01/1420-14.pdf
(asserting that in 2011, the number of uninsured, non-elderly Americans totaled 47. 9 million,
approximately seventeen percent of the population).
23. Dep’t Health & Human Serv., The Affordable Care Act Helps People Living with
HIV/AIDS, http://aids.gov/federal-resources/policies/health-care-reform/ (last visited Sept.
24. See infra Part II. B.
25. WHITE HOUSE, NATIONAL HIV/AIDS STRATEGY FOR THE UNITED STATES (2010),
available at http://www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf.