Vol 23, 2014 Annals of Health Law 58
THE ACA AND PEOPLE LIVING WITH HIV/AIDS
cover a broader range of HIV care. This includes the use of PrEP as a
preventative tool in certain high-risk communities.241 HHS has already
issued similar requirements for preventative services for women242 after
concluding that such services required more stringent regulation in order to
prevent coverage gaps.243 PLWHA also face unique health challenges that
have resulted in a systemic lack of health care access.244 They require
regular visits to doctors, costly medications, and screening for HIV-related
illnesses.245 Moreover, the need for additional federal guidelines for HIV
care is even stronger, because the time that a person with HIV/AIDS spends
without regular medical treatment is especially damaging.246 If HHS issues
guidelines to require health insurers to cover these services, PLWHA would
be assured of comprehensive medical care instead of having to contend with
the uncertainty of state-to-state variation.247
D. The Essential Gap-Filler: The Ryan White Program
Congress must also continue to fully fund the Ryan White Program in
order to meet the health care needs of PLWHA who are in need of
supplemental coverage.248 Many expect that PLWHA will transition into
new forms of health insurance (whether public or private) once PPACA is
fully implemented.249 However, this does not make the Ryan White
241. See supra Part IV. A.iii.
242. 42 U.S. C. A. § 300gg- 13(a)( 4) (West, WestlawNext through P.L. 113-36) (“[W]ith
respect to women, such additional preventive care and screenings not described in paragraph
( 1) as provided for in comprehensive guidelines supported by the Health Resources and
Services Administration for purposes of this paragraph.”); Dep’t Health & Human Servs.,
Women’s Preventative Services Guidelines: Affordable Care Act Expands Prevention
Coverage for Women’s Health and Well-Being, http://www.hrsa.gov/womensguidelines/
(last visited Oct. 15, 2013). The services that plans are required to cover include: ( 1) annual
“Well-woman visits,” which includes preconception and prenatal care, ( 2) screening for
gestational diabetes, ( 3) human papillomavirus testing (“HPV”), ( 4) counseling for sexually
transmitted infections and diseases, including HIV, ( 5) contraceptive methods and
counseling, ( 6) breastfeeding support and counseling, and ( 7) screening and counseling for
domestic violence. Id.
243. See Women’s Preventative Services Guidelines: Affordable Care Act Expands
Prevention Coverage for Women’s Health and Well-Being, supra note 242.
244. See supra text accompanying notes 5–11.
245. See Robin Bidwell, Supporting Patients in Care, in GUIDE FOR HIV/AIDS
CLINICAL CARE (Susan Coffey ed. 2011), http://hab.hrsa.gov/deliverhivaidscare/clinical
246. See generally NAM Aids Map: HIV and Anti-HIV Drugs 7 (2002),
247. See U.S. GEN. ACCOUNTABILITY OFF., supra note 136, at 4.
248. See Crowley & Kates, supra note 4, at 2.
249. Id. at 6.