Nearly 60,000 uninsured and low-income people with HIV/AIDS live in states that are not expanding Medicaid.

Health insurance gives people living with HIV/AIDS access to medical care, including antiretroviral therapy, which in turn can dramatically improve health and reduce the risk of HIV transmission. Yet many people living with HIV/AIDS remain uninsured. The Affordable Care Act (ACA) seeks to decrease the number of uninsured Americans in part by extending Medicaid coverage to individuals with incomes of up to 138 percent of the federal poverty level. However, many states are not moving forward with this expansion. Using national HIV surveillance data and data from the National Health Interview Survey, we estimated that nearly 115,000 uninsured, low-income people living with HIV/AIDS would be eligible for Medicaid if all states adopted the expansion. Of these, nearly 60,000 live in states not moving forward with the Medicaid expansion. States' decisions about whether or not to participate in the expansion are likely to have important consequences for the health of this population and the evolution of the HIV epidemic.