Are safety net sexually transmitted disease clinical and preventive services still needed in a changing health care system?

Aprimary goal of the Affordable Care Act (ACA) is to increase access to health care, particularly among the uninsured. Reforms under the ACA will therefore likely impact access to sexually transmitted disease (STD) services, including services for the underinsured or uninsured (safety net services). We raise considerations related to the provision of safety net STD services that have resulted from the US Supreme Court’s 2012 decision that upheld much of the ACA while striking down portions of the law that resulted in states deciding whether to expand Medicaid. Furthermore, we highlight the complex and unique role that safety net providers have traditionally played in STD prevention.