The public health insurance in the US is Medicaid, which covers health and continuing service care for low-income individuals.  Medicaid is the largest single source for coverage of HIV infected people in the US. While Medicaid administers a wide variety of medical help to those infected with HIV one of the most important is the recommended drugs, which help, slow the progress of HIV and lowers the risk of transmission.

Number Of Medicaid HIV Beneficiaries

The number of HIV Medicaid beneficiaries is reportedly over 230,000 people. People who are HIV positive are about two thirds more apt to be covered by Medicaid than the overall population. Most Medicaid beneficiaries are not only low-income but also disabled by HIV. About 3 in 10 are both eligible for both Medicaid and Medicare due to having the most chronic conditions and needing long-term care. Medicaid beneficiaries who are HIV positive are predominately likely to be black males over the age of 19, as are the majority of people with HIV. On the other hand, Medicaid beneficiaries who are not HIV positive are predominately likely to be white females under the age of 19.

Medicaid Spending On HIV

Medicaid an entitlement program that is means tested is financially supported by both federal and state government. In the period of 2014-2016 due to the expansion of the affordable care act the federal side of government will cover 100% of all newly eligible Medicaid beneficiaries, in 2020 that will lower to 90% and continue to lower thereafter.

In the year 2012, the federal government reportedly spent more than a third of the federal spending ($5.3 billion) on HIV care along with the state’s share ($4.3 billion), this shows that Medicaid is the single biggest payer in the US for HIV care. The largest category of spending on HIV beneficiaries is prescription drugs that are used for the treatment of HIV.


Medicaid Eligibility

Federal law mandates that states that want to receive matching federal funds must cover mandatory groups.

Under the law, in order to qualify for Medicaid, people must meet financial criteria as well as belong to one or more Medicaid categorically eligible groups.

The majority of Medicaid beneficiaries are low-income and disabled; as well as also receiving SSI (supplemental security income), which makes them fit a required Medicaid eligibility category. Despite the fact that early treatment for HIV delays disability and prevents further transmission of the virus, Medicaid by federal law does not include low-income non-disabled adults without dependent children. This group of people seems to be caught in a catch – 22 and unfortunately cannot get help with HIV treatments from Medicaid which seems to defeat the purpose of early treatment in order to slow the progression of disability and stop the transmission of the disease.