Healthcare Reform's impact on underserved groups, including LGBT, HIV/AIDS patients

The Affordable Care Act's prohibition of discrimination against people with pre-existing conditions and its removal of payment caps may help two groups that have faced insurance barriers to quality healthcare: HIV and AIDS patients and the lesbian, gay, bisexual and transgender community.

"Full implementation of the Affordable Care Act is getting HIV-positive patients onto the exchanges," said Michael Horberg, M.D., director of HIV/AIDS at Kaiser Permanente, in an interview with ABC News. Only 17 percent of people diagnosed with HIV currently have commercial health insurance and approximately 30 percent have no coverage whatsoever, ABC noted.

HIV/AIDS patients may face serious financial problems due to high healthcare costs: although prices of drug treatment for HIV and AIDS have fallen, treatment can still cost upwards of $10,000 per patient annually, making insurance coverage a critical health asset. The HIV drug Tivicay (Dolutegravir), for example, costs about $14,000 per patient per year, ABC reported.

Dr.  Kevin Maxey, co-founder of the Southern Arizona Gender Alliance and Herb Schultz, Regional Director of the U.S. Department of Health and Human Services, recently led a panel discussion in Tucson to raise public awareness of healthcare reform's effects on gender-variant Americans, according to The Arizona Daily Star.

"The Affordable Care Act is the first enactment dealing with sex discrimination and healthcare," Schultz told participants. "It's historic."

When asked about coverage of gender transition-related services under ACA, Maxey said that without a universally-accepted definition of medical necessity, benefit payment for services such as hormone treatments for Americans diagnosed with gender dysphoria may not be immediately forthcoming; but with ACA's nondiscrimination provision at work in a complaint healthcare system, that may change, The Star reported. 

The Tucson forum coincided with the city's annual transgender awareness week. University of Arizona employee Michael Woodward called these events "an opportunity to educate the community and healthcare providers about who we are. We're not that different and we need healthcare just like everyone else."    

For more:
- read the ABC News report
- see The Daily Star article