Given OAC’s role in helping Ohio communities navigate the journey and challenges ahead down the Road to 2014, I attended the American Academy of HIV Medicines (AAHIVM) policy forum which focused on “What’s Ahead for HIV Providers with the Affordable Care Act, Ryan White and Medicaid” on Saturday, July 21, 2012. To watch video from the forum, click here.
AAHIVM is a professional organization that supports the HIV practitioner and promotes accessible, quality care for all Americans living with HIV disease. Their membership of HIV practitioners and credentialed HIV Specialists™ provide direct care to more than three-fourths of HIV patients in the US.This program offered an All-Star line-up of experts to engage in conversations around how HIV care providers will be affected by looming changes to the health care system.
The following experts led our dialogue for the afternoon providing insight into what the coming years hold for providers, their practices and their patients:
- Dr. Deborah Parham Hopson, Associate Administrator for HIV/AIDS, HIV/AIDS Bureau, HRSA
- Dr. Steve Cha, Medical Director, Medicaid and CHIP, CMS
- Jeffrey Crowley, former Director of the White House Office of National AIDS Policy (ONAP)
- Jennifer Kates, PhD, Vice President and Director of HIV Policy at the Kaiser Family Foundation
- Amy Killelea, JD, Senior Manager, Health Care Access, National Alliance of State & Territorial AIDS Directors (NASTAD)
- Courtney Mulhern-Pearson, Director of State and Local Affairs, San Francisco AIDS Foundation
- Dr. Donna Sweet, Chair of the AAHIVM Board of Directors
- Richard Sorian, former Assistant Secretary for Public Affairs to Secretary Sebelius at the Department of Health and Human Services will serve as moderator Program Take-Aways
As we look towards the expansion of the Medicaid program the way forward exists under three themes:
- Collaborations at the National Level.
- Collaborations at the Local Level.
- Understanding/ “unpacking” and Implementation of Reform.
Collaborations will be critical at a high level as well as when we begin to “unpack” the major reforms of the Affordable Care Act at the National level.
It is unknown still in Ohio the future of the Medicaid expansion, but we must begin to mobilize and effectively create a transition plan that examines the strengths and limitations of the ACA for People Living with HIV in our communities as the support and foundation of our arguments for full implementation.
Health and Human Services sent a formal letter to the governors of all states that remain undecided or opposed to the expansion of the Medicaid program requesting a dialogue about the impact of this reform on July, 10, 2012. At this time Ohio is still undecided about expansion and our governor has yet to comment on when this decision will be formally made in Ohio.
In the meantime, HRSA and the Centers for Medicaid Services (CMS) are working together at a high-level with the President’s Advisory Council on HIV/AIDS (PACHA) regarding what the future integration of Ryan White and the Affordable Care Act.
It will be important for Ohio in discussions around the ACA/Medicaid expansion to:
- Leverage Partnerships and Allies with focus on benefits of expansion (e.g. Hospitals / Docs / Hospital Associations).
- Conduct an Analysis of which providers are already accepting Medicaid.
- Post November elections assess the “true story” for the Road to 2014, which will be critical for those states still wavering on Medicaid expansion.
- Reauthorization of Ryan White as a saftey net, but additionally for the 1/3 of those that are still going to fall through the cracks of the ACA and/or those whom are undocumented and ineligible for the major reforms of the ACA.
- Conduct a savings analysis of cost-savings for People Living with HIV/AIDS in Ohio under full implementation.
- Ensure that the Essential Benefits Package in Ohio is descriptive enough to meet the Care and Treatment needs of people living with HIV/AIDS.
- Conduct an analysis of ACA transition and its impact on the Ryan White Budget in Ohio.
Suggestions for Ryan White Providers
- Begin planning to screen newly eligible under Medicaid NOW!
- Learn about the Ohio Exchange as it unfolds, where gaps exist and where wrap-around will be needed.
- Visit www.healthcare.gov and www.healthhivreform.org
In summary, We must mobilize around the full implementation of the ACA and stress the importance of the Ryan White program, because of the variation of the program from state to state and the crucial role it plays as the payer of last resort.
The Bridge from Reauthorization to the full roll out of ACA is not going to be a smooth process, but rather a journey full of challenge and transition. There is a common understanding that, “If you cannot do it right for People Living with HIV, you probably cannot do it right for a lot of people.” At this time it is still unknown what flexibility will exist for Ryan White as the payer of last resort during this time of transition.
We must be engaged, prepared, and informed to continue providing life-saving high-quality, competent HIV Care.
Tyler Andrew TerMeer, MS
Director, Ohio AIDS Coalition
A Division of AIDS Resource Center Ohio