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CountyCare Offers Historic Opportunity to Improve Care for People with HIV




 

Careful Planning Now Will Bolster Successful Implementation of ObamaCare Next Year

The AIDS Foundation of Chicago (AFC) today released a report that praises Cook County leaders for implementing CountyCare. The new program implements a provision of the Affordable Care Act (ACA) that allows states to expand Medicaid programs to cover most low-income individuals. The federal Center for Medicare and Medicaid Services (CMS) granted Cook County permission to launch this program in October 2012. Previously, as many as 250,000 Cook County residents were excluded from Medicaid because they did not meet the program’s restrictive eligibility requirements, such as being totally disabled.

“CountyCare is an unprecedented opportunity for people with HIV to obtain more comprehensive, life-extending health care,” said David Ernesto Munar, President/CEO of AFC. “We strongly support this early expansion of Medicaid in Cook County, which will give HIV-affected populations and the organizations that service them a keyhole view of the larger system changes coming next year. AFC has been at the forefront of advocacy on Medicaid expansion for over a decade, so it is especially gratifying to witness CountyCare’s rollout.”

AFC’s report, CountyCare & the Ryan White Program: Working Together to Optimize Health Outcomes for People with HIV, outlines the importance of CountyCare and the role it can play in improving the HIV community’s access to health services. It also contains a number of policy recommendations for the city and state departments of public health, Cook County, and the federal government.

“We have worked for the last 18 months to make sure CountyCare would be implemented successfully for people with HIV,” Munar said. “We face significant challenges to coordinate CountyCare with the Ryan White Program. We are grateful for the extensive hard work that county officials – including Dr. Ram Raju, who heads the County health system – have done to make CountyCare and the Ryan White Program work together.”

The federally-funded Ryan White Program provides HIV medical care, medications, and supportive services to low-income people with HIV. The program is a payer of last resort, meaning all other sources of payment must be accessed before Ryan White Program funds can be used to cover needed services for people with HIV/AIDS.

“We strongly support the provisions in the Ryan White Program that require other funds to be used first,” said John Peller, AFC’s Vice President of Policy. “Scarce program dollars must be used only for the people who have no other means or safety net to finance care and needed services.”

As the report outlines, this requirement means that hundreds of people with HIV might have to switch from their current health care provider to one that is in the CountyCare network. Federal requirements prevented Cook County from enrolling all Ryan White Program providers in CountyCare.  AFC’s report contains recommendations to avoid significant disruptions.

It is estimated that half of all Americans diagnosed with HIV do not receive regular medical care, making CountyCare an unprecedented opportunity to reverse this trend in Northeast Illinois. Unlike traditional Medicaid, which requires single, low-income adults to be disabled, CountyCare eligibility is based solely on lawful residency in Cook County and income level.

“This benefit is not restricted to people with HIV,” Peller said. “In fact, all uninsured, low-income Cook County residents should apply for CountyCare. AFC especially encourages people at risk of contracting HIV to apply immediately, so that they can have access to consistent HIV testing and other vital services, including many unrelated to HIV.”

“Establishing the right enrollment and service systems under CountyCare to help people affected by HIV is paramount,” Munar said. “We have a unique opportunity to improve health care access and services for people with HIV. If we plan accordingly, we can help the most vulnerable people with new health insurance and other services from Ryan White, which Medicaid won’t cover. Getting this right is imperative, so we can learn from this rollout to help tens of thousands of other Illinoisans affected by HIV, who will have new insurance options in 2014 when the Affordable Care Act is fully implemented.”

The new report from AFC details recommendations for service organizations, case managers, government officials, and people with HIV to take full advantage of CountyCare.

To access the report, visit http://aidschicago.org/pdf/2013/countycare_report.pdf.

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Founded in 1985 by community activists and physicians, the AIDS Foundation of Chicago is a catalyst for local, national, and international action against HIV/AIDS.



 


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Information in this article was accurate in May 23, 2013. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.