What Medicaid unwinding means for people living with HIV

Millions of people are set to lose Medicaid coverage as the federal government unwinds some of the protections put into place at the beginning of the COVID-19 pandemic.

The federal government made some temporary changes to the Medicaid program at the onset of the pandemic. One of these changes — continuous enrollment — prohibited states from disenrolling people coverage during the pandemic. This kept millions of people with Medicaid from losing their health insurance.

That protection ended March 31. As a result, as many as 8-24 million people, including people living with HIV, will lose their insurance coverage. Many recipients who may have received Medicaid approval just before continuous enrollment was put in place may not know about the renewal or confirmation process.

The number of people without health insurance will increase if people who lose Medicaid are unable to transition to other coverage. Certain groups may be more likely to lose coverage during this unwinding period, including people with disabilities, immigrants and people who have moved. Additionally, of those predicted to lose coverage, 30% are Latino and 15% are Black.

Currently, 40% of people living with HIV receive care through Medicaid.

Losing coverage increases the risk of avoidable adverse health outcomes for people living with and vulnerable to HIV. The pandemic has not only shown a need for improved public health response but the need to maintain Medicaid coverage for low-income populations to ensure access to care they need.

To reduce the risk of people who are still Medicaid eligible from losing their coverage, some community health organizations are helping individuals reapply. Ryan White HIV programs have been using this method to help people transition from Medicaid to the AIDS Drug Assistance Program. Those not affiliated with Ryan White don’t always have this assistance. Additionally, the shortages of health care workers to perform these services may make it more difficult to provide these services.

Those at risk for losing their HIV coverage — or who have already lost coverage — need the HIV community’s help. For organizations supporting their at risk communities, reaching out to the department managing Medicaid in your state and collaborating with other local HIV organizations to help stem this tide of people losing their insurance is critical.

Here are some resources that could help with your advocacy.

Organizations can:

Individuals can: