Health Care Reform and HIV: Policy Experts Examine How to Protect and Advance HIV Public Health Gains
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WASHINGTON (March 24, 2017) – As the U.S. health care landscape potentially changes, leading HIV/AIDS policy experts say renewed investment in the federally-funded Ryan White HIV/AIDS Program is critical for continued progress in improving the health of people with HIV, preventing the transmission of HIV to others and reducing health care spending.
In a new report, “The Ryan White HIV/AIDS Program: Protecting and Advancing HIV Public Health Gains During Health System Reform,” the authors emphasize that fewer new infections result in reduced national health care costs.
The report was issued today ahead of AIDSWatch 2017, the nation’s largest annual constituent-based national HIV/AIDS advocacy event March 27-28, 2017, presented by the Elizabeth Taylor AIDS Foundation and organized by AIDS United.
The Ryan White HIV/AIDS Program, enacted by Congress in 1990 and last reauthorized on a bipartisan basis in 2009, is a federally funded program that provides lifesaving HIV treatment and critical health services to more than a half a million uninsured and underinsured people living with HIV in the United States. It acts a safety net to the safety net and bolsters the impact of Medicaid, Medicare, and private insurance.
“HIV no longer may be front-page news every day, but because of significant federal investments in care and treatment, prevention, and research through programs like the Ryan White HIV/AIDS Program, we are making major progress” says Jeffrey S. Crowley, program director of infectious disease initiatives and distinguished scholar at the O’Neill Institute for National and Global Health Law at Georgetown Law, and the lead author of the report. “HIV health outcomes are improving and new infections are falling,” Crowley says.
Crowley and the report co-authors Sean Bland and Connie Garner say the facts support continued funding for the program. “As many as 83 percent of Ryan White clients are virally suppressed compared to only 30 percent among all people living with HIV in the US,” says Bland, an associate at the O’Neill Institute. Viral suppression is a clinical measure indicating HIV treatment is working.
The report states that “roughly seven in ten HIV transmissions arise from persons diagnosed with HIV who are not receiving regular HIV care.” The Ryan White Program bolsters efforts across the health system to engage people with HIV in regular HIV care.
“At a time when policy makers are looking for ways to reduce national health spending, we need to recognize success when we see it,” adds Crowley. The estimated medical cost saved by avoiding one HIV infection is $229,800. “In 2014, there were 8,500 fewer HIV infections than in 2008. That difference in annual infections alone will result in $2 billion in less national health care spending. If these trends of fewer infections continue, the savings to the nation will grow exponentially,” he adds.
“When Members of Congress reflect on the gains we continue to make in the fight against HIV because of the impact of the Ryan White program, and when they see how modest changes can strengthen engagement in care and support better alignment of the Ryan White program with insurance coverage, I believe that bipartisan support for this critical program will be maintained. The Ryan White program is a true testament to the success of providing integrated healthcare,” says Connie Garner, policy director at Foley Hoag Law Firm. Garner staffed the late Senator Edward M. Kennedy on HIV/AIDS issues for over 10 years as his policy director for disability and special populations, including during the last two reauthorizations of the Ryan White program.
The Ryan White HIV/AIDS Program, administered by the Health Resources and Services Administration in the U.S. Department of Health and Human Services, supports more than half a million people living with HIV each year. The program was funded at $2.32 billion in fiscal year 2016.
The issue brief on the Ryan White HIV/AIDS Program released today, is online.
This project is supported by a grant from Gilead Sciences. Crowley received an honorarium from Gilead for a speaking engagement unrelated to this report. Bland reports no recent personal financial interests related to the report. Garner is policy director for Foley Hoag representing Gilead Sciences.
The O’Neill Institute for National and Global Health Law at Georgetown University is the premier center for health law, scholarship, and policy. Its mission is to contribute to a more powerful and deeper understanding of the multiple ways in which law can be used to improve the public’s health, using objective evidence as a measure. The O’Neill Institute seeks to advance scholarship, science, research, and teaching that will encourage key decision-makers in the public, private, and civil society to employ the law as a positive tool for enabling more people in the United States and throughout the world to lead healthier lives.
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