Posted submitted by W. David Hardy, MD, Chair, HIV Medicine Association, Adjunct Professor of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine

The open enrollment period for purchasing coverage through the Affordable Care Act (ACA) marketplaces started November 1. Over the next few weeks, people living with HIV and millions of others, including many LGBTQ individuals, will have important decisions to make about selecting a health care insurance plan. Despite the Trump-Pence administration’s repeated efforts to thwart the ACA, marketplace coverage options are available across the country and premiums have largely remained flat or have decreased.

I have seen firsthand the importance of people living with HIV and other chronic conditions being able to purchase comprehensive health care insurance thanks to the ACA by barring health plans from denying, or charging patients more for coverage due to a pre-existing condition. The strong protections against discrimination including ensuring coverage for essential health benefits have been critical to my patients, including those who are transgender, who before the ACA could be denied care and treatment important to their health, well-being and identity.

While the Ryan White HIV & AIDS Program remains critical to supporting comprehensive care for people living with HIV, it is not insurance and does not cover non-HIV related services or treatment or hospital care. The marketplace coverage, in addition to the Medicaid expansion in the 34 states including the District of Columbia where it has been implemented (so far), leveled the playing field for my patients with HIV and other chronic conditions. With the Democrats gaining control of the House of Representatives in the recent midterm election, Congressional repeal of the ACA is no longer a threat, but we will continue to face actions by the Trump-Pence administration’s attempts to reverse or undermine key coverage and non-discrimination protections.

By December 15, it will be important for health care and social service providers to ensure that as many of their patients and clients as possible get enrolled or re-enrolled in the best health care plan for them. For the near term we all must continue to fight to maintain and improve access to affordable health care coverage free of discrimination for all.

Enrollment tips and resources specific to people with HIV are available from the ACE TA Center and for LGBTQ people from Out2Enroll. Individuals can purchase coverage through healthcare.gov.