Research from Vanderbilt University Reveals New Findings on Health Policy (The Impact of Medicaid Expansion under the Affordable Care Act on HIV Care Continuum Outcomes Across the United States): Health Policy

2024 OCT 18 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- New research on health policy is the subject of a new report. According to news reporting out of Vanderbilt University by NewsRx editors, research stated, “HIV care continuum outcome disparities by health insurance status have been noted among people with HIV (PWH).”

The news editors obtained a quote from the research from Vanderbilt University: “We therefore examined associations between state Medicaid expansion and HIV outcomes in the US. Adults ( 18 years) with 1 visit in NA-ACCORD clinical cohorts from 2012-2017 contributed person-time annually between first and final visit or death; in each calendar year, clinical retention was 2 completed visits >90 days apart, ART receipt was receipt of 3 antiretroviral agents, and viral suppression was last measured HIV-1 RNA <200 copies/mL. CD4 at enrollment was obtained within 6 months of enrollment in cohort. Difference-in-differences(DID) models quantified associations between Medicaid expansion changes (by state of residence) and HIV outcomes. Across 50 states, 87,290 PWH contributed 325,113 person-years of follow-up. Medicaid expansion had a substantial positive effect on CD4 at enrollment (DID=93.5, 95% CI: 52.9, 134 cells/mm3), a small negative effect on proportions clinically retained (DID=-0.19, 95%CI: -0.037, -0.01), and no effects on ART receipt (DID=0.001, 95%CI: -0.003, 0.005) or viral suppression (DID=-0.14, 95%CI-0.34, 0.07).”

According to the news editors, the research concluded: “Medicaid expansion had a positive effect on CD4 at entry, suggesting more timely HIV testing and care linkage, but generally null effects on downstream HIV care continuum measures.”

For more information on this research see: The Impact of Medicaid Expansion under the Affordable Care Act on HIV Care Continuum Outcomes Across the United States. Health Affairs Scholar, 2024. The publisher for Health Affairs Scholar is Oxford University Press (OUP).

A free version of this journal article is available at https://doi.org/10.1093/haschl/qxae128.

Our news journalists report that additional information may be obtained by contacting Peter F Rebeiro, Vanderbilt University, Nashville, TN, . Additional authors for this research include Julia C Thome, Stephen J Gange, Keri N Althoff, Stephen A Berry, Michael A Horberg, Richard D Moore, Michael J Silverberg, Daniel E Sack, Timothy R Sterling, Pedro Sant’Anna, Bryan E Shepherd.

ORCID is an identifier for authors and includes bibliographic information. The following is ORCID information for the authors of this research: Peter F Rebeiro (http://orcid.org/0000-0003-1951-9104), Julia C Thome (http://orcid.org/0000-0003-4387-1458), Stephen J Gange (http://orcid.org/0000-0001-7842-512X), Keri N Althoff (http://orcid.org/0000-0002-5068-6595), Michael A Horberg (http://orcid.org/0000-0002-6971-7646), Richard D Moore (http://orcid.org/0000-0001-8250-5069), Michael J Silverberg (http://orcid.org/0000-0001-9322-1395), Daniel E Sack (http://orcid.org/0000-0003-0864-8875), Pedro Sant’Anna (http://orcid.org/0000-0002-7280-7431).

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