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Public Financing and Delivery of Hiv/Aids Care: Securing the Legacy of Ryan White
FIGURE D-2 Estimated insurance coverage of people living with HIV/AIDS in care, United States, 1996. Includes those with other coverage, primarily Medicare.
SOURCE: Fleishman, J., Personal communication, Analysis of HCSUS Data, January 2002.
HIVRN patients. Of the full sample, including those for whom coverage data were not available, 30% had Medicaid coverage, 5% had Medicare coverage, 4% were uninsured, and 3% were privately insured. Of the 42% for whom coverage data were available, 70% were covered by Medicaid, 13% by Medicare, 10% were uninsured, and 7% were privately insured.36
There are important differences in coverage by race, ethnicity, and sex (see Figure D-3). HSCUS found32 that African Americans and Latinos with HIV are much more likely to depend on Medicaid than whites (59% and 50% respectively, compared with 32% of whites). Minority Americans with HIV also are more likely to be uninsured than whites (22% of African Americans and 24% of Latinos compared with 17% of whites). Whites with HIV have the highest rate of private insurance across all racial and ethnic groups (44%). Women with HIV are also much more likely to rely on public insurance than their male counterparts, particularly Medicaid (61% of women compared with 39% of men), and less likely to be covered through the private sector (14% of women compared with 36% of men). This may be due in part to the fact that women are more likely to qualify for Medicaid as parents of dependent children or when pregnant. The intersection of race/ethnicity and sex is important here—most women newly infected with HIV and living with AIDS are women of color.13,37
Persons in care do not fare equally in the health care system. Analysis of data from HCSUS found that people with HIV who were covered by