FIGURE 2-3 Pathways to coverage for people with HIV: Full implementation of the ACA, 2014 and beyond.

NOTE: The ACA provides new dependent coverage for children up to age 26 for all individual and group policies. Also, as of 2014, the ACA prohibits health plans from being able to deny coverage to people with pre-existing health conditions. Individuals with pre-existing conditions will be able to obtain insurance in the exchange or non-group market (the temporary PCIP program will no longer be needed).

aMedicaid eligibility (state-based): low-income and categorically eligible (disabled, pregnant women, children, medically needy); states may seek waivers to cover other groups (such as nondisabled, childless adults); must be a U.S. citizen or legal resident for at least 5 years. Under the ACA, as of 2014, low-income adults up to 133 percent of the FPL become a new Medicaid-eligibility group. The Supreme Court has limited the authority of the federal government to enforce this provision, making it uncertain whether all states will comply. For current state eligibility requirements and information on which states have moved to expand Medicaid as permitted by the ACA, see KFF, State Health Facts, Medicaid Income Eligibility

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