In states that aren't participating, thousands could miss chance for expanded coverage.
William Wilson has one word for what health care reform means for him: freedom.
Eleven years ago, Wilson was diagnosed with AIDS in Chicago. He had health insurance that he purchased as a self-employed graphic designer before his diagnosis.
Wilson continued paying his health care premiums for a year and a half following his diagnosis, but said his health insurance provider denied the vast majority of his claims. Enormous medical expenses soon forced Wilson into bankruptcy. He says he could not obtain health insurance of his own because of his pre-existing condition.
The freedom Wilson talks about is the ability to get many more of his health needs met, obtain insurance without discrimination and have less stigma attached to getting his health care. Wilson won't have to work around the income limitations that previously forced him to maintain a low income in order to be eligible for existing federally funded HIV/AIDS programs, or live without insurance.
Gina Brown, who lives in Louisiana, isn't so lucky.
Lawmakers in Wilson's state of Illinois have thrown their support behind both health care reform and Medicaid expansion. Those in Louisiana have not. When states don't participate, the federal government will help set up exchanges that some fear will be weaker. The health care exchanges are slated to go live Oct. 1 and the coverage will take effect Jan. 1.
The health care exchanges under the Affordable Care Act, in the states that participate, could see to it that 20 to 30 percent more HIV-infected people are covered, according to experts.
