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White House World AIDS Day Event

November 29, 2012
Washington DC

Thank you for that kind introduction.

Valerie just described a historic shift in our fight against HIV/AIDS.

Our National Strategy has given a new sense of direction and purpose to our domestic response. And we have made it a priority to intensify our efforts in the communities that have been hardest hit by this disease.

Approximately half a million people living with HIV are being served through our Ryan White Programs. The Centers for Disease Control and Prevention report that in the first three years of their expanded HIV-testing initiative, they provided nearly 2.8 million HIV tests and diagnosed more than 18,000 people unaware of their infection. As a result, an estimated 3,300 new infections were prevented among their partners.

We’re also taking steps to improve how we evaluate our programs. I have asked our department’s senior leaders to identify and implement a set of seven common core program indicators. This data will allow us to make sure our HIV programs are reaching the right people with the right services.

Our department has also used new media to build a cutting-edge response, targeting HIV prevention and testing messages to the people who need them most.  We are reaching out through channels like to meet people where they are, educate Americans about HIV, and reduce stigma and discrimination.

That’s more important than ever at a time when we know youth accounted for nearly 26% of all new HIV infections diagnosed in 2010. The majority of these infections were diagnosed among young black and Hispanic men who have sex with men. And it is another reminder of just how important it is make sure we continue getting young men and women tested – while improving their access to prevention, treatment, and care.

The good news is that today more Americans have better access to these life-saving interventions than ever before.

For years, we had a health insurance market in which insurers made profits by trying to avoid sick people.  This was great for insurance companies, but it was terrible for the people with the greatest health needs, including those living with HIV/AIDS.  In effect, the people who needed health insurance the most were the ones shut out of the market.

This wasn’t right, and the Affordable Care Act is bringing these days to an end. 

Starting in 2014, the law bans insurance companies from turning anyone away because of their health status.  Already the law provides protection from some of the worst insurance company abuses. For example, it is now illegal for insurance companies to deny coverage to children living with HIV/AIDS. And your insurance company can no longer put a lifetime dollar cap on your benefits, or cut your coverage when you get sick because of an error on a form. 

In the past, we had reports about an insurance company that was using a computer program to search the applications of anyone recently diagnosed with HIV, looking for any excuse to cancel their coverage.  Now, that practice is gone for good.

In the years to come, the Affordable Care Act will expand Medicaid so that it will be available to many more Americans with HIV/AIDS, including adults without children. As a result, many people living with HIV will no longer have to wait for an AIDS diagnosis to become eligible for Medicaid. And the law is investing in community health centers, and increasing access to testing, treatment, and care -- especially in underserved areas.

What these reforms mean is that far more Americans with HIV/AIDS will be able to get coverage they can count on through Medicaid or the private insurance market. But we have also begun to see another change taking place thanks to the health care law. And that is a new focus on the quality of care people receive once they’re covered.

That starts by making prevention a priority. The law helps eliminate barriers to HIV testing by requiring most private plans to cover HIV testing for women and individuals at high risk at no cost to the patient out-of pocket. They are also now required to cover with no co-pay many other recommended services, like flu shots or mammograms, that will help people living with HIV stay healthy.

In addition, the health care law provides long overdue relief from prescription drug costs for Medicare beneficiaries. Beneficiaries with HIV/AIDS often quickly hit the prescription drug coverage gap known as the donut hole.  Now, when they do, they get a 50 percent discount on their brand-name drugs.  And if the AIDS Drug Assistance Program covers their medicines, those payments will count toward moving beneficiaries through the donut hole -- so they don’t get stuck there.

Finally, the Affordable Care Act has made a series of investments to help providers support patients with chronic diseases like HIV/AIDS.

For example, under the law, states can receive extra federal funding -- an enhanced 90% federal match in the first two years -- to support coordinated care through “health homes” for Medicaid beneficiaries with chronic health needs. The goal of a Health Home is to treat the whole person, coordinating all their care from primary and acute care to behavioral health and long-term services.

With our guidance, New York and Oregon have already established health homes specifically to serve individuals living with HIV/AIDS. And we continue to work with other states on their proposals. Today, I am proud to announce that we will be issuing a rule to explicitly include HIV/AIDS on the list of chronic conditions that every state may target in designing effective Health Homes. This will help more states adopt the kind of innovations that we know can improve the care and health of people living with HIV/AIDS.

These are all big steps forward.  But we will continue to need the Ryan White program to fill in the gaps of our health insurance system. And we will keep reaching out to providers and community leaders on the frontlines to make sure those programs remain strong.

When President Obama took office four years ago, our nation’s fight against HIV/AIDS had nearly stalled. The number of new infections had plateaued while the general public’s concern about the disease continued to fade.

But we are here today because we refused to accept those trends. Over the last four years, we looked closely at how and where we were using our resources. And together, we made a commitment to help the best approaches reach those most in need.

Out of that collaboration came a powerful national strategy. And today, it provides a roadmap for the months and years ahead. But in order to achieve these goals we will need your continued leadership.

So today, I want to ask you to keep your foot on the accelerator. If we are going to reach our ultimate goal of an AIDS-free generation, we must all challenge ourselves to do more. We need your expertise, your best practices, and your collaboration to make the most of the Affordable Care Act and to realize the goals of the National HIV/AIDS Strategy.

Together, we can raise awareness to new heights and make our programs even more effective. We can push the boundaries of science even further. And we can help even more people get the support, treatment, and care they need to live long and healthy lives.