Healthcare Reform

Welcome to APLA’s web portal for information regarding the implementation of healthcare reform measures in California. We will update this page as new information becomes available, so please bookmark this page and keep checking back and visiting.

Here are some basics you should know:

  • You can no longer be denied health insurance due to a pre-existing condition, including HIV/AIDS.
  • With the exception of undocumented or recent immigrants of fewer than five years, some Native American tribes, and anyone currently incarcerated, most individuals will be required to have health insurance.
  • If you are one of those individuals required to have health insurance and you do not do so, the federal government will penalize you for not buying health insurance.
  • Covered California is the marketplace where California residents can buy private health insurance.
  • Open enrollment in Covered California takes place October 1, 2013 through March 31, 2014.
  • Anyone earning below 138% of the Federal Poverty Level (about $15,900 a year for a single person) will automatically qualify for Medi-Cal.
  • Federal premium assistance & cost-sharing reductions may be available to you based on your income.
    • Premium assistance covers part of your monthly health insurance premium so that you never pay more than 9.5% of your income toward health insurance premiums.
    • Cost-sharing reductions help with the cost of co-pays and deductibles.
  • If you are currently on ADAP and you are also eligible for private insurance through Covered California, you will be penalized by the federal government if you do not buy health insurance. However, it may make sense for you to remain on ADAP and out of private insurance, depending on your individual circumstances. If this applies to you, APLA encourages you to contact your ADAP benefits counselor to consider your healthcare enrollment options.

APLA recently completed the following analysis that looks at the cost considerations for people living with HIV/AIDS in California who are currently on ADAP and will be eligible for private health insurance through Covered California beginning January 1, 2014:

APLA’s healthcare outreach specialist is Frankie Darling-Palacios. If you have specific questions about the implementation of various healthcare reform measures, you can call Frankie at 323.329.9926 or email her at fpalacios@apla.org.

For more information, please fill out the form below, and we will connect you with an individual to provide one-on-one assistance as you consider your healthcare options.

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