HIV Patients in Georgia are Drowning. Will the State Do the Right Thing?

With the nation hurdling towards January 1, 2014, when some important parts of the Affordable Care Act (ACA) kick in, individual states are frantically scrambling to get ready — or digging in their heels in stubbornness that could have serious consequences for their residents. Georgia is one of several states that has refused Medicaid expansion, a decision that represents serious risks to its most low-income, vulnerable residents, especially the population of people living with HIV and AIDS.

In a curious twist, while Georgia may be home to the Centers for Disease Control and Prevention, site of some of the most cutting-edge medical and public health research, the state has the highest rate of new HIV infections in the nation. Those infected with the virus are often low-income with low levels of education, which makes them extremely reliant on government programs intended to help HIV and AIDS patients. That’s a dangerous combination when some of those programs are slated for funding cuts or total dismantling under a changing health care system combined with an economic depression.

These programs are not, of course, streamlined; patients in Georgia struggle to meet the state’s extremely strict Medicaid guidelines while also applying for assistance through Georgia’s AIDS Drug Assistance Program, housing help and other means to help them afford food, medications and a place to live. Simply applying for services can eat up hours of time every week, as can maintaining the documentation necessary to support eligibility claims and stay covered. Living with HIV and AIDS can be a costly proposition and while there are a few innovative AIDS clinics in Georgia working on facilitating patient care, many patients don’t have access to them.

Governor Nathan Deal has taken a hard line on Medicaid expansion as part of his overall commitment to conservative politics, even though it could cost some Georgia residents their lives. At the same time ACA is moving into full swing, many agencies providing health care and outreach services are experiencing substantial cuts because of the sequester, and some of those cuts are especially deep. Federal funders assume that ACA will be able to pick up the slack, while in states like Georgia, that isn’t the case, and patients won’t be able to get the services they need.

Writing for Creative Loafing Atlanta, Cathy Woolard notes that: “Without at least $9 million in unanticipated new funding from either federal or state sources beginning on January 1, we will once again have a waiting list for the AIDS Drug Assistance Program, and see HIV infection rates grow to even more alarming levels.” She predicts a snowball effect as funding shortages disrupt access to medications and housing, making people with HIV infections more likely to transmit the virus to others and creating a situation where the state’s pigheadedness could create a bigger problem than the one it started with in the long term.

This case illustrates what happens when enforcement of comprehensive federal legislation is left to the states, who get to determine on an individual basis how they want to implement it. In many conservative states, there’s considerable resistance to expanding Medicaid and taking other measures to provide coverage for low-income residents, many of whom are more likely to experience disability and disease. In these states, conditions are only going to get worse after 1 January, but the party at fault is not ACA: it’s administrators and political officials who choose not to take full advantage of ACA’s opportunities.

For low-income HIV and AIDS patients in Georgia, political wrangling and discussion provide cold comfort. They need secure and reliable access to services to stay healthy and limit spread of HIV, and it’s seemingly increasingly likely they won’t get that unless Deal experiences a change of heart in time for the state to implement an expanded Medicaid program.

Will the state do the right thing?


Related articles:

Scott Brown Wants to Repeal Affordable Care Act He Uses to Cover His Daughter

HIV/AIDS: The Tide Is Turning, But Not Fast Enough

Integrated Family Planning and HIV/AIDS Services


Photo credit: Elvert Barnes


Carole R.
Carole R.3 years ago

Thanks for the post.

Jeaneen Andretta
Past Member 3 years ago

How will man kind ever be truly kind, if we leave anyone out who needs help.

Ro H.
Ro H.3 years ago


Cynthia B.
cynthia AWAY b.3 years ago

so disheartening =people need to be helped

Debbie Williamson

Thanks for the information. Maddening and disheartening.

faith v.
faith v.3 years ago

Repubs have a name for this.

They call it death panelling.

John B.
John B.3 years ago

Thanks Ms. Smith for the article. Shameful and sad. When will the conservatives find compassion?

Andrew Davis
Andrew Davis3 years ago

The Real Problem - DICKS in Power!

Dennis F.
Dennis F.3 years ago

This happens time and time again - the most vulnerable are easy targets, and we let "them" get away with it. People tend to not want to think about AIDS, until someone that's near and dear to them contracts the disease, then it's an entirely different story.

Marianne C.
Marianne C.3 years ago

Wisconsin governor Scott Walker has also "declined" to initiate the Affordable Health Care Act.

Yes, this is the same Scott Walker who has no college degree because he was kicked out of school in his senior year for illegal electioneering activities during a student election. The same Scott Walker who worked in a fairly low-level marketing job for The American Red Cross after being kicked out of college, but who now opposes caring for the people of his own state. The same Scott Walker whose aides and assistants have fallen on their swords to keep him out of jail. The same Scott Walker whose campaign funding was either illegal enough to get his contributors charged and jailed, or came from out-of-state sources like the Koch Brothers. The same Scott Walker who was punked by a fake phone call alleged to be from David Koch, and eagerly reported the many Koch-friendly plans he was putting in place.

That would also be the same Scott Walker who spends more time outside the state of which he is ostensibly governor than he does in it, because he's coincidentally the same Scott Walker who wants to run for President in 2016. And a guy has to make contacts if he wants to do that.