POSITIVELY COVERED
POSITIVELY COVERED
STAY ENROLLED, STAY HEALTHY.
A PROJECT OF
A MEDICAID ENROLLMENT PROGRAM FOR THE HIV COMMUNITY
Positively Covered is a project of The National HIV/AIDS Housing Coalition and The AIDS Institute that equips both HIV and Housing community-based organizations with the tools, training, and staffing needed to help clients assess their current Medicaid enrollment status and stay enrolled through renewals, redeterminations, and new federal work reporting requirement rules.
CHANGES BEGIN JANUARY 1, 2027
New Medicaid work requirements and 6-month renewals for adults in states that expanded Medicaid, plus new checks for everyone on Medicaid — is your organization ready?
WHY IT MATTERS
H.R. 1 requires nearly all states that expanded Medicaid (40 states plus D.C., along with Georgia and Wisconsin) to start work requirements by January 1, 2027. Work requirements and renewals every 6 months apply only to adults in states that expanded Medicaid who qualified based on income. Address checks, narrower immigrant eligibility, and shorter retroactive coverage apply to everyone on Medicaid, including people who qualify through a disability. Which rules apply to your clients? The Congressional Budget Office estimates H.R. 1 will reduce Medicaid enrollment by more than 11 million people by 2034.
For people living with HIV and vulnerable to HIV, losing Medicaid coverage will mean loss of comprehensive healthcare. For families torn between healthcare and housing costs, the problem is compounded. And for people who are unhoused, the emergency room too often reverts to primary care.
60%
of adults under 65 living with HIV in expansion states were covered through Medicaid expansion in 2023, the group that faces the new work requirements unless exempt.
Source: KFF
4 in 10
new HIV transmissions are associated with someone who knows their status but is not in care.
Source: CDC (2016 data)
62%
of unhoused people in expansion states were covered through Medicaid as of 2023.
Source: National Healthcare for the Homeless Council
~20%
overlap between people living with HIV and those who are unstably housed or homeless.
81%
of HOPWA (Housing Opportunities for Persons with HIV/AIDS) households have incomes at or below 30% of their area's median income — HUD's threshold for "extremely low income."
Source: HUD HOPWA National Performance Profile
Medicaid is the primary payer for HIV care and treatment
Medicaid — 45%
Medicare — 39%
Ryan White — 9%
Other — 7%
Distribution of U.S. federal spending on HIV by program, FY 2022. Source: KFF analysis of Congressional Budget Justifications and related budget documents.
THE IMPORTANCE OF HOUSING ORGANIZATIONS AND COMMUNITY-BASED CLINICS
Housing organizations and community-based HIV organizations have existing relationships with clients and interface with them regularly. CBOs also have some basics — like a consistent physical address, places to store documentation, and access to WiFi. Often out in the community at testing and community events, CBOs often have relationships with shelters, hospitals, and local faith communities.
We can ensure our clients stay enrolled and stay healthy.
HOW POSITIVELY COVERED CAN HELP YOUR ORGANIZATION
We will monitor federal regulation, lawsuits, and more to make sure you have the information you need. We will host monthly webinars to discuss enrollment strategies, highlight existing agencies' efforts, and disseminate information and best practices.
We hope to hire a full-time Positively Covered Coordinator who can help identify enrollment assisters and help your staff get trained. Until then, we will develop materials to address the following:
Address & Contact Verification
Helping clients maintain a reachable mailing address and phone number so renewal notices never go missing.
Enrollment Strategies
Practical, field-tested approaches for getting and keeping clients enrolled, from events to case manager training.
Work Reporting Requirements and Exemptions
Clear guidance on new federal work requirements and how to help clients document exemptions.
PARTNERS IN THE EFFORT
POSITIVELY COVERED
Stay Enrolled, Stay Healthy.
A PROJECT OF
Site and Project Run by the National HIV/AIDS Housing Coalition, in Partnership with The AIDS Institute