According to a brief submitted by Lambda Legal as amici curiae supporting the Minimum Coverage Requirement (MCR) issue of the Affordable Care Act, "When the Patient Protection and Affordable Care Act (“ACA”), Pub. L. No. 111-148, 124 Stat. 119 (2010) (as amended), was enacted, only 17% of Americans with HIV/AIDS had private health insurance, and nearly 30% had neither public nor private insurance". See AIDS.gov, Health Care Reform and HIV/AIDS: How Does the Affordable Care ActImpact People Living with HIV/AIDS? 2 (Jan. 14, 2011) (“Health Care Reform and HIV/AIDS)."

Of the 30% of individuals living with HIV without insurance, many are unable to afford expensive, life-saving medication. Even the 83% of individuals with insurance use either Medicaid, Medicare, VA, or other non-profit based sources of financial assistance--all of which often leave HIV-positive individuals under-insured and financially overwhelmed. These populations tend to be marginalized groups like poor, black, or queer individuals.

Lambda points out that the way our insurance system is currently structured, the HIV-positive under-insured often do not qualify for insurance plans because of a "pre-existing condition." Under the Affordable Care Act, an individual mandate would prohibit health insurance companies from denying coverage for individual conditions--like HIV. Without such a mandate, these marginalized communities are at the mercy of the public assistance, and this often leads to people dying from preventable cases of AIDS. I'm not sure I want to live in a country where someone is sentenced to death because they can't afford to pay for drugs (that would've otherwise been affordable with an insurance plan). Moreover, even more upsetting is the way historically oppressed classes are disproportionately and overwhelmingly impacted by ACA, yet receive little regard because they live on the fringes of society.

The individual mandate provides that everyone must have insurance and denies the banning of coverage for individuals with pre-existing conditions. Sometimes I feel like the Court and lawyers get caught up in a circlejerk of Constitutional theory--and resort to desperate interpretations of the law--and often ignore the more practical implications of legislation. This subgroup of the population desperately needs health care to end senseless, preventable deaths. This mandate has the potential to save many lives; but because these stories come from groups society historically doesn't care about (poor, black, LGBTQ groups), people will be less apt to pay attention and think about the devastating implications for the under-insured living with HIV.

-- AjGarcia - 29 Mar 2012