Expanding Access Through the Affordable Care Act
Texas Health Action’s Kind Clinic was recently awarded a $250,000 grant from St. David’s Foundation to further expand access to health insurance coverage in Central Texas. The grant will allow Kind Clinic’s Patient Support Services program to continue to provide vital assistance in healthcare coverage enrollment and help patients navigate insurance complexities for labs and HIV prevention medications known as PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis), as well as HIV care. This type of support helps to ensure that underserved populations, particularly those identifying as LGBTQIA+ or impacted by HIV, can access essential healthcare services.
“Health insurance status plays a critical role in PrEP adherence and long-term retention in care. By helping uninsured patients at Kind Clinic secure health insurance, Texas Health Action is reducing healthcare disparities and improving access to essential medical services, including PrEP, ultimately lowering HIV transmission rates,” Christopher Hamilton, CEO of Texas Health Action, said. “We are grateful that St. David’s Foundation recognizes the importance of insurance enrollment efforts as a pathway to health equity and improving public health.”
Interventions Drive Access
Since 2022, Kind Clinic’s Patient Support Services program has successfully enrolled over 800 individuals in health insurance during open enrollment periods. Additionally, the program has provided vital assistance in navigating insurance complexities, including premium support. However, a significant challenge remains: currently, approximately 40% of Kind Clinic patients are uninsured. Texas Health Action aims to reduce this percentage to better align with statewide trends.
Recent U.S. Census Bureau estimates indicate that nearly 17% of Texans were uninsured in 2022. The uninsured rate among Kind Clinic patients is more than twice this statewide figure, highlighting a critical need for focused interventions. Texas Health Action helps uninsured patients secure health insurance coverage, which then enables them to access necessary medications through trusted pharmacies, including co-located Avita Pharmacies at our Austin locations.
“As St. David’s Foundation turns to its new strategic plan and pathways to health equity, we are deeply appreciative of the foundation’s recognition of Texas Health Action’s efforts to address disparities in healthcare coverage for LGBTQIA+ communities and those impacted by HIV,” Juan Benitez, Chief Advancement Officer of Texas Health Action, said. “Philanthropic support remains vital in our pursuit of health justice. The support of St. David’s Foundation will help us close healthcare gaps in Central Texas and address the lack of insurance coverage for the communities we serve.”
Health Insurance Coverage Critical Driver of PrEP Adherence
Research from the CUNY Graduate School of Public Health and Health Policy in New York City underscores the importance of health insurance in adherence to HIV-prevention regimens like PrEP. Similarly, a study of patients in Seattle, Washington, found that approximately 13% of patients discontinued PrEP due to health insurance issues. Although a comparable study does not exist for Texas, the highest uninsured state in the country, insights from Texas Health Action’s patients indicate that health insurance status significantly impacts PrEP adherence and long-term retention in care.
Texas Health Action expects to begin helping patients enroll in coverage for a third year, when open enrollment through the Affordable Care Act starts on November 1.
