The epicenter for HIV/AIDS infection in the U.S. is not the inner cities of New York, or Chicago, or Los Angeles. It's not San Francisco. It's South Carolina and the remaining states in the
deep South.
Southern states now have the highest rates of new HIV diagnoses, the largest percentage of people living with the disease and the most people dying from it, according to Rainey Campbell, executive director of the Southern AIDS Coalition, a nonprofit serving 16 Southern states and the District. Fifty percent of all new HIV cases are in the South. In some Southern states, blacks account for more than 80 percent of new HIV diagnoses among women.
States in the South have the least expansive Medicaid programs and the strictest eligibility requirements to qualify for assistance, which prevents people living with HIV/AIDS from getting care, according to a coalition report. In the South, Campbell said, people living with HIV have to reach disability status before they qualify for aid. This is significant, because nationally the vast majority of HIV/AIDS patients rely on Medicaid for their health insurance, according to research conducted by the Morehouse School of Medicine in Atlanta.
None of the nine Deep South states with the highest rates of new HIV/AIDS diagnoses—Alabama, Georgia, Florida, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee and Texas—has opted to expand Medicaid under the Affordable Care Act. Those states also have the highest fatality rates from HIV in the country, according to the coalition.
What they all have in common, along with the refusal to accept Medicaid expansion, is deep levels of poverty and rural and minority populations. They also have the highest rates of uninsured populations and the
poorest health in the nation.
Fighting HIV/AIDS in the region is an incredibly complex problem. There's the lack of funding and the lack of medical infrastructure in many of the rural areas that are particularly hard hit. There's cultural barriers and the massive stigma still attached to the disease. But there's also the brutal callousness of the political leadership in these states, the leadership that has decided to ignore the plight of their constituents and withhold help.
Medicaid expansion wouldn't be the silver bullet to solve the HIV/AIDS problem in the South, but it would be a damned good start. That infusion of money would not just provide health insurance to so many who desperately need it, it would free up other money the state and local governments have to spend now in uncompensated care. It could give these states the opportunity to start building the medical infrastructure they need. But that would be accepting the evil Obamacare, and nothing is worse than that to these Republicans. Not even watching their people needlessly suffer and die of diseases that can be treated.