Financial Impact of California's New Law to Increase HIV Screening by Mandating Insurance Coverage (AIDS Care)

In 2008, California became the first state to mandate that private insurers pay for HIV testing even when it's not related to a patient's primary diagnosis during a medical visit. The law addresses the major public health challenge presented when people who aren't aware they have HIV unwittingly transmit the infection and delay treatment. What's the cost to insurers for routine screening? That's the question Center Senior Research Scientist Ying-Ying Meng, Center Associate Director Gerald F. Kominski and colleagues answer in a new article in the February issue of AIDS Care. Most of the 22,190,000 privately insured Californians already have coverage for HIV testing, and the authors found if those who previously paid out-of-pocket for tests were now covered, the increased cost for could be as low as $554,000 in 2009 when the law took effect. But even if guidelines proposed by the Centers for Disease Control and Prevention to screen widely for HIV are fully adopted, costs to insurers are expected to be small, about $10 million a year or 0.013% of total private health insurance expenditures in California. This policy change could serve as an important step toward making HIV testing a routine screening testing.

Publication Authors:

• Ying-Ying Meng, DrPH
• Janet M. Coffman
• Jay C. Ripps
• Chankyu Lee
• Gerald F. Kominski, Ph.D.