Medicaid and HIV: Five Things to Know

Approximately 40% of people living with HIV in the United States rely on Medicaid, making it the largest single coverage source for this demographic, according to recent data published by KFF. Still, people living with HIV account for less than one-half of one percent of all Medicaid enrollees overall, which makes Medicaid a vital source for people living with HIV.

Medicaid spending cuts are a hot topic right now, with the House passing a budget resolution to reduce the federal deficit by at least $880 billion over 10 years. A letter published by the Congressional Budget Office on March 5 revealed that 93% of non-Medicare spending in the E&C jurisdiction is from the federal share of Medicaid spending: $8.2 trillion out of a total $8.9 trillion.

One proposed way to reduce Medicaid spending is through work requirements. In February 2025, Congress introduced a bill that would require most Medicaid recipients ages 18 to 65 to work or volunteer at least 20 hours a week to keep their coverage. Approximately five million Affordable Care Act expansion adults could lose their coverage in 2026 if this bill passes, according to a recent analysis by the Urban Institute. Losses would result from the enrollee’s confusion about the policy and difficulty using complicated work reporting systems, the analysis says.

HIV is no longer the death sentence it once was and as people live longer, the need for coverage grows. Cuts to coverage could result in increased morbidity and, in severe cases, mortality, the KFF report says.

The following are facts about the impact of Medicaid coverage on enrollees with HIV: