Given the large numbers of people with HIV (PWH) with Medicaid coverage, it is important to understand the patient experience with Medicaid. Understanding experiences with and attitudes around the program have important policy and clinical implications. The objective was to understand the patient perspective of PWH in Virginia, who transitioned to Medicaid in 2019 due to Medicaid expansion. English-speaking PWH who gained Medicaid due to Medicaid expansion in 2019 were recruited at one Virginia Ryan White HIV/AIDS Program clinic. The goal was to enroll >33% of those who newly were on Medicaid for 2019. Participants were surveyed about demographic characteristics, and semistructured interviews were performed. Descriptive analyses were performed for cohort characteristics. Using qualitative description and an open coding strategy, codebooks were generated for the interviews and themes were identified. The cohort (n = 28) met our recruitment goal. Most participants had positive feelings about Medicaid before enrollment (general: 68%; good for general health: 75%, and good for HIV care: 67%) and after enrollment (general: 93% and good for HIV care: 93%). All participants expressed incomplete understanding about Medicaid before enrollment. Seventy-nine percent needed outside help to complete enrollment. Approximately 40% described overlaps of Medicaid with other insurance/payers or gaps in insurance coverage when transitioning from one insurance/payer (such as AIDS Drug Assistance Program [ADAP] medication provision and ADAP-subsidized insurance) to Medicaid. Participants suggested more access or easier access to information about Medicaid and more explanation of Medicaid benefits would be helpful. Our findings indicate participants had mostly positive perceptions of Medicaid before and after enrollment. Even with enrollment help, participants voiced that dealing with insurance is hard. Medicaid and other programs should prioritize more access to information, smoother processes, and less burdensome enrollment/re-enrollment.

中文翻译：

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通过扩大医疗补助获得医疗补助的 HIV 感染者的患者观点：一项横断面定性研究

鉴于有大量 HIV 感染者 (PWH) 获得 Medicaid 保险，了解患者使用 Medicaid 的体验非常重要。了解项目的经验和态度具有重要的政策和临床意义。目的是了解弗吉尼亚州 PWH 的患者观点，由于医疗补助计划的扩张，他们于 2019 年过渡到医疗补助计划。由于 2019 年医疗补助计划的扩张而获得医疗补助的讲英语的 PWH 被招募到弗吉尼亚瑞安怀特艾滋病毒/艾滋病项目的一家诊所。目标是在 2019 年招募超过 33% 的新加入医疗补助计划的人。参与者接受了人口学特征调查，并进行了半结构化访谈。对队列特征进行了描述性分析。使用定性描述和开放编码策略，为采访生成了密码本，并确定了主题。队列（n = 28) 达到了我们的招聘目标。大多数参与者在入学前（一般：68%；对一般健康有益：75%，对 HIV 护理：67%）和入学后（一般：93%，对 HIV 护理有益：93%）对 Medicaid 有积极的感觉。所有参与者在入组前都对 Medicaid 表示不完全了解。79% 的人需要外部帮助才能完成入学。大约 40% 的人描述了从一个保险/付款人（例如 AIDS Drug Assistance Program [ADAP] 药物供应和 ADAP 补贴的保险）过渡到 Medicaid 时，Medicaid 与其他保险/付款人的重叠或保险范围的差距。参与者建议更多地访问或更容易获得有关 Medicaid 的信息，并且更多地解释 Medicaid 福利将是有帮助的。我们的研究结果表明，参与者在入学前后对 Medicaid 的看法大多是积极的。即使有招生帮助，参与者也表示处理保险很困难。医疗补助计划和其他计划应优先考虑更多的信息访问、更顺畅的流程和更少的注册/重新注册负担。