Just over one-quarter of clients (26%) are White. Most clients are people of color (74%), including 47% who are Black and 24% who are Hispanic. Smaller shares are under 25 (4%) or over 64 (10%). More than one-third (38%) are between 25-44. Approximately half (49%) are between the ages 45 and 64, up from 22% in 2016. Clients are largely male (72%), 26% are female and 2% are transgender.Other coverage includes: private insurance (20%), Medicare only (11%), and other or multiple sources of insurance (12%). Most clients (80%) have some form of insurance coverage: Medicaid is the primary payer for Ryan White clients, covering 38%, including those dually eligible for Medicare. One-fifth (19%) were uninsured, a decrease from 28% in 2013, prior to enactment of the major coverage provisions under the Affordable Care Act (ACA).
Nearly two-thirds (61%) had incomes at or below the federal poverty level (FPL) (which in 2020 was $12,760 for a single person or $26,200 for a family of four) 29% had incomes between 101% and 250% FPL.More than half a million people receive at least one medical, health, or related support service through the program in 2020, with many clients receiving multiple types of services: The initiative includes new federal funding, some of which has been channeled to Ryan White. HRSA is one of the lead agencies in the federal government’s Ending the HIV Epidemic (EHE): A Plan for America initiative, launched in 2019, and the Ryan White Program is set to play a key role in efforts to reach the goal of reducing new HIV infections by 75% in five years and by 90% in ten years. The program is administered by the HIV/AIDS Bureau (HAB) at the Health Resources and Services Administration (HRSA) of the Department for Health and Human Services (HHS), and programs and services are delivered by grantees and sub-grantees at the state and local levels. The current authorization lapsed in FY 2013, but the program has continued to be funded through the annual appropriations process as there is no “sunset” provision or end date attached to the legislation.
The program has been reauthorized by Congress four times since it was first created (1996, 2000, 2006, and 2009) and each reauthorization has made adjustments to the program. Many “parts” of the program (described below) can purchase health insurance on behalf of clients which is often less expensive than paying for drugs alone and offers broader health coverage. It provides outpatient care and support services to individuals and families affected by the disease, functioning as the “payer of last resort,” by filling the gaps for those who have no other source of coverage or face coverage limits or cost barriers. First enacted in 1990, Ryan White has played an increasingly significant role as the number of people living with HIV has grown over time and people with HIV are living longer. The Ryan White HIV/AIDS Program (Ryan White), the largest federal program designed specifically for people with HIV in the United States, serves over half of those in the country diagnosed with HIV. In FY 2022, the Ryan White HIV/AIDS Program was funded at $2.5 billion which includes continued funding for the federal “Ending the HIV Epidemic” initiative. Funding is distributed to states/territories, cities, and HIV organizations in the form of grants.
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