For people living with HIV/AIDS, and the clinicians and advocates caring for them, the Affordable Care Act (ACA) was almost too good to be true when it was introduced in 2010. Suddenly, chronic disease management was available to the uninsured, the uninsurable and for the poor. This included the preventive and wellness services required for living into old age with HIV/AIDS.

Until this point, being HIV positive and uninsured caused incredible uncertainty for many who were just trying to stay alive. And for those struggling with addiction and/or mental illness alongside HIV, adherence to treatment was even more challenging and the danger of developing AIDS was more likely.

Desert AIDS Project (D.A.P.) is very blessed to have a volunteer workforce of about 600 and a paid staff of about 250. And our valley is probably the most generous community anywhere when it comes to charitable giving.HIVlivng But the ACA has done something for our clients living with HIV/AIDS that love alone could not. It has made them proactive participants in their own health care, regardless of employment status or pre-existing health conditions. Life-sustaining primary care has been made available to them while they are still well, so that they can partner with their clinicians to make sure the virus stays suppressed in their bodies, and that additional complications from living with HIV/AIDS can be managed.

Before the ACA, our uninsured clients living with HIV/AIDS would wait months for specialized and lifesaving treatments at county facilities after being referred by a D.A.P. clinician. We are so thankful for the life-sustaining treatments administered there, but the reality is that long waiting lists for the uninsured resulted in many of our clients dying.Even with medications available to treat their HIV, opportunistic infections and cancers threatened to take their lives, and often did so without timely medical intervention. Today, thanks to insurance provided through the ACA we do not have to worry about long waiting lists for our patients. That is cause for celebration.

In addition to helping our core client group live longer and more meaningful lives, the ACA has enabled us to open our doors wider to care for people in our community who might not have HIV, but who face other health care needs.

• More than half of our 5,500 clients are HIV negative. They receive primary medical care, regular checkups and health screenings and they receive care for more serious health issues when they need it.
• Our Behavioral Health Program is helping approximately 700 clients receive the support they need, utilizing psychiatry, psychology and group sessions, whether they live with HIV/AIDS or not.
• We have become known for our program to cure Hepatitis C, a silent killer that is threatening the lives of about 5,000 people locally.
• Our Transgender Care Program is led by award-winning staff dedicated to linking our transgender siblings in the Inland Empire to gender-affirming health care.

In Riverside County by 2017, approximately 400,000 adults caught in the coverage gap had been given access to medical care. In less than 10 years, the ACA has elevated the quality of health care and made it accessible for all residents.

If it were to be abolished, we would go back to a time of needless mortality and more people living in the shadows. That is a fate that this valley cannot face.