1. Navigating POWER with HIV/AIDS in Indiana: Poverty and Personal Responsibility in the Era of Health Care Reform
- Author
-
Alyson J. O’Daniel
- Subjects
CARE Act ,Poverty ,business.industry ,Best practice ,General Social Sciences ,Participant observation ,Public relations ,medicine.disease ,Arts and Humanities (miscellaneous) ,Acquired immunodeficiency syndrome (AIDS) ,Anthropology ,Political science ,medicine ,Moral responsibility ,Health care reform ,business ,Medicaid - Abstract
This analysis considers HIV/AIDS care policy and practice in relation to Indiana's alternative Medicaid expansion plan. Since enactment of the Ryan White CARE Act in 1990, federally-funded HIV/AIDS programs have been crucial to the American public health care landscape. However, Medicaid expansion provisions of the 2010 Affordable Care Act have prompted new questions concerning the need for a vertical HIV/AIDS health program, how best to coordinate access to HIV/AIDS care, services eligibility criteria, and standards of best practice. Drawing from participant observation and ethnographic interviews among HIV-positive women and care providers, I document women's barriers to health insurance access and consider how the work of insurance enrollment and bureaucratic navigation were shifted onto HIV/AIDS care providers. I argue that neoliberal logics of “personal responsibility” underpinning Indiana's expansion plan saddled women and care providers with new financial and social obligations that ultimately dimi...
- Published
- 2018