The 2024 report from The AIDS Institute (February 29, 2024) revealed that copay accumulator adjustment policies were still ubiquitous in the ACA marketplace plans in 2024. The full report provides in depth information about how these policies harm people living with HIV and others with serious chronic conditions.

A national map overview of the state ratings is available here.


States with “A” Ratings:

ArizonaArkansasConnecticutDelawareGeorgiaHawaiiIllinoisKentuckyLouisianaMaineNew MexicoNew YorkNorth CarolinaOklahomaTennesseeTexasVirginiaWashingtonWashington D.C.West Virginia


States with “B” Ratings:

MassachusettsNew Jersey


States with “C” Ratings:

AlaskaCaliforniaIndianaKansasMarylandNorth DakotaRhode IslandVermontWyoming


States with “D” Ratings:

AlabamaColoradoFloridaMississippiNebraskaNevadaNew HampshireOhioSouth DakotaWisconsin


States with “F” Ratings:

IdahoIowaMichiganMinnesotaMissouriMontanaOregonPennsylvaniaSouth CarolinaUtah