The prospect of a generation free of HIV may be within reach if the right policy decisions are made.

Scientific advances have transformed HIV treatment and prevention, leading to the adoption of an approach that emphasizes broad testing and antiretroviral treatment at earlier stages in the disease, called "test and treat." In addition to clinical benefits, early treatment generates considerable social and economic value. These changes raise the prospect that for the first time since the 1980s, an entire generation might be free of HIV. However, achieving such a goal will require continued scientific advances and the presence of policies and programs to ensure that people living with HIV/AIDS have access to health care and adhere to treatment regimens. This article explores the opportunities and challenges that the Affordable Care Act (ACA) presents for people living with HIV/AIDS and discusses how the act's various components might interact with existing support for people with HIV/AIDS, such as the Ryan White Program. As the ACA's reforms proceed, coordinated state and federal programs must make smart policy choices so that critical access to and affordability of comprehensive care are maintained in the fight against HIV/AIDS.