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Alabamians are being diagnosed with HIV at the 13th highest rate in the nation. The State of Alabama has not yet expanded Medicaid under the Affordable Care Act.  As a result, an estimated 1,900 of the lowest-income HIV+ residents of Alabama have been left out of coverage available in other states. They must rely on Ryan White funding for crucial medical care and other supportive services. In 2011, an estimated 7,133 Alabamians received services through the Ryan White program.