Even while serving a quarter or less of the eligible population, ADAP initiatives are going broke. Medicaid is clearly unable to afford triple combination therapy for all the Medicaid recipients with HIV who might benefit from it. People with HIV don't have to worry about having their names in a state HIV registry because existing privacy laws protect them from discrimination. If her recommendation is passed into law, it could very well give them legal access to name-based HIV registries. State privacy laws are only as strong as the legislatures' will to uphold them.
States can, and do, change their laws regarding privacy all the time.
If a state Health Department has a name-based registry listing people with HIV, it can be forced at any time to open that registry by either legislative mandate or court order. The fear that HIV name reporting will cause people to avoid getting tested for HIV turns out not to be true. Health Departments need the names so that they can contact people and get the names of their sex and needle sharing partners for partner notification. The MESH study also disproved this. In partner notification, it is the partners who are contacted during follow up.