摘要:The Affordable Care Act presents financial challenges and opportunities for publicly funded service providers. We assessed billing practices and anticipated barriers to third-party billing among organizations in Texas that provide publicly funded HIV, sexually transmitted diseases, tuberculosis, and viral hepatitis services. One third to one half of the organizations did not bill for medical services. The most common barrier to third-party billing was lack of staff knowledge about billing and coding. Future research must evaluate options for organizations and communities to maintain access to infectious disease services for vulnerable populations. The Affordable Care Act (Pub L No. 111–148) and policymakers’ perceptions about funding public health programs present new challenges and opportunities for service providers. 1–4 Organizations that provide HIV, sexually transmitted diseases (STDs), tuberculosis (TB), and viral hepatitis prevention and care services and that rely on discretionary grant funding may face difficulties adjusting to the new financial landscape. Conversely, reimbursements through subsidized private insurance plans (and through Medicaid in states expanding coverage) offer opportunities to generate new sources of revenue. To understand Texas organizations’ capacity to adapt to funding changes, we surveyed community-based organizations, local health departments, community health centers, and hospital-affiliated specialty clinics.