Advocates decry the bill as a setback for people living with HIV.
May 4, 2017
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The U.S. House of Representatives passed the American Health Care Act
(AHCA), with the support of 217 Republicans and no Democrats; 213
lawmakers, including 20 Republicans, voted against it. The GOP bill,
which aims to repeal and replace the Affordable Care Act (a.k.a.,
Obamacare), now heads to an uncertain future in the Senate.
Immediately
after the vote on May 4, AIDS organizations began issuing statements
condemning the bill, spelling out the meaning of the legislation and
rallying the HIV community to oppose it. Below is a roundup of
trimmed-down responses with the newest ones at the top. Click on the
organization’s name to read the full statement, check back here for
regular updates.
A
last-minute amendment to the bill providing a small amount of
additional funding to help offset the insurance costs of people with
pre-existing conditions is woefully inadequate and does nothing to
mitigate the harmful impact the bill would have on vulnerable
populations.
“The bill simply does not live up to the
promise made by the President and Members of Congress that people living
with pre-existing conditions, including HIV and hepatitis, will be
protected,” noted NASTAD executive director Murray Penner. “The bill
will make it harder, if not impossible, for people living with HIV and
hepatitis to find affordable insurance that actually meets their
prevention, care, and treatment needs. It will decimate Medicaid, the
biggest safety net program for low-income people living with and at risk
for HIV and hepatitis. Moreover, it will hamper our nation’s ability
and momentum to end the HIV and hepatitis epidemics.”
If passed, this bill would:
- Do
harm to people living with pre-existing conditions by allowing
insurance companies to go back to pre-Affordable Care Act (ACA) rules
and charge people higher premiums because of their health status
- Permit
states to waive Essential Health Benefits requirements, meaning that
insurers will no longer be required to provide the services people
living with and at risk for HIV and hepatitis need to stay healthy,
including prescription drugs, mental and behavioral health services, and
preventive services
- Ends
the Medicaid expansion and significantly reduces federal Medicaid
funding through a per capita cap. These cuts will force states to limit
eligibility, benefits, and important consumer protections and would mean
going back to cruel pre-ACA rules where a person must wait to be
disabled by HIV or hepatitis in order to be eligible for Medicaid
- Eliminates funding for vital services provided by the Prevention and Public Health Fund, which funds 12% of the Centers for Disease Control and Prevention’s budget
If
the deadly bill is signed into law in its current form, hundreds of
thousands of Alabamians — and millions of Americans — will face
discrimination for their age, gender, and/or pre-existing conditions
when they shop for health insurance.
While proponents
of the bill claim coverage for pre-existing conditions are protected,
this couldn’t be further from the truth. AHCA leaves the choice on
whether pre-existing conditions should be covered to the states, and
Alabama — one of 19 states yet to expand Medicaid — is historically
resistant to funding optional coverage. AIDS Alabama firmly believes
coverage for pre-existing conditions shouldn’t depend on a person’s ZIP
code.
Alex Smith, director of policy and advocacy for
AIDS Alabama, stated: “As a person living with HIV, this bill poses a
direct threat to my health and my ability to remain virally suppressed,
which helps ensure a long, healthy life and eliminate the risk of
transmission.”
“At AIDS Alabama, we are disheartened
that the US House of Representatives has passed the American Health Care
Act, a piece of legislation that takes health coverage away from the
country’s most vulnerable citizens,” added the group’s CEO, Kathie
Hiers. “FDR once said, ‘The test of our progress is not whether we add
more to the abundance of those who have much; it is whether we provide
enough for those who have too little.’ Clearly the politicians who voted
for this bill are not concerned about the millions of people who will
lose the chance to live healthy, independent lives.”
The
AHCA has the potential to take people living with HIV back to the days
when they were denied insurance coverage or could not afford the
coverage offered. High-risk pools have repeatedly failed to provide
affordable, quality coverage for people living with HIV and other
pre-existing or chronic conditions. Coverage in high-risk pools often
has excessively high premiums, deductibles and co-pays along with
limitations on needed drug coverage and care. The extra $8 billion
provided by the AHCA to support access to insurance through high-risk
pools is not sufficient and will result in under-capitalized pools,
years-long waiting lists and limits on eligibility. This will ultimately
cost the United States more money in future hospitalizations and other
expenses.
“The American Health Care Act would be
disastrous for people living with HIV, potentially causing unnecessary
illness and death, and moves us away from the national goal of ending
the HIV epidemic,” said AIDS United president and CEO Jesse Milan Jr.
“We are extremely disappointed in the legislators who voted for this
bill and who ignored the will of most Americans and the voices of people
living with HIV. We will work to ensure that constituents have all the
facts to hold their elected officials accountable.”
As
women living with HIV, including women of trans experience, many of us
know all too well the fear, dread and uncertainty of not having access
to the health care coverage we need just to survive, let alone thrive.
We are outraged that House Republicans today passed cruel legislation
intended to dismantle health care for millions of low-income and
middle-class Americans in order to give more tax breaks to the richest.
Further, this happened on the same day that Trump signed a sweeping
executive order that would legalize violations of women’s reproductive
rights and discrimination against LGBTQ communities. We understand that
these attacks on our communities are absolutely interconnected.
We
know that our community is heartbroken and afraid. We worked hard to
defeat this legislation. Thank you to all of our members and allies for
making phone calls, meeting with legislators and showing up at protests.
We lost this round.
But this was one battle, not the
war. The so-called “American Health Care Act” (AHCA) as written faces an
uphill battle in the Senate—and we will fight it every step of the way,
vote by vote, to prevent this catastrophic House vote from denying us
the care we depend on. Now is the time to regroup, get smarter, and
fight harder. We are committed.
If passed by the Senate, the AHCA will:
- dramatically
change Medicaid funding, reducing the amount of funds and allowing
states to establish their own eligibility rules. 14 million of those
predicted to lose coverage under the AHCA are those who gained coverage
through Medicaid expansion under the ACA. Since Medicaid is the single
largest source of health care coverage for people living with HIV in the
U.S., we are extremely concerned about any changes to funding formulas
and eligibility requirements. We will keep fighting to protect Medicaid
expansion and funding and to increase access to Medicaid.
defund Planned Parenthood, a nonprofit health care provider that serves the sexual, reproductive and preventive health care needs of millions of Americans, many of whom do not have other affordable options for those services in their areas. We will keep fighting to protect Planned Parenthood and other providers of quality, affordable sexual and reproductive health services.
make insurance drastically more expensive for older Americans, many of whom are already struggling to get by.
leave people with preexisting conditions—like us—at the mercy of state governments, which would be able to seek waivers to requirements that we be treated equally by insurance markets.
We
are right to be furious, outraged, and heartbroken when our elected
representatives clearly show us that our lives, dignity, and health do
not matter to them. Now let’s turn that into action on the ground and at the ballot box.
Read more articles from POZ, here.
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