American Health Care Act passes House; will decimate health care for people living with HIV
The “American Health Care Act” (AHCA) passed through the House of Representatives early in May, threatening to undo all the progress toward health care access that has been made over the last 8 years. The bill was pushed through the House without waiting for the Congressional Budget Office (CBO) analysis, which calculates the costs and impact of the proposed bill. The CBO score for the AHCA was released last week. Some highlights from their analysis:
- 23 million more people will be without health insurance by 2026 as compared to under current law.
- 14 million people will lose coverage as early as 2018.
- The bill rolls back Medicaid expansion and restructures Medicaid funding, resulting in severe cuts.
- The AHCA would make obtaining coverage extremely difficult and costly for people with pre-existing conditions.
Meanwhile, an all-white and all-male committee of Republicans in the Senate has been working on their own version of the AHCA behind closed doors, planning to bypass the usual process of sending the bill through committees for review, amendments and approval. The committee plans to bring their bill to the full Senate only when they are confident they have enough votes to pass it. While the specific details of the final bill will likely be quite different from the one that passed the House, the lack of transparency and refusal to seek any bipartisan support is extremely troubling and signals that the final product will still almost certainly still leave millions more Americans uninsured and decimate the quality of care for everyone else.
- Read how the House version of the AHCA and the Administration’s positions on health care are already wreaking havoc on state marketplaces.
- Read what’s on the mind of some women living with HIV here.
Fiscal Year 18 Budget
Last week, the president released his 2018 budget, reflecting a set of priorities consistent with previous Republican proposals, including those put forth by House Speaker Paul Ryan. If enacted, the President’s budget will spell disaster for basic survival needs of our communities while providing tax cuts that will benefit only the richest. As proposed, Trump’s budget would reduce discretionary non-defense spending—which provides funding for health care, affordable housing, food stamps, scientific research, education, and environmental protection, among other essential services—to its lowest level as a share of the national economy in 50 years. The devastating impact of this proposal would land most heavily on people of color, women, and low-income folks.
The budget especially attacks people living with HIV and disabilities, with:
- $1.4 TRILLION in cuts to Medicaid over 10 years
- $400 billion in cuts to discretionary programs for low- and moderate-income people, including utility support and housing vouchers
- $192 billion in cuts to SNAP (food stamps) over 10 years
- $72 billion in cuts to disability over 10 years (including Social Security Disability Insurance – SSDI)
- $1.2 billion cut from the Centers for Disease Control and Prevention (CDC)
- Eliminates two Ryan White-funded programs: the AIDS Education and Training Centers (AETC) and Special Projects of National Significance (SPNS), with cuts of $59 million
- blocks Planned Parenthood from participation in any federal programs
- bans federal funds from being used for syringe exchange programs
Although many legislators have said that the budget is “dead on arrival” and does not have a chance of being approved by Congress, it is important for advocates to know that this budget shares many of the same features as budgets that have been approved by the Republican-controlled House of Representatives in previous years, and is very much in line with what Republicans have indicated they would like to see in the budget this year. The budget approval process is expected to drag out through the summer, as both sides of congress work on coming up with their own budget proposals, which then must be reconciled. In the meantime, it is important to remain vigilant and fight back against any budget proposal that would tear away basic necessities from our most vulnerable community members.
- Here is the executive summary of the budget.
- Here are some graphs and infographics that explain the cuts.
- Here is more on how this budget will further enrich the richest and hurt everyone else.
- Learn more about how the budget will affect people with low and moderate incomes here.
- Send a message to your members of Congress to oppose this budget here.
Sexual and Reproductive Health and Rights Watch
Opponent of Reproductive Health Care Appointed to Head FDA
On May 9, the Senate confirmed Scott Gottlieb, the president’s appointee to lead the U.S. Food and Drug Administration (FDA), which is responsible for testing and approving drugs for use. Gottlieb was an official during the Bush Administration, and has a track record of supporting policies that block access to reproductive health care and threaten women’s safety and bodily autonomy.
The National Women’s Health Network reports, “Gottlieb has also established himself as a committed opponent of women’s reproductive health. Throughout the 2000s, he defended the Bush Administration’s unprecedented decision to overrule agency scientists on Plan B emergency contraception, argued that women should not have been informed about the dangers of menopause hormone therapy, and fear-mongered against the Affordable Care Act’s contraception mandate. During his Senate confirmation hearing this April, Gottlieb refused to answer a direct question from committee vice chair, Senator Patty Murray, when asked, ‘can you commit to me today that you will not allow [the Trump Administration] to use the FDA to further a political agenda against women’s health?’” Read more about Gottlieb’s concerning stances on drug approval here.
Expanded “Global Gag Rule” vs the Global Health, Empowerment and Rights (HER) Act
On May 15, the Department of State began issuing regulations to implement the “Mexico City Policy,” otherwise known as the “Global Gag Rule,” which prohibits federal funding to foreign organizations that provide or counsel women about abortions. While Republican presidents have traditionally adopted this rule, in the past it has applied only to the $600 million the U.S. actually allocates to support family planning services in other countries. Trump’s version, on the other hand, will apply to almost all of the $8 billion in global health assistance–$6 billion of which comes from PEPFAR, the fund that helps treat and prevent HIV in developing countries. This means organizations receiving any PEPFAR funds cannot also provide abortions or counsel women about abortions, even if they are not funding those services with PEPFAR dollars. The change is predicted to be deadly for women around the globe, as clinics providing crucial family planning services and counseling could lose funding for fighting HIV and other communicable diseases.
The good news: In January, Sen. Jeanne Shaheen (D-NH), along with 46 other Senators, introduced S. 210 (the Global HER Act) that would permanently repeal the Global Gag Rule.
On May 25, Sen. Bernie Sanders and other Democratic Members of Congress reintroduced the Raise the Minimum Wage Act, which would raise the federal minimum wage for the first time in years. If passed, the law would raise the minimum wage from its current level, $7.25, to $15 an hour, over the course of a seven year period. It would also gradually eliminate the minimum wage exception for workers who earn tips, who can be paid as little as $2.13 an hour under current law, as well as lower minimum wages allowed when employers hire people under 20 and people with disabilities. The bill has significantly more support this time around than it did when first introduced in 2015, with 22 cosponsors in the Senate, and a companion bill in the House.
Jeff Sessions Reinstates Racist, Ineffective & Inhumane “War on Drugs” Policies
Attorney Jeff Sessions recently issued a memo instructing federal prosecutors to pursue the maximum sentences available for low-level drug offenses. This is a step backwards from the Obama administration’s policies, which attempted to start to undo some of the damage wreaked by the failed “War on Drugs.” The harsh policies reinstated by Sessions are well-documented to have a devastating impact on communities of color, undermine public safety and the economy, further marginalize people who use drugs or face addiction, and thwart HIV and STI prevention efforts. Read more about why these tactics are so counterproductive here and how the drug war has been a key tool for racial oppression here and here.
Immigrant Rights, Safety & Dignity
On May 25th, the Fourth Circuit Court of Appeals refused to reinstate Trump’s travel ban, which banned people from six predominantly Muslim countries from travelling into the U.S. The ban had previously been blocked by a lower federal court. The Court of Appeals found that the travel ban, which was revised by the administration after being found unconstitutional, was still discriminatory and embodied religious intolerance. If the Administration chooses to pursue enactment of this travel ban, it will next be taken up at the United States Supreme Court, where Attorney General Jeff Sessions has vowed to defend the ban.
The city of Denver recently stepped up its efforts to protect its immigrant community members by changing a law impacting criminal sentencing. The city changed the sentences for some low-level offenses to a maximum of 364 days, rather than 365 days or more, which is the length of a sentence required for immigration officials to seek out someone for deportation. By shortening the length of these sentences, the city reduced the chances that people who are arrested for minor crimes, like breaking a park curfew, will be detained and deported by ICE. The policy change is a creative approach to resisting the Trump administration’s attack on immigrant community members.
The legislative session just ended in Iowa, where advocates were successful in passing a “Fail First” bill, which will change the law so that insurance companies can no longer discriminate by requiring people to fail on generic medication regimens before prescribing the medication regimens that work for them.
On May 22nd, the U.S. Supreme Court found that efforts to limit the voting power of Black people in North Carolina were unconstitutional. The Court decided that the way Republican legislators used race when drawing the lines for congressional voting districts, known as “gerrymandering,” violated the Equal Protection Clause of the 14th Amendment. This is an important decision that may help in combatting voter suppression efforts around the country.
PWN-USA Pennsylvania has launched a petition in opposition to two current Pennsylvania House bills, HB 305 and 306, which would further criminalize incarcerated people living with HIV in the state. You can sign the petition here!
In early May, the Governor of Texas signed SB 4, a law banning “Sanctuary Cities” and expanding police officers’ authority to question and detain people based on their immigration status. The law says that local police officers can be fired or even face criminal penalties if they do not cooperate with ICE. Advocates report that this has led to a climate of fear where people who are immigrants are afraid to even go to the doctor. The law has already faced tremendous backlash, with demonstrators gathering at the capitol to protest the inhumane policies through the end of the month. The Texas Civil Rights Project has filed a lawsuit to try to stop SB 4 from going into effect.
At the end of May, the Virgin Islands successfully expanded eligibility requirements for its Medicaid program, making 19,000 Virgin Islands residents newly eligible for health care coverage. As the territory’s legislature decides how to allocate the funding to cover the additional program recipients, now that more people will be able to access care through Medicaid, efforts to protect Medicaid funding and preserve the Affordable Care Act at the federal level are even more important.
What’s happening where you live? Contact Cammie at firstname.lastname@example.org.
Want to discuss the issues in this policy update in more detail and learn how public policies and laws affect people living with and affected by HIV? Join a PWN-USA Policy Workgroup call on the 4th Wednesday of the month at 6 PM ET/3 PM PT. The PWN-USA Policy Workgroup is for women living with HIV only. To be added to the Policy Workgroup listserv, please check the Policy Workgroup box when you fill out our membership form here.