By John Cunningham
Executive Director, National AIDS Memorial
As the Senate gets ready to vote on a new health care bill this week that will reverse many of the key elements of the Affordable Care Act, (aka “Obamacare”), many individuals and families will be faced with the terrifying reality of their essential benefits being gutted and their premiums possibly increasing.
Countless thousands in our community living with HIV/AIDS will be among those who stand to lose their health care coverage if President Trump’s American Health Care Act becomes law. In addition to severely threatening access to life-saving healthcare and HIV medications now available because of Medicaid Expansion, both the House and Senate’s proposals will cripple the provision of Obamacare that prevents health insurance companies from denying coverage based on pre-existing – often expensive – medical conditions, like HIV/AIDS.
When six members announced earlier this month they were resigning from the Presidential Advisory Council on HIV/AIDS, it was a clear sign that they had lost faith in the President and his support for their mission. The Council was created to advise the White House on policy matters concerning the HIV/AIDS epidemic. The resignations are not the first indication that President Trump is not forging ahead in the fight against the epidemic, which affects more than 1.1 million Americans, has infected more than 70 million and has killed about 35 million people around the world, according to the World Health Organization.
In fact, the resignations should come as no surprise for people living with HIV. There have been many signs since President Trump took office that suggest HIV/AIDS isn’t at the top of his agenda. He has yet to appoint anyone to head the White House Office of National AIDS Policy. In fact the organization’s website was removed following the inauguration, and five months later the Administration has still not replaced it with a new one.
President Trump made repealing Obamacare one of his signature campaign promises. Ending Obamacare not only means the end of the provision on pre-existing conditions for people with AIDS, it also means severe cuts to the Medicaid program, which provides healthcare to many low-income Americans. It is important to note that, according to data from the Centers for Disease Control and Prevention (CDC), the majority of individuals with HIV/AIDS live at or near the poverty line.
From 2008 to 2014, the estimated number of annual HIV infections declined 18 percent, according to the CDC. This suggests that we are experiencing uneven, but meaningful success in reining in the devastating disease. But if the proposed Trumpcare provisions are enacted into law, much of the progress made in the fight to end the AIDS epidemic and contain the disease will be negatively affected.
All these signals are of great concern for those of us who care deeply and have been passionately working to end the AIDS epidemic. With communities of color bearing the disproportionate number of new HIV infections, particularly women of color and African-American gay and bisexual men (especially in the South), what we need now is MORE leadership, MORE funding, MORE of a national effort to make sure that ALL Americans have access to life-saving HIV prevention efforts (including PrEP) and that ALL Americans have access to life-saving care (including HIV drugs). To do anything less is dereliction of duty.
With no clear direction and a complete lack of communication from Trump administration officials about issues related to HIV/AIDS, it is no surprise that six members of the Presidential Advisory Council threw up their hands and walked out. We should use their act as a clarion call for all of us to redouble our efforts to have this Administration fulfill its moral and public health obligation to bring the HIV/AIDS epidemic to an end. We owe it to our communities and we owe it to future generations.