March 29, 2012
In January 2012, Women Organized to Respond to Life-threatening Diseases (WORLD) and 16 other organizations led by Lambda Legal filed with the Supreme Court a friend-of-the-court brief in support of the Affordable Care Act (ACA). This week, the Supreme Court held a three day hearing on the constitutionality of health care reform. As we hold our breath to see how the Court will decide the fate of the ACA, now is a good time to remind ourselves of the importance of health care reform for women living with HIV and affected by HIV.
We know that the HIV epidemic thrives on a lack of quality, acceptable, affordable and accessible health care. We also know that discrimination in health care based on race, ethnicity, gender and gender identity, pre-existing conditions, and economic status is rampant. No one law can solve all of these problems but the Affordable Care Act is a first and necessary step toward reforming our health care system to better meet the needs of all people.
The full implementation of health care reform is vital to women living with and affected by HIV for a number of reasons:
President Obama signs the Affordable Care Act into law in 2010!
This will have a hugely positive impact on the health of all people living with HIV since currently 29% of HIV-positive people have no health insurance whatsoever often because they have not become so sick as to be considered disabled for the purposes of Medicaid eligibility. Removing the cruel disability requirement from Medicaid eligibility for those living below 133% of the FPL is especially important for HIV-positive women. Women living with HIV, 76% of whom have children under 18 living in their households, as well as other care taking responsibilities, cannot afford for their health to deteriorate in order to qualify for health care. Nor should they have to. Removing these barriers and expanding the Medicaid program is a key to reducing the health disparities experienced by so many women living with HIV.
Photo Credit: Feminist Majority
The provision of these prevention services, free of cost, mean a phenomenal health care win for all women and especially for women living with HIV. As we know, gender-based violence contributes to women's' vulnerability to HIV and hampers the wellness of women living with HIV. The fact that the ACA recognizes the far-reaching nature of violence in women's lives by insisting that intimate partner violence screening and counseling be a free service is an extremely important step in coming to terms with what our Attorney General Eric Holder says is the "staggering" amount of intimate partner violence experienced by women.
Moreover, these prevention services for women can begin to address some of the discrimination HIV-positive women face in exercising their reproductive options. HIV-positive women are often not offered sexual and reproductive health care services such as prenatal counseling, STI testing, or human papilloma virus (HPV) testing because doctors assume that people's sex lives end with an HIV-positive diagnosis. We know this is not true. Many women living with HIV have happy and healthy sex lives and need these types of reproductive health services as much if not more than other women in order to stay healthy.
The Affordable Care Act is an amazing opportunity to reform our health care delivery system. It lowers costs for insurance, prohibits gender and health status discrimination, provides continuous health care coverage, and prioritizes women by fully covering our key health care needs. It would be a national tragedy if the Supreme Court finds the bill to be unconstitutional because it requires all people to be insured. Expanding coverage to everyone should be our national goal, not our fear.