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Not Much Good News: Implications for HIV From the U.S. Midterm Elections

November 6, 2014

As I finally turned off the TV at 2 a.m. on Nov. 5, incredulous and in despair about the results of the election, I asked myself how it was possible. Was it just apathetic, whiney liberals who didn't vote? Or did Republicans put something in the water to make people vote for harm escalation, a wider wealth gap, more business for bankruptcy and divorce lawyers, and perpetual war? There seemed to be no other explanations.

In addition to Snyder in Michigan, every other Republican governor who had viable Democratic challengers won re-election, despite the data that prove how harmful their administrations have been to the residents (especially the poor ones) of their states. Scott in Florida, Walker in Wisconsin, LePage in Maine and Brownback in Kansas all won against strong opponents, despite their abysmal records.

In federal elections, the biggest heartbreaker was the unbelievable taking of the Senate by Republicans. Mitch McConnell as majority leader? His victory over Alison Lundergan Grimes was distressing and an omen of bad times ahead. North Carolina's Kay Hagan, Colorado's Mark Udall, Alaskan Mark Begich, and Mark Pryor of Arkansas all lost to Republicans. Mary Landrieu of Louisiana will have to prevail in a runoff on Dec. 6 to keep her seat.

House incumbents who were re-elected include New York's Michael Grimm who, in addition to threatening to break a reporter in half, faces 20 counts of tax fraud related to a health food restaurant he once co-owned. Stellar representative!

The "Good News"

Incongruent with the vote tallies, several liberal ballot initiatives won despite conservative objections. In Arkansas, Alaska, Nebraska and South Dakota, where voters were asked if the minimum wage should be raised, they replied with a resounding YES. The problem is that -- except for Alaska's Bill Walker -- each of those states has a Republican governor who will most likely veto any increase in the minimum wage. Massachusetts statewide, Oakland, California, and Trenton and Montclair, New Jersey, passed ballot measures on paid sick days, though except for in California, Republican governors may block those too.

Alaska, Oregon and Washington, D.C., all passed marijuana legalization initiatives, but Florida defeated an initiative legalizing medical marijuana while re-electing the guy with the veto pen if it had passed.

In Colorado, a "personhood" ballot measure was defeated for the third time. It would have given legal rights to all unborn fetuses, meaning that while it wouldn't have banned any type of abortion outright, it would have given anti-abortionists a way to accuse a woman having an abortion of murder.

The HIV/AIDS Implications

So, how will the 114th Congress affect those living with HIV? There are, of course, no set-in-stone facts about that, but here's my take:

The Ryan White CARE Act is the largest source of federal funding for HIV/AIDS services and is subject to the congressional appropriations process every year. It has long enjoyed bipartisan support, but with Republicans in control of both chambers, there may be reductions in funding to existing programs and less willingness to fund new ones.

If Republicans are still determined to "repeal and replace" the Affordable Care Act (ACA), that would mean that all the people who've benefitted from the Medicaid expansion may find themselves priced out of insurance, let alone care.

HIV-positive people were supposed to transition from Ryan White programs to expanded Medicaid or ACA exchange policies assisted by subsidies. But what if Ryan White is systematically underfunded or defunded and cannot push such transitioning and what if Medicaid is not expanded in some states and is dismantled by Republican governors and legislatures in others? People with HIV may find themselves in the same no-win situation as other Americans who need care and medication, but who are unable to pay the high premiums and deductibles, as well as other out-of-pocket costs of ACA policies.

What to Do

First, know who your elected representatives are. And, as onerous as it may be, meet face to face with them. Just as with any anti-stigma campaign, it's hard for them to ignore the people behind the issue, especially if they need your vote.

There are several HIV-related organizations that send out updates on legislative issues. AIDS United, NASTAD and, if you want to get really wonky, the Federal AIDS Policy Partnership.

Politics do matter and can affect your life in many ways. You don't have to start watching C-SPAN -- the next time you're updating your status online, just check out these (as well as some other) political Facebook pages!

Democracy only works if we all refuse to drink the poison.

Sue Saltmarsh has worked in the HIV/AIDS field for over 20 years, the first 10 as an herbalist and energy therapist at Project Vida, the last six as a writer and copy editor for Positively Aware magazine. She is now a freelance writer and editor and is also able to devote more time to her passion as founder and director of the Drive for Universal Healthcare (DUH).

Copyright © 2014 Remedy Health Media, LLC. All rights reserved.

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