On Thursday, May 4, the American Health Care Act (AHCA) passed the U.S. House of Representatives in a narrow 217-213 vote. With the vote, the House effectively moved to roll back the Affordable Care Act (ACA), also known as Obamacare. The HIV community reacted swiftly, warning that people living with HIV face distinct risks of life-threatening loss of health care if the AHCA is ultimately signed into law. In critiquing the vote, community groups and leaders also issued calls to oppose the AHCA as it moves into the Senate, where Republicans hold only a small majority.
HIV Organizations React
From AIDS Alabama director Alex Smith:
Without building consensus across the aisle and without regard to the voices of millions of their constituents across the country, 217 Republicans in the US House of Representatives have given their stamp of approval to a disastrous bill that jeopardizes the entire American healthcare system.
From AIDS United:
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.
From National Alliance of State and Territorial AIDS Directors executive director Murray Penner:
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. 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.
From National LGBTQ Task Force Action Fund executive director Rea Carey:
We urge everyone to continue the resistance against this repeal effort and stand alongside so many who oppose what the Republican-led Congress is doing. There are a lot of reasons why we oppose this bill. It is worth noting that Trumpcare is so bad that members of Congress are exempting themselves from it.
From Project Inform executive director Dana Van Gorder:
The American Health Care Act is cynical, cruel and not befitting of a civilized nation, especially one with the resources of the United States. We are extremely disappointed in the legislators who voted for this bill, ignoring the will of most Americans and the needs of middle and low-income individuals, especially those with serious illnesses.
From Human Rights Campaign government affairs director David Stacy:
Donald Trump and his allies in Congress are one step closer to ripping away care from millions of people, with a particularly devastating impact on low-income senior citizens, women, children, LGBTQ people, and people living with HIV. It is unconscionable that Congress might restrict vital health care for the very people they represent.
From AIDS Foundation of Chicago:
Recent amendments to the bill unfortunately weaken discrimination protections for people with pre-existing conditions, like people living with HIV, thus making a bad bill even more awful and morally insensitive.
From Treatment Action Group executive director Mark Harrington:
The American Health Care Act ought to be called what it really is, The Unaffordable Care Act. If enacted, this bill puts the lives of people with HIV, TB and hepatitis C -- along with millions of others -- in grave danger.
From HIV Medicine Association chair Wendy Armstrong, M.D.:
The best way to prevent HIV is to keep in care and on treatment those who are infected. By decreasing access to HIV care and treatment, the AHCA may worsen the HIV epidemic in the U.S. at a time when new infections were beginning to go down.
From San Francisco AIDS Foundation CEO Joe Hollendoner:
The House vote today to pass the American Health Care Act (AHCA) undermines the ability of people living with HIV to access affordable health insurance and sadly perpetuates the health disparities faced by individuals here in California and in states across the country.
From Health Care in Motion:
The version of the AHCA that was passed this week was substantively the same as the version that failed to come to a vote last week. The AHCA continues to gut Medicaid funding, render the expansion meaningless, shrink subsidies to purchase insurance, and remove key consumer protections that keep coverage affordable and accessible to people living with chronic illnesses and disabilities. Republican amendments, particularly one sponsored by Representative Tom MacArthur (R-NJ) further attack consumer protections, allowing states to waive Essential Health Benefits and allow insurers to scale premiums based on health status. Although a further amendment by Representative Fred Upton (R-MI) provided some funding for programs to offset these changes to consumer protections, this funding is simply not enough to achieve these aims.
From Black AIDS Institute CEO Phill Wilson:
In a homage to failed policies of the past, the bill reintroduces high-risk pools. Is it me, or did the Supreme Court not already decide that "separate but equal" is inherently "unequal". Should we start looking out for Colored drinking fountains?
From Positive Women's Network - USA:
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.
HIV Community Reactions
Other Reactions and Analyses
From Congresswoman Barbara Lee (D-CA):
Today Republicans' core values were on full display, demonstrating the disgusting belief that only the rich are worthy of access to healthcare. Losing the lifesaving coverage provided by the Affordable Care Act would be a death sentence for thousands of Americans.
From "What Is at Stake in ACA Repeal and Replace for People With HIV?" by Lindsey Dawson and Jennifer Kates:
Prior to the [Affordable Care Act (ACA)], many people with HIV faced significant barriers to accessing health coverage despite national treatment guidelines recommending starting antiretroviral therapy at time of diagnosis. Several of the ACA's key provisions addressed these barriers ... and recent analysis demonstrates that the ACA significantly increased insurance coverage for people with HIV.
Ken Stockwell is senior web producer for TheBody.com and TheBodyPRO.com.