Tuesday was the 25th anniversary of AIDSWatch, the annual convening of people living with HIV and their allies in Washington, D.C., to urge Congress to protect access to health care and services. This year's event was the biggest yet, with more than 600 people from 34 states, the District of Columbia, and Puerto Rico. There was good news to celebrate, but there much remains to be done. "This is the best of times and the worst of times for HIV," said Amfar's Greg Millett.
For the first time since the epidemic began, the trend looks promising: the number of new HIV cases fell 18 percent from 2008 to2014. Last week, the American Health Care Act was pulled, a law that would likely have reduced access to health care for the 242,000 people living with HIV on Medicaid. Medicaid covers more than 40 percent of people living with HIV, including Roberta, a 47-year-old bus driver from Campti, Louisiana who has lived with HIV for more than a decade.
Protecting her health has not been easy for Roberta. A single mom, she had no health insurance until the state expanded Medicaid last July. "I couldn't always afford my medications. Sometimes I had to buy my pills from people I knew who had extra, a few pills at a time." Now with Medicaid coverage, she has gotten glasses, been to the dentist, discovered a thyroid condition through blood tests, and most importantly, not missed a dose of her antiretroviral prescriptions.
But legislative threats to health care are not over with the demise of the AHCA. President Trump has said he will "let Obamacare explode," but many fear his administration will all but ensure that happens. Trump's Health and Human Services Secretary, Tom Price, supported billions of dollars in cuts to Medicaid in the AHCA, and health advocates are bracing for similar proposals during the budget process now underway. As Ansley Rhyne, legislative aide to Senator Marco Rubio, told AIDSWatch participants on Tuesday, "It is likely that Medicaid will be rolled back."
Millions of Americans like Roberta depend on Medicaid to get the care they need. For them, the fight may only just be getting underway.
Megan McLemore is a senior researcher in health and human rights for Human Rights Watch.