Dear Trump and Congress: Here's 4 Ways to Sustain Health Insurance Protections for People With HIV

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Calling on Congress and the administration to save health care for people with HIV:

AIDS United, NASTAD, the National Coalition of STD Directors, NMAC and The AIDS Institute oppose the repeal of the Affordable Care Act (ACA or Obamacare).

They say the American Health Care Act (AHCA or Trumpcare) would "sharply reverse progress that has been made over the years in reducing new HIV infections and providing access to affordable, high-quality, and life-saving care and treatment for people living with HIV," according to a shared statement from the groups.

"The American Health Care Act would substantially decrease coverage options and increase insurance costs for people living with HIV and decrease [sexually transmitted disease] STD screening and treatment through reduced insurance access," they say.

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New plan could make it hard, if not impossible, to get HIV care and treatment:

"We believe that the proposed legislation would make it much harder, if not impossible, for people living with HIV and other chronic conditions to get the coverage needed to meet their care and treatment needs," says NASTAD executive director Murray Penner, who has been living with HIV for over 30 years, in the release.

"We need a system of health coverage that works for everyone, including people with chronic conditions and disabilities and the proposed legislation achieves the exact opposite," he concludes.

"The plan also reduces federal Medicaid contributions through a per capita cap, which could cause states to make cuts to eligibility, benefits, and important consumer protections and would mean going back to cruel pre-ACA rules where a person must wait to be disabled by HIV in order to be eligible for Medicaid. The legislation also cuts funding for vital services for women's health and eliminates the Prevention and Public Health Fund, which funds 12% of the Centers for Disease Control and Prevention's budget," the statement notes.

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How to preserve crucial aspects of care:

"We strongly urge Congress and the Administration to preserve crucial aspects of the existing Affordable Care Act and Medicaid to continue the progress we have made on HIV and STD prevention, treatment, care, and support and make changes where improvements need to be made."

Here are the key elements that should be included in any plan, according to the groups.

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"Maintain the current Medicaid funding structure, including expansion of the program, to allow states to respond to current need and increased demand for Medicaid coverage during tough economic times, unanticipated outbreaks or disasters and when there are health innovations, such as the recent curative breakthrough treatments for hepatitis C.

"This bill eliminates Medicaid expansion in 2020 and drastically changes the funding mechanism for the overall Medicaid program to a per capita calculation, rather than reflecting the actual costs of the Medicaid population."

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"Ensure access to an affordable minimum essential benefits package that includes the range of services and treatments that people at risk for and those living with HIV and STDs need to stay healthy, including prescription drug benefits, substance use and mental health treatment, and preventive services without cost sharing. Though the proposed bill preserves most of the Essential Health Benefits requirements, we are concerned that Congress and the Administration continue to uphold these important protections."

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"Keep health care affordable and accessible by maintaining non-discrimination protections and ensuring adequate, up-front premium and cost-sharing assistance for low-income individuals. This includes maintaining the bans on annual and lifetime benefits caps to ensure access to care and coverage when it is needed most.

"This legislation eliminates actuarial value requirements for health plans and reduces the amount of premium support low-income people will receive, which will disproportionately impact individuals living with chronic conditions."

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"Maintain funding for the Prevention and Public Health Fund and Centers for Disease Control and Prevention to ensure that the end of HIV remains a winnable battle within our lifetime. With additional effort and support for evidence-based, cost-effective strategies that we can implement now and a robust health care infrastructure throughout our nation, we will have a significant impact on our nation's health."

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Keep the fundamentals in place:

"We believe there are ways to enhance and stabilize the healthcare system that will not place the burden on individuals most vulnerable, as this bill does. With its emphasis on preventive services, ensuring access to community providers, and assistance for individuals living in poverty, including those newly eligible for expanded Medicaid, the ACA's provisions are proven as critical for reducing new HIV and STD infections and assisting those living with these conditions to continue living long, productive lives," says Jesse Milan Jr., president and CEO of AIDS United, who has been living with HIV for over 30 years, in the release.

He emphasizes, "Any changes to the health system should keep these fundamentals in place."

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