How We Lost the War Against AIDS

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The Deadly Consequences of Repealing Obamacare

The battles in Washington over the future of American health care will have major consequences in the war against AIDS.  Both the AHCA bill passed by the House and the bill proposed last week in the Senate include provisions that will have deadly consequences for people living with HIV.  Although the details differ slightly, both bills would drastically cut Medicaid and and both bills would make insurance much more expensive for people with pre-existing conditions.

Medicaid is the largest source of health care coverage for people living with HIV in the United States.  Currently, 42% of people living with HIV are currently on Medicaid, primarily through the Medicaid expansion created by the Affordable Care Act.  Both the House and Senate versions of bills to replace the ACA would significantly curtail the expansion.  In addition, traditional Medicaid would also be cut, further weakening support for people living with HIV.

Before the ACA was passed, it was very difficult for people living with HIV to get affordable health insurance on the individual market because HIV infection was considered to be a pre-existing condition.  As a consequence, people living with HIV were either unable to get private insurance or could only get it by paying extremely high premiums.  This barrier was eliminated by the ACA, which required that insurance policies purchased through the health insurance exchanges cover all pre-existing conditions.  Both the House and Senate versions of ACA replacement bills would significantly weaken that requirement.  As a consequence, people living with HIV would again be unable to purchase health insurance or could only do so by paying extremely high premiums.

If anything like these two bills becomes law, many Americans living with HIV will not be able to get treatment and will ultimately die of complications from AIDS.  For many of my friends, the political battles in Washington right now are matters of life or death.  Literally.

A report by the Kaiser Family Foundation provides detailed explanations of these and other consequences of the AHCA bill passed by the house.