
Five national non-partisan health organizations call on Congress and the Administration to sustain health insurance protections for people living with HIV
On March 6, 2017, Republican members of the House of Representatives
released proposed legislation to
repeal key provisions of the Affordable Care Act (ACA) which would
significantly limit access to private insurance and Medicaid for those who
need it most. The American Health Care Act would substantially decrease
coverage options and increase insurance costs for people living with HIV
and decrease STD screening and treatment through reduced insurance access.
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.
AIDS United
(AU), NASTAD, the National Coalition of STD Directors
(NCSD), NMAC, and The AIDS Institute (TAI)
believe the American Health Care Act 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. 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. Key
elements should include:
1.
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.
2.
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.
3. 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.
4.
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 healthcare
infrastructure throughout our nation, we will have a significant impact on
our nation's health.
“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,” noted NASTAD
Executive Director Murray Penner who has been living with HIV since 1986.
“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.”
“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,” commented Jesse Milan, Jr., President & CEO of AIDS
United who has been a person living with HIV for over three decades. “Any
changes to the health system should keep these fundamentals in place.”
AIDS United (AU), NASTAD, the National Coalition of STD Directors
(NCSD), NMAC, and The AIDS Institute (TAI) are national non-partisan,
non-profit organizations focused on ending HIV in the U.S. They have
been working in partnership to identify and share resources to sustain
successes and progress we have made in HIV and STD prevention, care and
treatment in the United States.