BY COREY JOHNSON AND CHARLES KING
March 23, 2017
When the HIV/AIDS epidemic raged across the United States in the 1980s, the federal government looked the other way. The result was unimaginable suffering and the loss of hundreds of thousands of lives. If you think our federal government learned the lessons of that moral outrage, think again.
Thursday, the House votes on a GOP plan to repeal and replace the Affordable Care Act that would effectively gut access to lifesaving HIV prevention and care for thousands of low-income Americans. That plan, if enacted, would reverse years of hard-earned progress and sabotage realistic plans for the United States to become the first country to end AIDS as an epidemic.
Recent studies have proven that people with HIV who get early and consistent anti-retroviral treatment will maintain good health and cannot transmit the virus to others. We also have the most promising drug yet for protecting against HIV/AIDS: Truvada, a preexposure prophylaxis (“PrEP”) pill that reduces the risk of contracting HIV by close to 99% when taken daily.
With these advances, we finally have the tools to end AIDS, even without a cure.
Through the Affordable Care Act’s Medicaid expansion and other programs, hundreds of thousands of people have been able to get consistent HIV care or access PrEP and stay HIV-negative.
The American Health Care Act would drastically decrease health coverage options, increase costs and make it harder, if not impossible, for many people to get lifesaving HIV prevention and treatment services.
Rolling back Medicaid expansion and reducing federal Medicaid contributions with per capita caps would be especially harmful, and could return us to a time when people with HIV had to become so ill they were disabled before qualifying for Medicaid.
Let’s build on our progress, not undo it. Uninsured rates were halved for people with HIV in states that expanded Medicaid under the Affordable Care Act, compared with no change in states that haven’t expanded. The act also created opportunities for many of our at-risk citizens to obtain PrEP and protect themselves from the virus.
And we see the results. New HIV infections in New York State are down over 40% from 10 years ago, compared with increasing rates of infection in other parts of the country.
Experts agree that current anti-retroviral therapy, taken as treatment or prevention, holds the key to ending the HIV/AIDS epidemic altogether. In fact, retaining people with HIV in consistent care and increasing the availability of PrEP are key planks in Gov. Cuomo’s plan to end the epidemic in New York State by 2020.
If the federal government impedes access to this cutting-edge medicine, it is virtually guaranteeing that these positive trends will be reversed.
To keep moving forward, we need a health plan to stabilize and build on what’s working. We must maintain the current Medicaid structure, including expansion in all parts of the country.
We must guarantee access to an affordable, essential benefits package that includes preventive services, prescription drugs and behavioral health care . Nondiscrimination protections and upfront premium and cost-sharing assistance are critical for thousands of low-income people with HIV and other chronic conditions. And we must commit to not defunding or cutting the Prevention and Public Health Fund or the Centers for Disease Control and Prevention.
We were diagnosed with HIV in 2002 and 2004, respectively. We are both alive today because activists organized, pleaded, protested and put their bodies on the line, demanding that the federal government take action.
We cannot turn back. We cannot allow President Trump, House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell to take us back. We have made too much progress and we have come too close to victory to let this happen. Lawmakers must come together and oppose this plan. Lives are literally depending on it.
King is the president and CEO of Housing Works. Johnson is a member of the New York City Council and chairman of the Council’s Health Committee.