In This Issue
On Thursday, in an effort to repeal and replace the Affordable Care Act (ACA/ObamaCare), House Republicans passed the American Health Care Act (AHCA/TrumpCare), a bill that would effectively take away healthcare coverage protection for at least 24 million people. The new bill allows states to waive requirements to provide a minimum package of essential health benefits, protections for people with pre-existing conditions, lifetime and annual caps, and/or community rating—the requirement that insurance companies charge the same price to everyone who is the same age.
All of these opt-outs increase the cost of insurance for people with pre-existing conditions and older people, and substantially reduce the value of the insurance they can get. For example, a person with HIV/AIDS might be able to buy insurance, but the plan would not be required to cover the anti-retroviral drugs, currently covered under Obamacare as essential health benefits.
These changes set the stage for higher premiums. Without community rating, insurers can charge patients as much as they want and offer as little as they want. In effect, a person with HIV/AIDS might only be able to buy a plan that does not cover ARVs, and costs much more that a similar plan would cost an HIV negative patient.
In a homage to failed policies of the past, the bill reintroduces high-risk pools. Is it me, or did the Supreme Court not already decide that "separate but equal" is inherently "unequal". Should we start looking out for Colored drinking fountains?
So, this is how the high-risk pools work. People shut out of the insurance market because they have a pre-existing condition—HIV/AIDS, diabetes, cancer, hepatitis, heart disease, etc.— or are older, would be able to buy "special" plans, possibly with help from state subsidies. Here's the problem: There is no guarantee of the benefits that these "special" plans might offer, and the Republican plan does not sufficiently fund the high-risk pool.
The Republican plan basically kills Medicaid expansion by 2020 and turns Medicaid into a block-grant program, stripping more than $800 million away from the program over 10 years.
Finally, the Republicans passed this bill without an analysis from the Congressional Budget Office (CBO). So, we don't know how much this plan is going to cost.
In the end, the Republican plan might make bare bones policies for healthy, young affluent people. But the Republican plan throws the rest of us under the bus, drives over us and shifts into reverse several times.
In this issue, we mark Mother's Day by running two articles reporting on the lived experiences of Black women and girls—one about Black women living in he rural South, the other about "push-out" policies that remove Black girls and young women from school and jeopardize their futures. Both pieces describe many of the social determinants that drive high HIV rates among Black women and girls.
We introduce the Institute's upcoming Instagram campaign, "A Day In The Life," where for the 30 days beginning on May 27 and leading up to National HIV Testing Day on June 27, we invite Black GBTQ/SGL men to share photos and short videos of themselves, particularly doing things that challenge the negative and limiting stereotypes about Black men that dominate the media and the erasure of Black GBTQ/SGL men's lives. We want you to help fill in the gaps in the visual imagery of Black men's lived experiences.
We run the Congressional Black Caucus's #StayWoke list of 100 "troubling" actions carried out by the Trump administration in its first 100 days, even as we learn more about President Trump's firing of FBI Director James Comey yesterday evening.
Finally, the Trump administration's stance on immigration and sanctuary cities has some local health departments worried it could cuts federal funding in ways that complicate a wide variety of public health initiatives.
Yours in the struggle,
Phill