Federal Updates

A federal policy agenda created by and for people living with HIV

The U.S. People Living with HIV Caucus, of which Positive Women’s Network-USA is a member, released Demanding Better: An HIV Federal Policy Agenda by People Living with HIV in July.

Health Care Access

CVS Pharmacy v. Doe to be heard by the Supreme Court next year

The Supreme Court agreed to hear a case this fall which has huge implications for people living with HIV. In CVS Pharmacy v. Doe, the Supreme Court will decide whether both the Rehabilitation Act–a law which prohibits discrimination based on a disability by organizations receiving federal funds–and the Affordable Care Act (ACA) allow individuals to bring claims arguing a policy is discriminatory because it disproportionately affects people with disabilities.

The case was brought by a class of people living with HIV who receive heath insurance through their employers. Their health plan gives individuals with disabilities, including people with HIV, in-network medication prices if they receive their HIV medication by mail or if they pick it up at a CVS pharmacy. If they chose to use an out-of-network pharmacy, they must pay the out-of-network price. Individuals without disabilities are not limited to these two methods to receive in-network pricing for their prescriptions.

The people living with HIV involved in the case argue that these terms disproportionately harm people living with HIV who cannot receive in-network prices at the pharmacy of their choice. Obviously, these are incredibly important considerations, and the broader question of whether these kinds of discrimination claims are allowed under the Rehabilitation Act and ACA could significantly impact when people can claim disability discrimination.

This case will not be argued until after October 2021, and then an opinion will likely not be released until 2022. You can read more and follow case updates here.

Missouri Supreme Court upholds Medicaid expansion

The Missouri Supreme Court ruled that the state’s Medicaid expansion amendment which was passed by voters last August did not violate the state constitution. This decision overturned a lower court finding that Amendment 2, a ballot initiative passed by in 2020 by 53 percent of Missouri voters, was unconstitutional.

Medicaid expansion will allow about 275,000 additional people in Missouri to access health care, including some of the 13,000 people estimated to be living with HIV there.

This is the second piece of celebratory news to come out of Missouri this month. Governor Mike Parson signed SB 53, a police reform bill that also makes important updates to HIV criminalization laws. The bill raises the level of intent required to convict someone of violating the law and reduces the minimum sentence from 10 to 3 years. This bill is a strong step in the right direction for HIV criminalization in Missouri. The updated law goes into effect August 28 and you can read more about it here.

NHeLP’s new brief on the Medicaid coverage gap

The National Health Law Program (NHeLP) released a new white paper called “Closing the Medicaid Coverage Gap: Preventing a Separate and Unequal Result” which provides recommendations for closing the Medicaid coverage gap in an equitable manner. The Medicaid coverage gap is generally defined as describing adults from 18-64 who are above their state’s income cap for receiving Medicaid but below the poverty line, meaning they are ineligible for tax credits through the ACA marketplace.

This is especially an issue for people living in the 12 states which have not expanded Medicaid. In non-expansion states, about 19% of people living with HIV are uninsured as compared to 5% in expansion states.

Some of NHeLP’s recommendations for equitability closing the gap include:

• Ensuring the enrollment structure incorporates Medicaid’s protections such as the right to apply and enroll at any time and to retroactively apply.
• Maintaining Medicaid’s strict limits on premiums, copayments, deductibles, and balance billing, and providing specific outreach and education.
• Ensuring the full scope of mandatory and “gold standard” optional Medicaid services covered by state plans, which include dental, vision, and supportive housing services.

This piece is full of information that advocates can use when evaluating the equity of any Medicaid coverage gap plan that is released. Be sure to check it out!

BAI’s African American HIV University program accepting applications

Black AIDS Institute (BAI) re-launched its African American HIV University (AAHU) program earlier this month. This program aims to build Black leadership and mobilization skills as a way to end the epidemic in Black America in alignment with BAI’s “We The People: A Black Strategy to End HIV.”

Two parts of the AAHU program, the Science and Treatment College and the Community Mobilization College, are accepting applications through August 15. Read more and apply here.

Economic Justice

HRSA’s Black Women First Initiative

The demonstration sites for a $3.8 million initiative, “Improving Care and Treatment Coordination: Focusing on Black Women with HIV”–also referred to as the Black Women First Initiative–were announced this month. The initiative provides grants and support to 12 organizations to design, implement, and evaluate the use of culturally competent interventions to improve HIV care and treatment coordination for cis- and transgender Black women.

Positive Women’s Network – USA Co-Executive Director Venita Ray serves as a member of the advisory council for the initiative and has provided training for grantees on the meaningful involvement of people living with HIV.

This initiative is an important step forward, but it is important to recognize that only 10% of the funding went to organizations explicitly founded and run by Black women, and none of the organizations are trans-founded or trans-led. Read more about the organizations who received the grants here.

Sexual and Reproductive Health, Rights and Justice

Sterilization reparations bill funded in California

California passed a budget bill which included $7.5 million to provide reparations to survivors of state-sponsored forced or involuntary sterilizations. California is the third state in the nation to provide monetary compensation to survivors who were sterilized under state eugenics laws and the first state to both provide notification of coerced sterilization and reparations to survivors who were sterilized while incarcerated in its state women’s prisons.

These sterilization practices affected many Black, Indigenous, and other people of color, people with disabilities, LGBTQ people, and people living in poverty. These funds are estimated to provide approximately $25,000 each to about 150 individuals. This amazing work has been led by California Latinas for Reproductive Justice, the Disability Rights Education and Defense Fund, and the California Coalition for Women Prisoners.

Ending Criminalization

Updates on California SB 357

The Safer Streets for All Act – a bill that would decriminalize “loitering with the intent to engage in prostitution” – passed the California Senate and the California General Assembly Public Safety Committee. It now heads to the Assembly Appropriations Committee.

Currently California law permits the police to use subjective perceptions of a person’s “intent,” including their clothing and behavior, to target those they believe to be sex workers. This results in the disproportionate criminalization of trans, Black, and brown women and perpetuates violence toward sex workers. This is an important step in the effort to decriminalize sex work and Positive Women’s Network is proud to be participating in this effort along with St. James Infirmary, SWOP LA, Trans Latin@ Coalition, Asian Pacific Islander Legal Outreach, Equality California, and ACLU California.

LGBTQ Rights, Safety, and Justice

Activists and members of Congress call to release ICE detainees who are transgender and/or living with HIV

Following a letter from advocates and a protest where more than 100 people marched to the White House demanding the Biden administration end the detention of transgender people and people with HIV in Immigration and Customs Enforcement (ICE) facilities, a group of 30 Democratic members of the U.S. House of Representatives called for these same things in a letter to Homeland Security Secretary Alejandro Mayorkas and acting ICE Director Tae Johnson.  

Both advocates and the letter note that ICE is not equipped to handle the needs of people living with HIV or people of transgender experience. Specifically, the letter noted several horrifying incidents in the past several years of trans immigrants and immigrants living with HIV dying from the conditions in ICE facilities.