Honoring National Latinx AIDS Awareness Day
October 15th marked National Latinx AIDS Awareness Day (NLAAD). NLAAD is a day to raise awareness about the impact of HIV on the Latinx community in the U.S. This year’s theme was “It’s Time to Act. It’s Time to End HIV.” The theme took a historical look at the 40 years since the first published reports of HIV/AIDS, focusing on increasing awareness, testing, and HIV treatment for folks in the Latinx community.
The Latinx community faces cultural and societal challenges that further disrupt their access to HIV prevention, care,
Even with the Affordable Care Act, many undocumented people continue to lack the ability to access the health care and supportive services they need and deserve. Further, the National HIV/AIDS Strategy (NHAS) and End the HIV Epidemics (EHE) plan do not explicitly address the needs of immigrants of documented or undocumented status. Read the Demanding Better policy agenda by the US People Living with HIV Caucus which calls for making immigrants a priority population in the NHAS.
Language access is one step towards improving services for the Latinx community, but true language justice goes beyond just words; culture is embedded in language. Thus, translation and interpretation have to be better than a mere word-for-word exchange. Language justice ensures access and engagement in communities, making health terms and information understandable and allowing people the option to make healthy choices with their lives by giving them not only the language but the cultural context and relevance to make thoughtful health decisions.
Healthcare Access
Ryan White HIV/AIDS Program Eligibility Changes
The Health Resources & Services Administration (HRSA) released Policy Clarification Note 21-02 in regard to the Ryan White HIV/AIDS Program recipients’ eligibility and compliance with payors. There are two major and important changes to eligibility: 1) HRSA affirmatively clarifies that immigration status is irrelevant for the purposes of eligibility for Ryan White services and that Ryan White funded programs should not share Ryan White recipients should not share their immigration status with immigration enforcement agencies and 2) HRSA eliminates the six-month recertification requirement. Both of these changes will enhance access to the Ryan White program and reduce barriers to care and treatment for people living with HIV. Congratulations to the many advocates and federal partners who helped to make these momentous changes possible!
Congressional Budget Office Says Build Back Better Act Would Provide Health Insurance to More than 4 Million People
The Congressional Budget Office (CBO) released an analysis of the healthcare coverage provisions in the Build Back Better Act. The CBO determined that if the healthcare coverage provisions are enacted, nearly four million more people would be able to enroll in Medicaid and 3.6 million more people are expected to enroll in subsidized Affordable Care Act (ACA) marketplace coverage. This is what is at stake in the debate of the budget!
Closing the Medicaid coverage gap is necessary for people living with HIV, especially in states where Medicaid has not been expanded. For example, the healthcare coverage gap in Georgia – a state refusing to expand Medicaid – is leaving 640,000 people uninsured who would otherwise qualify for Medicaid if they lived in a state that expanded Medicaid. Congress must prioritize including a comprehensive fix in Medicaid nonexpansive states in the reconciliation package. Medicaid is the second-largest public funding source for HIV care in the United States, making the Build Back Better Act provisions key in progressing healthcare for people living with HIV.
As of the writing of this update, the Build Back Better package includes the important Medicaid Re-entry Act, which will allow Medicaid to cover health services – including mental health and substance use disorders services – for individuals who are incarcerated for the 30 days prior to their release, saving lives by reducing drug overdoses, advancing equity, and increasing
Equity in Pre-Trial Health Coverage Act
Senators Edward J. Markey (D-MA), Jeff Merkley (D-OR), and Sherrod Brown (D-OH) introduced the Equity in Pre-Trial Health Coverage Act. Folks who are awaiting trial and sentencing are being deprived of their right to health benefits under Medicaid, Medicare, CHIP, and Veteran Affairs while pending disposition of charges creating a gap in coverage for folks who are awaiting trial. Currently, if a person has been arrested and can post bail they are then able to maintain their health care benefits. However, if a person cannot post bail, they lose their benefits despite not having been convicted of the crime yet. This is particularly concerning for individuals with existing medical conditions, substance use disorders, and mental health conditions that require consistent and sustained medical treatment. “Americans who have serious health conditions — including those who are awaiting trial — need access to quality healthcare and can’t afford to be disqualified from those benefits,” said Senator Merkley. The Equity in Pre-Trial Health Benefits Act would protect health care for those who cannot afford bail by ensuring that there is no gap in health care coverage for those who are awaiting trial. A copy of the bill can be found here. Although access to healthcare should not rest on involvement in an individual’s involvement in the carceral system or their ability to post bail, no person should lose out on their much-needed access to the healthcare that they deserve – convicted or not. This bill is a step in the right direction.
California Statute Protects Privacy in Use of Health Insurance by Dependents
Last month, California Governor Newsom signed Assembly Bill 1184 into law. This bill requires health care plans and insurers to accommodate requests to refrain from disclosing services a patient receives under an insurance policy held by another person, such as a parent or spouse. Under this law, “sensitive services” include all health care services related to mental or behavioral health, sexual and reproductive health – including abortion, substance use disorder, gender-affirming care, and intimate partner violence. Disclosure of certain information from an insurance company to an insurance policyholder may endanger a person who is covered under a policyholders plan, therefore this bill will ensure that the information requested to be confidential will not be allowed to be shared with anyone other than the patient, including the primary insurance policyholder.
Tackling the Opioid and Overdose Epidemic in New York
Thanks to New York State Attorney General Letitia James, settlements from lawsuits filed against pharmaceutical companies that manufacture and distribute opioids will now help fund the opioid crisis in New York. $1.5 billion has been received and is now being distributed to cities and counties impacted by the opioid epidemic. The opioid crisis is directly linked to injection drug use which also fuels the transmission of HIV. James explains that the funds will be used toward combating the epidemic with investments in prevention, treatment, and recovery. Jasmine Budnella of VOCAL-NY – an advocacy group fighting HIV, addiction, homelessness, and incarceration – stated that this money will save lives while a harm reduction infrastructure is built and lifesaving programs are being invested into.
Increases to Funding for Ryan White
The U.S. Department of Health and Human Services will provide $2.2 billion in new funding for the Ryan White program, via the Health Resources & Services Administration (HRSA). HRSA oversees the Ryan White HIV/AIDS Program, a program for cities, counties, states, and local community-based organizations providing care for people living with HIV. Nearly half of people living with HIV in the U.S. are supported by Ryan White, and because of its holistic focus which includes facilitative and “wrap-around services”, people living with HIV have significantly better clinical outcomes when enrolled in the Ryan White program.
Sexual and Reproductive Health, Rights, and Justice
Update on SB8, Texas’ Anti-Choice Legislation
On September 30, the U.S. the House of Representatives Oversight Committee held a hearing to examine how Texas Senate Bill 8 (SB8) threatens reproductive rights around the country.. Congresswomen Rep. Cori Bush, Rep. Jackie Speier, Rep. Pramila Jayapal, and Rep. Barbara Lee all testified to their experiences having an abortion. Advocates hoped to shed light on the frequency and importance of having the option to choose and the importance of having access to safe abortions and reproductive care.
On October 6, a U.S. District Court in Texas issued a preliminary injunction, essentially rendering SB8 unenforceable. However, on October 8, the Fifth Circuit of Appeals issued a stay on the District Court’s ruling, ensuring SB8’s enforceability yet again. On October 18, the U.S. Justice Department sought review of the Fifth Circuit’s order in the Supreme Court in efforts to challenge the law again. The U.S. Supreme Court has agreed to weigh in on SB8 sometime next month but has declined to block the enforcement of the law in the interim. In December of 2021, the U.S. Supreme Court is expected to hear the case of Dobbs v. Jackson Women’s Health Organization, which will ultimately ask justices whether Roe v. Wade is still good law. These new hearings will decide the future of abortion care and methods that states can use to regulate reproductive health. Meanwhile, nearby states are already experiencing an influx of people seeking abortion care. We must continue to fight for access to reproductive health care everywhere, for everyone. Abortion care is health care.
The Biden Administration Reverses a Trump-era Abortion Rule
The Biden Administration announced that it is reversing a controversial Trump-era rule that prohibited federally funded health care providers from making abortion referrals. Title X is a federal Family Planning Program run by the presidential administration which ensures individualized health care planning to low-income and uninsured families in efforts to promote positive childbirth outcomes. Under the new rule, health centers that receive federal funding from the Title X program will once again be allowed to advise patients on abortion care without the penalty of losing federal funding. This is an important step towards enhancing access to reproductive rights and justice for all people who can get pregnant, especially low-income people and Black, Indigenous, and People of Color (BIPOC) communities.
Without Access to Abortions in Kansas, the Midwest Abortion Desert Will Be Bigger than the Country of France
As the states circling it continue to tighten abortion restrictions, Kansas has increasingly 
become an important access point for abortions in the region. About half of Kansas’ abortions are currently performed on people from out of state. But even this limited access for pregnant people in the region may soon be eliminated. change. In 2022, abortion will be on the ballot in Kansas.. Three of Kansas’ neighbors — Oklahoma, Arkansas, and Missouri — have passed “trigger laws” designed to immediately outlaw abortion if Roe v. Wade is overturned, leaving people seeking abortions to turn to other states. It’s not clear if Kansas will remain an option, but if Kansas tightens abortion restrictions, the Midwest Abortion Desert will be bigger than the country of France. This reinforces the importance of elections. Take the pledge to be a HealthCare Voter and get involved in PWN’s Get Out the Vote efforts in 2021, 2022, and beyond.
Telehealth Abortions in Virginia
As of October 2021, Virginians are now able to access at-home abortion medication through telehealth visits. At-U.S. home abortion medication will now be offered through the mail once a patient has had a virtual consultation with a healthcare provider. The service will eliminate the need for an in-person visit before an individual can receive at-home abortion medication. This initiative eliminates the burden that in-person visits have on folks who live in rural areas, lack access to transportation, who would need time off from work, or would need to secure childcare in order to make an appointment. The service will only be available to people who are nine weeks pregnant or less – which is when most abortions happen. Folks will be provided with Mifepristone and Misoprostol through the mail once they are screened to ensure eligibility for the procedure.
Ending Criminalization
HIV Decriminalization Hearing in Pennsylvania
Pennsylvania is one of 35 states that criminalize the behavior of people living with HIV through HIV- or STD-specific laws or regulations. The Pennsylvania House Democratic Policy Committee held a hearing led by Rep. Mary Isaacson and Rep. Malcolm Kenyatta on the negative impact and consequences of HIV criminalization. Four advocates, including two PWN members, spoke out against HIV criminalization laws, testifying to the personal impact of Pennsylvania’s practices in criminalizing people diagnosed with HIV.
Michelle Troxell, Co-chair of PWN’s Pennsylvania chapter, testified that “while she has seen many advances in the way we medically treat people living with HIV, I have barely seen any advances in the way we treat people living with HIV.” She further added that “HIV criminalization laws reduce people to our viral status. It is dehumanizing and disempowering.”
HIV criminalization laws are archaic, hazardous, and discriminatory.. People living with HIV who are charged under these laws can face the threat of involvement with the criminal justice system – arrests, prosecution, incarceration, and more. PWN looks forward to continuing to work with Pennsylvania advocates to decriminalize HIV and supporting the emerging PA HIV Justice Coalition.
U.S. Supreme Court Declines to Hear Appeal on Sex Offender ID Stamp
Until advocates successfully defeated it, Louisiana had a policy requiring the phrase “SEX OFFENDER” to be stamped in large orange letters across a person’s driver’s license or government ID if they are on the state’s sex offender registry. In some cases, those who are accused of not disclosing their HIV status, sex workers, and those charged with solicitation are placed on sex offender registries. The policy is humiliating and makes it difficult or impossible for those impacted to get jobs, housing, access schools, and daycares, and to do normal everyday things like entering a bar. That policy was stricken down in the Louisiana Supreme Court when and the U.S. Supreme Court decided not to hear an appeal of that decision – therefore the policy will no longer stand. The stamp will no longer appear on state IDs. This is a victory for human rights.
LGBTQ Rights, Safety, and Justice
Biden Expands Health Care for Transgender Coloradans
The Biden administration has approved Colorado’s request to add gender-affirming care among required healthcare benefits ensuring that individual and small-group insurers will cover gender-affirming care such as hormone therapy l by January 1, 2023. This is a great win for the trans and gender-expansive community in Colorado as people of trans experience are one step closer to being able to access the care that they need and deserve.
U.S. Issues First Passport with Non-Binary “X” as Gender Identity
The U.S. Department of State announced that it has issued the first U.S. Passport with a non-binary “X” as the gender marker. This is a major win in the validation of folk’s identities. The Department expresses a commitment to updating its policies around gender markers ensuring the inclusion of non-binary and trans folks in its service to U.S. citizens. This option will be available for all passport applicants once system and form updates have been completed in early 2022.
Massachusetts State Senate Passes Two New LGBTQ Focused Bills
The Massachusetts State Senate has approved two pro-LGBTQ bills. One bill adds the non-binary “X” to birth certificates and state IDs, like Drivers Licenses. The second bill requires sex education provided in public schools K-12 be “medically” accurate and comprehensive. There are currently only 38 states who mandate sex education or HIV education in public schools but even fewer schools require that that education be accurate and comprehensive. This win ensures that sex education will be taught in an LGBTQ-inclusive manner, will affirm the experiences of LGBTQ folks, and will also ensure that there is proper and accurate education around HIV. These bills must pass the State House and be signed into law by the Governor before they are enacted.
Texas Governor Greg Abbott Signs Harmful Law Against Transgender Student-Athletes
Texas Governor Greg Abbott has approved a bill, House Bill 25 (HB25) that will restrict 
transgender student-athletes from participating in school sports consistent with their gender identity. Now that the law has passed, K-12 public school students will be required to participate in sports that correspond with the sex listed on their birth certificates and prohibited from participating on the sports team that matches their gender identity if that is different from their sex assigned at birth. This new law does not recognize legally modified birth certificates unless those changes were the result of clerical errors. This law further inflicts harm on an already marginalized group of people and highlights a terrible proposal of a solution to a problem that does not exist. There is absolutely no evidence that trans folks are over-dominating in school sports. Texas is the 8th state to enact this type of law out of 32 states that have introduced similar anti-trans laws this year.