We expect that the American Health Care Act (AHCA) will be voted on in the Senate by June 29.
This proposed legislation will decimate healthcare for people living with HIV and other chronic conditions.
This document is intended to help you prepare talking points for visits to your Senator’s office. We also encourage our members and allies to consider writing op-eds to your local newspapers for placement as soon as possible. An op-ed template is available for use; contact us for this.
Section I. Talking Points for AHCA District Visits
- The American Health Care Act (AHCA) will be deadly for people living with HIV. In fact, it’s so bad that 6 members of the President’s Advisory Council on HIV/AIDS (PACHA) resigned last week.
- Before the Affordable Care Act (ACA), it was legal for insurers to discriminate against people with pre-existing conditions, making it harder for us to access coverage. Under the AHCA, premiums will skyrocket for women and for people with pre-existing conditions who are not currently in the insurance market or who have a gap in coverage at any point.
- Note: this is a good place to insert a personal story here from someone in the group who struggled to get health care before the ACA due to a pre-existing condition
- “High risk pools” don’t work. As people living with HIV, we have been there and done this. Higher cost, inferior coverage, supported by inadequate subsidies that advocates must fight for all of the time.
- As passed by the House, the AHCA will make it possible for states to waive the essential health benefits requirement, including coverage for prescription drugs
- The American Health Care Act is the worst bill for women’s health in a generation; it puts women’s health and economic security in dire jeopardy.
- Those most impacted by HIV/AIDS today also include: gay and bisexual men of color, particularly young gay and bisexual men of color; transgender women, particularly transgender women of color; people with lower incomes; people in the Southern U.S., particularly in rural areas in the South; gay and bisexual men in general.
- As people living with HIV and their advocates, we are gravely concerned. Here in the state of ____ alone, XXX people are living with HIV.
- Note: Check out AIDSVu.org for statistics on HIV in your state or region.
- Ensuring access to care for people with HIV is good for everyone. Conclusive research shows that people who are HIV-positive, in care and on continuous treatment cannot transmit HIV to others
- Medicaid is the single largest source of health care coverage for people living with HIV in the United States. 42% of people living with HIV (PLHIV) who are in care are currently on Medicaid, which would be decimated by the proposed AHCA.
- Find out if your state is a Medicaid expansion state here
- Download a factsheet on how your state will be harmed by Medicaid caps here. This is a link to state by state guides.
- You may be able to find statistics on the number of people living with HIV in your state who are currently on Medicaid. Contact your state health department, local health department, or local AIDS service organization
Section II. Downloadable resources to leave with your Senator or their staff:
One-pager on how the AHCA as passed by the House will harm people with HIV and undermine Medicaid (from the FAPP HIV Health Care Access Working Group).
What’s at Stake in the ACA Repeal and Replace for People Living with HIV? A factsheet (from the Kaiser Family Foundation)
Section III. Additional reading to help you prepare:
Proposal to Repeal the Affordable Care Act and Cut Medicaid Threaten HIV Care (National Health Law Program)
General info on projected impact of the American Health Care Act:
- If the Senate version resembles the House version, 23 million people will lose health care coverage over the next 10 years. 14 million could lose coverage by the end of 2018
- The AHCA reduces financial assistance by repealing the existing cost-sharing subsidies that assist with copays and deductibles, and replacing the ACA-created tax credits, which fluctuate by need, with less generous tax credits for low- and middle-income individuals.
- Prior to the ACA, insurance companies could define pre-existing conditions to include a variety of conditions including pregnancy, prior cesarean sections, prior treatment for domestic violence or sexual assault, cancer, respiratory illness, and disabilities. Repealing the ACA pre-existing conditions protections would allow insurers to charge people more just because of their health status, in certain circumstances.
- Insurance companies could go back to charging people with pre-existing conditions much higher premiums – for example, someone with asthma could have to pay over $4,000 more for coverage. (CAP report, 4/21)
Impact of AHCA on Medicaid:
- The AHCA significantly reduces funding for Medicaid, which means that millions of women, kids, low-income folks, seniors in nursing homes and people with disabilities will lose their health coverage or be forced to pay a lot more.
- Medicaid federal cap proposals, such as block grants and per capita caps, would result in dramatic changes and cuts to the Medicaid program overall. States could limit who is eligible for Medicaid, end or limit coverage for currently required healthcare services, and reduce long-term services and supports. (Justice in Aging/NPWF fact sheet, March). Read more about Medicaid per capita caps here
Impact of AHCA on women:
- Premiums would skyrocket for women who need affordable health care the most: lower-income women, older women, and women with pre-existing conditions.
- The AHCA legalizes discrimination against women: it would allow insurance companies to discriminate against women and charge women who had breast cancer or who was previously pregnant, or was a victim of domestic abuse tens of thousands of dollars more in premiums.
- The AHCA eliminates maternity coverage, newborn care and other Essential Health Benefits (EHB) coverage standards. The bill guts the Essential Health Benefits provision, which requires the majority of health plans to cover services like maternity and newborn care, mental health services, and prescription drugs.
- This is a direct attack on women of all ages, since women disproportionately rely on every one of the EHB standards – not just maternity coverage.
- Some reports estimate that women may have to pay as much as $1000 per month for maternity coverage.
- Before the ACA was enacted, few states required coverage of maternity care in the individual insurance market, and eight in 10 plans in that market failed to cover maternity care at all.
- Approximately 13 million women who gained access to maternity coverage under the ACA stand to lose their coverage.
- Despite the fact that the proposal claims to maintain the current prohibition on gender rating, it still allows insurers once again to discriminate against women. Eliminating the community rating provision disproportionately affects women – insurers can claim having given birth, having had a C-section, or having been a survivor of domestic violence is a so-called pre-existing condition.
o For example, a woman who had breast cancer could be charged a premium surcharge of more than $28,000 per year for coverage, and a woman who was previously pregnant could face an additional surcharge of more than $17,000 per year for coverage. (CAP, 4/20)
Impact of AHCA on sexual and reproductive health care:
- The AHCA would block people from going to Planned Parenthood for preventive care, including birth control, cancer screenings, and STI testing and treatment.