#HIVResists Monthly Policy Update – August/September 2017

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Federal Updates

Charlottesville & Community Response

August brought an elevated level of attention to exploding racial justice tensions, fueled by white nationalist rhetoric and policies emanating from the current White House occupant. On the second weekend of August, KKK members and neo-nazis rallied to preserve the historical legacy of slavery in the United States. Many were armed and openly threatened violence, yet these demonstrations were protected by law enforcement. Heather Heyer, a young counter-protester, was violently killed and several others were seriously injured. For a background look into the thinking of organizers that makes this violence inevitable, check out this 25-minute documentary released by Vice.

In response, activists staged solidarity actions and counter protests nationwide, including a crowd of 40,000 people who rapidly mobilized to march in Boston. As our partners at the HIV Prevention Justice Alliance said in their powerful statement on Charlottesville, “We must understand this is directly related to the growing popularity and recent rise in far-right nationalism and rise in white supremacist rhetoric as evidenced by more and more blatant political and cultural attacks on the humanity, dignity, and rights of Black, Brown, queer and other marginalized communities. This is an attack on us all.”

FY18 Budget

Congress Returns to Washington, DC, with Short Timeline to Pass Budget and Harvey Aid Package

Pressed with the urgent need to provide federal relief to the victims of Hurricane Harvey, in addition to a very short timeline to pass a federal budget and raise the debt ceiling to prevent a government shutdown, Congress rapidly negotiated and delivered a funding package to the president who signed a bill to keep the government funded through December 8. The package provided $15 billion in federal disaster relief funding Hurricane Harvey and rebuilding communities after Harvey and Irma, as well as putting in place a short-term increase to the federal debt limit, which is the amount of money the government is allowed to borrow to meet its existing spending obligations. The continuing resolution (CR) will allow the government to continue operating at current Fiscal Year (FY) 2017 funding levels, which were set to expire on September 30, while legislators continue negotiating spending for FY 2018.

Senate Appropriations LHHS Advances FY 18 Spending Bill

On Wednesday September 6, the Senate Labor Health and Human Services (LHHS) appropriations committee passed a bipartisan bill that would provide the Ryan White Program and the Secretary’s Minority AIDS Initiative Fund (MAI) with level funding. And though slated for elimination in the President’s budget, the Teen Pregnancy Prevention Program (TPP) and Title X family planning programs both also received funding levels consistent with FY 17 levels, despite an increase to abstinence only funding. The bill includes $5 million for a new HRSA grant to support clinical training of sexual assault nurse examiners to administer medical forensic examinations and treatments to victims of sexual assault, and a $2 billion dollar increase to the NIH budget. Read more Senate LHHS bill highlights here.

Health Care

Protecting the Affordable Care Act (ACA) and Access to Medicaid

Although we defeated the Republican attempts to repeal the ACA in July, we must remain vigilant as some members of Congress and the White House are still considering ways to make drastic cuts and sweeping changes to Medicaid and the private insurance market. The Senate parliamentarian has ruled that Sept. 30, 2017, is the deadline to repeal the ACA with only 50 votes, as the fiscal year ends at that time. After that date, repeal legislation will require 60 votes to overcome a Democratic filibuster, which would present a significant hurdle to Republicans in Congress.

The Senate health care bill that dramatically failed by one vote in July could be brought up for a vote again if Senator McConnell believes he has enough votes. And members of Congress have indicated that they may consider other health care bills, such as the Cassidy-Graham plan, which would cause millions of people to lose coverage and make significant cuts to Medicaid, and which Senator John McCain has indicated he may support.

In the meantime, the Trump administration is utilizing administrative regulations to undermine Medicaid and the broader health care marketplace. For example, the administration has threatened to withhold the ACA’s cost sharing reduction (CSR) payments. These are subsidies paid by the government to insurance companies to help keep costs down for low-income people purchasing insurance. The Congressional Budget Office (CBO) has released a report predicting higher premium costs, fewer insurers offering plans, and an increase of $194 billion to the federal deficit over 10 years if the CSR payments are terminated.

Keeping an Eye on Anti-Discrimination Protections in the ACA

Furthermore, Democrats in Congress recently raised concerns over troubling changes to the Health and Human Services (HHS) department website, where information about Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination in healthcare on the basis of race, color, national origin, sex, age, and disability, has been removed. For example, a section of the website explaining that discrimination based on gender identity and sex stereotyping is prohibited under the law has been removed. Now, the only type of sex discrimination mentioned on the website is discrimination based on pregnancy. Anti-discrimination advocates are concerned that these changes, coupled with the appointment of several anti-LGBTQ officials to lead HHS, signal that the Department will not enforce – and may even work to undermine –  the civil rights protections they are supposed to uphold. Read more here.

LGBTQ Rights & Inclusion

Trump Signs Order to Put Discriminatory Anti-Trans Military Ban in Motion

Following up on his hateful July tweet announcing a ban on transgender individuals serving in the military, Trump recently signed an order directing military officials to ignore a policy put into place by former President Obama that would have allowed transgender individuals to openly serve in the military. The memo also bans the Department of Defense from providing medical treatment for transgender individuals currently serving in the armed forces. Trump did not provide clear guidance on how transgender individuals who are currently serving would be affected, instead leaving it up to the Departments of Defense and Homeland Security to decide how to address transgender individuals already enlisted. Read more about this despicable policy here.

HIV Prevention Justice

Opioid Crisis Declared a National Emergency – But White House Clings to Futile “War on Drugs” Approach

Recently, Trump reluctantly declared the opioid epidemic – which has affected people of all races, genders and walks of life – a national emergency. This could help funnel much-needed federal dollars and resources toward dealing with the crisis. The emergency was declared at the urging of the White House Opioid Commission, which unequivocally recommended that the president declare a national emergency and deal with this issue as the public health crisis it is – committing substantial resources to drug treatment, health care and other human services programs to help people using opioids.

Unfortunately, 45’s idea of a solution is to bring back outdated, Reagan-era “just say no to drugs” policies that would increase racial disparities and intensify mass incarceration, rather than embracing the recommendations of experts in health, harm reduction, and drug policy, which support evidence-based and compassionate strategies. Some of these strategies include increasing health care services; expanding access to Naloxone (a highly effective and easy-to-administer drug that can reverse an overdose); supporting safe consumption spaces; adequately supporting the Centers for Disease Control and Prevention (CDC); funding research trials on heroin-assisted treatment and ensuring that drug education for youth is scientifically sound, reality-based and honest. Read more here or here, and be sure to check out this statement from our partners at the Harm Reduction Coalition.

Racial Justice & Civil Rights

Trump Pardons Notoriously Racist Former Sheriff Joe Arpaio          

In yet another stunning abuse of power, on the same night Hurricane Harvey hit Texas, President Trump pardoned Joe Arpaio, a former Arizona sheriff known for actively promoting racial profiling, terrorizing immigrants and Latinx communities, and permitting inhumane and degrading treatment of people in jails under his control. Arpaio was found guilty of criminal contempt for violating a previous court order that required him to stop his unconstitutional racial profiling tactics. Arpaio and Trump have a long history of supporting each other’s bigoted politics and practices.

Many observers believe that Trump’s pardon in this case is especially egregious, since he is pardoning Arpaio for violating a court order – essentially rewarding him for disobeying the rule of law that he was sworn to uphold. It also sets a chilling precedent that those who break the law but do so in ways that Trump favors will be given a pass—and could send a message to allies and former campaign associates under investigation. Read more here or here.

Administration Rescinds DACA, Punts to Congress with Six-Month Delay to Act

On Tuesday September 5, Attorney General Jeff Sessions announced that the Trump administration is rescinding the Deferred Action for Childhood Arrivals program (DACA), an Obama-era policy that provided work permits and legal protection to undocumented people who immigrated to the U.S. as children. The administration’s decision catapulted the fate of nearly 800,000 young people into uncertainty, threatening to separate families and endanger education, health care and economic security for the 800,000 DREAMers and their loved ones. Trump called for Congress to enact comprehensive immigration reform within 6 months, which could impact an estimated 11 million undocumented immigrants who are living in the U.S. today and are vulnerable to detention and deportation.

The decision to end DACA has been condemned by legislators in both the Democrat and Republican parties, by former Presidents Obama and Clinton, and thousands of organizations and individuals who rallied to denounce the inhumane and reckless policy reversal already precipitating psychological harm and trauma for thousands young people who fear deportation from the only home they have ever known. 15 states and the University of California have filed lawsuits to sue the administration over this decision. Read PWN’s statement condemning the administration’s actions here.

Marijuana Justice Act Introduced!

Earlier this month, Senator Cory Booker (D-NJ) introduced the Marijuana Justice Act 2017, which would both end the federal prohibition on marijuana while seek to address the devastating impacts of the alleged “War on Drugs” – which has actually manifested as a war on communities of color. The bill seeks to remove cannabis from the list of “Schedule I” drugs in the U.S. Controlled Substances Act, where it is currently listed alongside heroin and LSD. If a state is found to disproportionately arrest and/or incarcerate low-income individuals and/or people of color for marijuana offenses, the bill would allow for lawsuits against that state and would cut federal funding for state law enforcement and prison construction.

The Marijuana Justice Act would prevent deportations related to marijuana offenses and would create a process for expungement and resentencing for marijuana offenses at the federal level. Importantly, The bill would also invest in communities most impacted by the war on drugs through the creation of a “Community Reinvestment Fund” of $500 million. Part of that funding would come from cuts to state law enforcement and prison construction. Read more here and here.

Sexual & Reproductive Health & Rights Watch

Expert Report Shows that Abstinence-Only Programs Still Don’t Work

new review of U.S. sexuality education policies and programs demonstrates, once again, that abstinence-only-until-marriage (AOUM) programs are harmful, ineffective, and unethical, despite substantial investments in these programs by the federal government. The report finds that scientific evidence supports investing in comprehensive sexuality education, reviewing scientific evidence which demonstrates that “AOUM programs are not effective at preventing pregnancy or STIs, nor do they have a positive impact on age at first sexual intercourse, number of sexual partners or other behaviors,” according to the Guttmacher Institute.

The federal government has spent around $2 billion on these programs over the past 20 years, and experts found that this funding has undermined sexuality education throughout the country. The review also found that AOUM programs are harmful to young people because they “often promote gender stereotypes that are associated with negative sexual health behaviors. They fail to provide pertinent sexual health information to sexually active adolescents and those who are already pregnant or parenting, and they stigmatize sexually active young people by implying that those who have sex are less worthy than their abstinent peers.”

These programs are particularly harmful to marginalized young people, such as LGBTQ youth. In contrast, the researchers found that comprehensive sexuality education programs are effective at preventing pregnancy and STIs among young people as well as “helpful in guiding young people as they learn how to navigate relationships, negotiate with partners and become sexually healthy adults” and urge these programs be supported as a fundamental human right. Access the full report here.

Senate Committee Votes Against White House on Anti-Abortion “Global Gag Rule”

During deliberations on the Foreign Operations Funding Bill, on Thursday, September 7, the Senate Appropriations Committee rejected the Trump administration’s approach to family planning abroad by voting (16-15) to reinstate funding for the United Nations Population Fund and to overturn the “global gag rule,” a Republican policy that prohibits U.S. funding going to international health organizations that offer or even talk about abortion services.

The global gag rule, known as the Mexico City Policy, applies even if the organization does not use U.S. funding to provide abortion-related counseling, referrals, or services, and was put into effect during the Reagan administration. While the policy has existed during every Republican administration since Reagan, the Trump administration’s version is more far reaching, prohibiting any funding for nutrition, child health, and disease-specific funding to international aid organizations that address abortion in any way. The Senate Appropriations Committee’s amendment passed with bipartisan support, with Republican Senators Collins (R-ME) and Murkowski (R-AK) voting for it. Democratic Senator Joe Manchin (D-NH) voted against women’s health. The amendment goes next to the full Senate for consideration.

Economic Justice                                                    

HOPWA Funding Remains Intact, With a New Structure

Amidst other attempts to cut funding for life-saving programs and health care services, the Housing Opportunities for Persons with AIDS (HOPWA) will fortunately receive increased funding this coming year. However, the program has been restructured to direct funding to areas most impacted by the HIV epidemic. Learn more about the changes to the program in this article featuring PWN’s own Shyronn Jones! The role of HOPWA and other housing support for people living with HIV cannot be understated – housing is health care!

State Updates

Reproductive Health & Rights Triumph in Oregon!

On August 15, Oregon Governor Kate Brown signed the Reproductive Health Equity Act into law, marking a tremendous victory for upholding reproductive rights. The law requires health insurance to cover birth control and abortion care without charging a co-pay. The law also provides state funds to cover reproductive health care to immigrants who are ineligible for coverage under Medicaid. At a time when reproductive rights face severe attacks by conservative policy-makers throughout the country, PWN applauds Oregon’s advocates for showing leadership in maintaining access to essential reproductive health services and upholding fundamental human rights. Read more here!

Texas Legislature Further Restricts Access to Abortion

During its Special Legislative Session, the Texas Legislature passed multiple bills that place additional burdens on people seeking to access abortion care. One of the more insidious laws bans insurance companies from providing coverage for abortion care in primary insurance plans, requiring people who want insurance coverage for abortion services to purchase supplemental plans. The supplemental plans have been dubbed “rape insurance” as the new ban on insurance coverage doesn’t make any exceptions for people who have experienced rape or incest and seek an abortion. This bill marks a disturbing trend, as several states have passed similar bans, making it nearly impossible for some people to obtain an abortion, especially low-income people, threatening individuals’ health, economic security, and bodily autonomy. Read more about this assault on human rights here.

Discriminatory Anti-Trans Bill Defeated in Texas!

After passing through the Texas Senate last month, a hateful anti-trans “bathroom bill” failed in the Texas House of Representatives in August! The bill (called SB 3) would have forced transgender individuals to use public restrooms that correspond with the gender listed on their birth certificate, rather than the one matching their gender identity, and would have barred local public entities from enforcing non-discrimination protections. The victory resulted from thousands of advocates showing up to oppose the bill, especially transgender leaders who courageously shared their stories. Read more here!

What’s happening where you live? Send your updates to Rebecca at rebecca.wang.pwn@gmail.com.

Policy Workgroup

Want to discuss the issues in this policy update in more detail and learn how public policies and laws affect people living with and affected by HIV? Join a PWN-USA Policy Workgroup call on the 4th Wednesday of the month at 6 PM ET/3 PM PTThe PWN-USA Policy Workgroup is for women living with HIV only. To be added to the Policy Workgroup listserv, please check the Policy Workgroup box when you fill out our membership form here.