September 6, 2017
This article originally appeared on Advocate.com.
A lot is happening these days that most of us are finding, frankly, pretty hard to believe. But it is not a dream. Donald Trump, who ran on repealing the Affordable Care Act, is now our president, and Republicans, who control the entire Congress, wasted no time and have already set in motion the process to repeal parts of health care reform. As someone who has advocated for years to ensure that people living with HIV have access to quality and affordable care and treatment, and worked with the Obama administration to make sure ACA implementation meets the needs of people with HIV, I am questioning how we are going to make America great for people with HIV without the ACA.
While the current law is not perfect and needs improvement, the ACA has provided health care coverage to more than 20 million Americans, including tens of thousands of people with HIV. Prior to the ACA, private insurance companies were allowed to exclude people with a preexisting condition. Now people living with HIV can purchase coverage and access health care and lifesaving medications to keep them healthy.
The ACA expanded access to Medicaid for low-income people with HIV. Prior to the ACA, low-income, childless adults with HIV (which is not considered a disability) had to progress to AIDS to become eligible for Medicaid. Now states are provided the option to expand their Medicaid program so that low-income individuals, no matter their health status, can receive health care. Today, Medicaid is the largest source of insurance coverage for people with HIV, covering 40 percent of people with HIV who are in care.