Without a doubt, the AHCA bill changes will affect at least 1 million American citizens that are HIV-positive. For one, the costs will be increased drastically. The MacArthur Amendment allows states to decide which benefits will be offered by insurers.
Under Obamacare, insurers were required to render Essential Health Benefits, guaranteeing basic service coverage including substance abuse and mental health treatment and prescription drugs. With the amendments of Trumpcare, states can now approve of insurers dropping such services. Insurers can also charge more for the services.
Furthermore, insurers will be allowed to charge a different price for each health status. Take note that with the changes, insurers won’t be able to limit health coverage access to people that have pre-existing conditions. However, people living with HIV, even those that are in their 50s or 60s, would be charged more just to get their health care as the checks and balances that were tasked with stopping this from pushing through are now grossly insufficient.
The checks and balances in question are the Long-Upton Amendment. It now moves those with pre-existing conditions into high-risk pools. The LGBTQ community is afraid that only 100 million American citizens that have pre-existing conditions will be able to get proper health care. The rest will be left with much less money to cover the increase in costs.
As the letter of American Medical Association opposing Trumpcare states, nobody knows if the replacement bill will be enough to give affordable health insurance to the American people. It’s also unknown whether Trumpcare will be able to prevent discrimination against those who are already living with high-cost medical conditions.
Also, the cuts that are made to Medicaid will be hurting HIV-positive and lower-income LGBTQ people. Obamacare helped in providing ample coverage to myriads of people living with HIV and this was done by expanding Medicaid. Medicaid is a health insurance program that benefits needy and low-income people.
In two years, the expansion of Medicaid by Obamacare has helped increase the number of people insured from 36 to 42%. The states that made sure to expand Medicaid also insured hundreds of thousands of low-income LGBTQ people.
The expansion also made sure that low-income LGBTQ people had access to PrEP or pre-exposure prophylactic medication. PrEP helps in reducing HIV transmission to almost 100%.
Even though the AHCA bill will allow the continuation of the expansion of Medicaid, the expanded enrollment will be put to a stop afterward. This is certainly not good news because this means that the enrollment criteria pre-Obamacare will resume. Enrollees, aside from being poor, need to be disabled or to have kids so they can qualify. As for LGBTQ people, they need to be very sick in order to get coverage. That also means they have to perform procreative heterosexual intercourse.
The new system for financing Medicaid from AHCA will also cut at least $100 billion from Medicaid’s federal funding in 10 years. Because of this, states will be forced to reduce Medicaid’s service range including PrEP.