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How Trump's attack on Obamacare might affect LGBTI community

HIV testing and transition-related care among things at stake

How Trump's attack on Obamacare might affect LGBTI community
The Republican-led US House of Representatives voted this week to repeal the Affordable Care Act

LGBTI groups across the country are furious and concerned over the US House of Representatives vote this week to repeal and replace the Affordable Care Act.

They say millions of Americans could be negatively affected if the repeal – backed by President Donald Trump – is passed by the US Senate. The repeal seeks to rolls back expansions of Medicaid, defunds Planned Parenthood for a year, and repeals taxes the Affordable Care Act put on high-income individuals, drug companies, and insurance providers.

With help from the Affordable Care Act, Los Angeles LGBT Center, for example, was able to expand their services. People with HIV or AIDS, who used to not be able to afford health insurance, were covered; as were thousands of low-income individuals, especially seniors.

The Center now fears all this progress will be taken away.

‘I think this is a step in the wrong direction, particularly for this community,’ says Aaron Fox, director of government relations at The Center.

The LGBTI community at large faces higher rates of HIV/AIDS, depression, and addiction.

‘If this bill were to become law, the services that are really essential in reducing those disparities as well as access to coverage would go away for many people,’ Fox says. ‘Medicaid is the largest provider of HIV care in the nation. A lot of our clients who have HIV gained Medi-Cal through Medicaid expansion.’

According to the Los Angeles Daily News, more than 900,000 residents in Los Angeles County are covered by Medi-Cal, California’s Medicaid expansion, via the Affordable Care Act. Additionally, at least 63,000 health care jobs are at risk if the ACA gets repealed.

‘In less than 24 hours, Congress has left 7.5 million Californians careening toward an impoverished retirement and four million Californians at risk of losing their healthcare,’ California State Treasurer John Chiang said in a statement.

‘While President Trump and Congressional Republicans style themselves as populist champions of every-day Americans, they have just cast votes to make us poorer, sicker, and less secure.’

Sarah Kate Ellis, President and CEO of GLAAD, said in a statement: ‘The U.S. House rammed through a destructive and dangerous bill that could strip away health insurance from millions of Americans, including many in the LGBTQ community. Healthcare is a human right, and no one should be denied access to care because of a preexisting condition or because a program like Planned Parenthood does not fit the ideology of one political party.’

‘Now more than ever, it’s time to buckle down and keep fighting to protect the healthcare that the LGBTQ community deserves.’

The Human Rights Campaign (HRC) also spoke out.

‘Donald Trump and his allies in Congress are one step closer to ripping away care from millions of people, with a particularly devastating impact on low-income senior citizens, women, children, LGBTQ people, and people living with HIV,’ said David Stacy, Government Affairs Director for HRC.

‘It is unconscionable that Congress might restrict vital health care for the very people they represent. With people’s lives on the line, we urge the Senate to stop this madness and reject this harmful piece of legislation.’

HRC also said the new proposal would ‘cut federal funding for Planned Parenthood, which could jeopardize the ability of clinics to deliver preventive health services, including HIV testing and transition-related care.’

‘The ACA’s public health and prevention fund, established to expand investments in the nation’s public health infrastructure, would also be repealed. Health centers, like those operated by Planned Parenthood, often offer the only culturally competent healthcare available, especially in rural and isolated areas,’ the press release stated.

According to the Department of Health and Human Services, before the ACA 24% of people with HIV had no health coverage at all. Over 1.2 million Americans live with the virus.

The ACA provided Medicaid expansion in 31 states and D.C., which meant that more Americans with HIV/AIDS could seek treatment, especially as the ACA guaranteed coverage for those with preexisting conditions. This health insurance was critical in helping prevent the spread of HIV to vulnerable communities, such as transgender women of color and gay men of color.

The Centers for Disease Control and Prevention estimates that one in two gay black men and one in four gay Latino men will be diagnosed with HIV in their lifetimes. If this new healthcare bill passes the Senate, it could mean that access to PrEP (a once daily preventative drug that’s up to 99% effective in stopping the HIV virus) would be greatly limited, leaving these marginalized communities at higher risk for contracting the virus.

Essentially, it could cause the HIV/AIDS epidemic to resurface.

If this new healthcare bill passes the Senate, it could mean the defunding of Planned Parenthood.

House Republicans are hell bent on defunding the health care provider due to their opposition to abortion – never mind that the Hyde Amendment already prohibits federal funds for abortion. So what defunding of Planned Parenthood actually means is less access to STI testing and treatment, and even stripping access to trans-related medical care.

Planned Parenthood centers in 16 states, including California, Florida, New York, and Illinois, offer hormone replacement therapy (HRT).

Considering how difficult it can be for trans people to access medical treatment (one-third of respondents to the 2015 U.S. Transgender Survey report having at least one negative experience with a healthcare provider due to being trans), Planned Parenthood’s offering HRT is significant.

‘I don’t trust most doctors to respect my gender, use the right pronouns, or use my chosen name, but I know that Planned Parenthood is great about that sort of thing,’ Alex Holiday, a transgender man living in Colorado, told The Daily Beast.

‘We know that Planned Parenthood health centers may be one of the few spaces where the identities of LGBTQ people are acknowledged, respected, and understood, and we’re proud to open our doors to everyone—regardless of gender identity, gender expression, or sexual orientation,’ said Elizabeth Clark, Planned Parenthood’s Director of Health Media.