Health Care Reform and HIV/AIDS

Phil Wilson Founder & Chief Executive Officer Black AIDS Institute

A little over a year ago the United States House of Representatives passed HR 3580—and the President signed into law, the Patient Protection & Affordability Care Act (ACA). Following the house vote, Congressman James Clyburn, said, "I consider this to be the Civil Rights Act of the 21st century. Tonight we took a giant step toward the establishment of a more perfect union."

While the ACA is far from perfect, the legislation already has some elements that dramatically change the healthcare prospects for the 1.2 million Americans living with HIV/AIDS.

Black people continue to bear the brunt of the AIDS epidemic; we are also being rocked by the economic recession. As Black families lose their homes, jobs, and health insurance, it is critical that a bigger and stronger safety-net be available. The health care reform legislation passed last year is a major step towards health-related security for all Black Americans especially those living with HIV/AIDS.

Health care reform has the potential to dramatically broaden and strengthen the safety net for low-income people living with HIV. Studies show that Black Americans are far more likely than other Americans to lack health coverage and that associated access barriers are a major reason why HIV-positive Blacks are less likely to receive life-preserving antiretroviral treatments. By expanding Medicaid, establishing new mechanisms to broaden private coverage, and prohibiting discriminatory practices by the private insurance industry, the ACA will enable many currently uninsured Black people living with HIV to obtain the coverage they need.

The legislation contains additional provisions that are of particular value to the AIDS response in Black America. The ACA authorizes community transformation grants to build capacity in underserved communities to address AIDS and other health priorities. The law also establishes a major new public health fund that will train and deploy community health workers to address key health care gaps, such as inadequate HIV testing rates, insufficient linkage to care for people who test HIV-positive, and support services to help patients adhere to treatment.

Here are four things in the legislation that are critically important for people living with HIV/AIDS or any other chronic disease:

• Requires that all Americans retain health insurance. By requiring that all Americans buy or otherwise obtain coverage, the risk pool is expanded and insurance premiums could go down. As a part of this requirement, the federal government obligates itself to provide subsidies to those who are unable to afford coverage.

• Ensures health insurance coverage for 32 million of the more than 40 million Americans who currently lack health insurance.

• It will no longer be legal for insurers to refuse coverage or terminate coverage for persons with "pre-existing conditions." (Like HIV/AIDS), because of those issues.

• Prohibits life-time caps on how much health care an insurance plan will cover in an insured person's lifetime. This is especially important for people with long-term chronic conditions.

The 2010 mid-term elections redrew America’s political map. Regardless of whether they wear the “Tea Party” banner or not, the new house majority share a common hostility toward health care reform. Although it is unlikely that Republicans will be able to muster the votes needed to repeal healthcare reform so long as Democrats control the White House and Senate, G.O.P. critics of health care reform are attempting to withhold the funding needed to implement key provisions of the legislation.

These new challenges are disheartening. But we have never given up the fight, even in the face of long odds. The truth is that America’s health shouldn’t be a political football. Americans of all political persuasions should be able to unite around the conviction that all people deserve a fighting chance to live and to contribute to their community.

We have come too far to turn back the hands of time. I remember the days of emergency rooms full of people with AIDS, the daily visits to death beds, and weekly memorial services. And no matter who controls the Congress, the Senate or the White House, we cannot go back there.

About the Black AIDS Institute

The Black AIDS Institute (The Institute) is the only national HIV/AIDS think tank in the United States focused exclusively on Black people. The Institute's mission is to end the HIV/AIDS pandemic in Black communities by engaging and mobilizing traditional Black leaders, institutions-clergy, media, academics, civic, social, celebrities, business, elected officials-and individuals in efforts to confront HIV/AIDS. The Institute offers training and capacity building, disseminates information, analyzes and offers critiques on private and public sector HIV policies, and provides advocacy and mobilization from a uniquely and unapologetically Black point of view.