This article was originally published at HousingWorks.org and is published here with permission from the author.
Many AIDS advocates are expressing concern about President
Barack Obama’s commitment to combating the epidemic, on the heels of a State of
the Union that downplayed the urgency of federal healthcare reform and
proposed freezing much government discretionary spending.
While
Obama pushed for the passage of healthcare reform, the ask was buried 31
minutes into his speech. That timing felt ominous, given that on Wednesday
Nancy Pelosi suggested passing healthcare reform in pieces. There
has been some talk of only passing the popular parts of healthcare reform,
such as regulations on the private insurance industry. But AIDS advocates say
that would be horrendous news for people with AIDS and other disenfranchised
people.
"We’re not the popular provisions," said Robert Greenwald,
executive director of the Treatment Access Expansion Project. "There’s no
question that this comprehensive package is the best we’ve seen in 50 years. We
need to remove barriers to Medicaid and Medicare. I don’t think many of those
things will happen if what we just see is incremental reform."
Christine Campbell, Vice President for National Advocacy and
Organizing at Housing Works agreed. "The majority of this bill takes us
strides above where we are. Democrats and Republicans in Congress just need to
do their jobs."
People with AIDS in the United States are poorer than the
general population and also less likely to have adequate health care.
Forty-five percent of people with HIV/AIDS in the United States have incomes
under $10,000 a year, and 50 percent lack regular medical coverage. The
situation is even more dire for people with hepatitis C, who aren’t co-infected
don’t have access to the Ryan White CARE Act safety net.
Campbell and AIDS advocates are recommending the House pass the
Senate version of the bill, as imperfect as it is. The Senate bill doesn’t
include a public option so people who purchase healthcare must go through an
insurance company. The Senate version also includes a provision to appease
anti-abortion supporters that would require people to purchase specific
abortion-only coverage separately from their regular premiums.
Gregg Gonsalves,
a longtime AIDS activist who has been critical of Obama’s policies, said that even
though he thinks there are parts of the Senate healthcare reform bill that
"stink", he thinks it should still be passed.
"The bill is terrible compared to what it could be but it’s
better than nothing basically," Gonsalves said. "I think they should pass this
with a reconciliation fix."
Gonsalves expressed concerned with Obama’s commitment to the
issue. "He said we can’t give up healthcare now. But he’s taken the backseat."
The HIV
Healthcare Access Group sent a letter to
House leadership calling on them to pass healthcare reform that includes a
largely federally funded expansion of Medicaid to low income individuals; an
exchange or regulated marketplace for the uninsured and the under-insured to
purchase health insurance; generous subsidies to make coverage affordable for
those who need it; stricter regulations that govern the private market
preventing discrimination; an investment in reorienting our health system to
focus on prevention and public health and critical measures to address primary
care and public health medical workforce shortages.
Discretionary
spending
Another
problematic part of Obama’s agenda was his call for a three-year freeze in
spending that wasn’t related to national security, Medicare, Medicaid, and
Social Security. A freeze could impact housing, federal aid, health care and
other programs essential to poor people with HIV/AIDS, and other disenfranchised
people.
"This is a hare-brained idea," Gonsalves said. "Obama’s throwing
a bone at Kent Conrad on the backs of poor people."
Although Obama mentioned global AIDS in his State of the Union
Address in the context of U.S.‘s global commitment, he has already essentially
flatfunded global AIDS spending, even though Congress authorized $50 billion
for PEPFAR over five years.
A rally was organized by Health GAP Wednesday near the White
House calling on Obama to rethink this proposal, as well as a Campaign to End
AIDS-organized phone zap of the White House.
After some listserv chatter questioning whether a protest was
necessary, Housing Works President and CEO Charles King defended the
"preemptive strike," saying, "The truth is that the Obama administration is
already not delivering on global AIDS and we have no idea whatsoever what their
intentions are on the domestic front. They have done a good job of collecting
information and making people feel like they have been heard. We still don’t know
that they have been really listening, and we probably won’t know until the
budget is out."
Although some advocates speculated there may be some efforts to
shield HIV/AIDS programs from some of the cuts, broader hits to the
social
services will be devastating both to people with HIV as well.
"There may be some efforts to carve out HIV from the freeze,"
said David Munar, vice president for policy and communications at AIDS
Foundation of Chicago. "But any cuts to health and human services programs, be
it Head Start or cuts to the CDC budget, will be harmful for people with HIV."