Proposed Budget is Bad Health for LGBTQ Communities, People Living with HIV/AIDS

This week, President Trump released his FY18 budget blueprint. Front and center are proposed cuts to Medicaid, a public program that provides health coverage for low-income individuals who fall in to a range of eligible categories. The blueprint also puts forth proposals for deep cuts to a wide-range of social programs that benefit millions. If passed, this blueprint would be disastrous for the health of LGBTQ people, people living with or affected by HIV and AIDS, and those who are economically disenfranchised. In short, devastating to those who are most vulnerable in our communities.

The cuts to Medicaid are, in essence, an embrace of plans to repeal and replace the Affordable Care Act. The proposed budget caps Medicaid’s federal funding, cutting $610 billion over the next decade. States would receive fixed funding from the feds with new flexibility to administer their Medicaid programs. The House version of the American Health Care Act, which passed narrowly earlier this month, proposes similar drastic cuts to Medicaid, to the tune of $838 billion.

Medicaid is in many ways at the heart of the health of our communities, with a high prevalence of poverty in LGBTQ communities, especially among transgender people and LGBTQ people of color.

Take note of these facts:

  • LGBTQ people are more likely than non-LGBTQ people to be living in poverty and to be uninsured.
  • Community Health Centers, like Callen-Lorde, nationally care for on average more than 1 in 6 Medicaid beneficiaries.
  • Medicaid is a lifeline to care for 42% of people living with HIV. The President’s proposals puts strain on already constrained state budgets to help provide care for vulnerable people living with HIV.
  • Medicaid benefits vary by state, and we in New York are fortunate to have a robust Medicaid program. In recent years, New York’s Medicaid coverage has extended coverage to HIV preventative treatments (PrEP) and gender affirmation services.
  • Trump’s budget also proposes cuts to the Ryan White Program, the Centers for Disease Control and Prevention, Minority AIDS Programs and the federal AIDS housing program.

Every day at Callen-Lorde, we observe the benefits of Medicaid, and further, the benefits of the Affordable Care Act. We are seeing fewer patients who are uninsured today than in 2012, shortly after roll out of the ACA. At the same time, expanded Medicaid has bumped up the number of patients on Medicaid at our clinic. In 2016, 28% of our patients were covered by Medicaid.

The good news is there’s still time to stop these proposals! The proposed federal budget still needs to be passed by Congress and that’s unlikely to happen in its current form. Additionally, with the Congressional Budget Office (CBO) score on the ACHA, the legislation will likely now move to the Senate for deliberation.

What’s more, there is an additional budgetary issue that will further complicate matters for Congress. A deal must be met by September on sequestration or representatives will have to stick to the sequester caps mandated by the Budget Control Act enacted in 2011. That would mean additional cuts and would include cuts to primary healthcare centers, unless there’s agreement to lift the caps.

We cannot stand by and let the infrastructure we have built to support our communities erode beneath our feet. Call or write your Congressperson  to let them know how harmful this budget would be for you and your communities, if passed. Specifically, call your US Senators and demand they rewrite the American Health Care Act in a way that does not jeopardize the health of millions. The importance of your voice and advocacy at this moment cannot be underestimated.