09 Mar Republican Healthcare Plan Decreases Access to Vital Health Coverage for HIV Patients
WASHINGTON, D.C. – The American Academy of HIV Medicine (AAHIVM), the nation’s largest independent HIV care provider organization, today responded with great concern to the American Health Care Act released by Congressional Republicans this week. The newly released plan seeks to repeal certain parts of the Affordable Care Act (ACA) and replace them with a series of initiatives that will ultimately reduce access to health care for the most vulnerable populations.
The ACA allowed almost 20 million people to gain new access to health coverage over the last 4 years, according to figures issued by the Department of Health and Human Services (HHS).
“We had hoped to see a plan that maintained the progress that was made under the ACA for patient access to health coverage,” said James Friedman, Executive Director of AAHIVM. “But given the proposed changes to Medicaid and tax credits for insurance purchasing, this plan makes it even harder for low-income patients to access the coverage they need, including the 40% of HIV patients that depend on Medicaid for coverage.”
The Republican plan would fundamentally change the Medicaid program by capping the amount paid to states by the federal government for Medicaid beneficiaries through what is known as “per-capita caps.” It would also reduce the funding that the ACA provided to cover Medicaid expansion patients to that of the basic Medicaid level, forcing states to bear more of the costs. Ultimately, this will likely result in a total rollback of the Medicaid expansion created by the ACA.
Additionally, the Republican plan seeks to replace ACA tax credits for low-income households to buy insurance, with tax credits based more heavily on age. Of the 20 million newly insured Americans, almost one-third purchased private insurance plans in the state exchanges, facilitated by tax credits for low-income households. However the Republican plan would offer a similar tax credit to those who purchase individual insurance, however, the credit would be based on both age and income.
“This plan would reduce the availability of tax credits to purchase insurance for some of the poorest, while it expanding it to wealthier households who need it less,” stated Margaret Hoffman-Terry, MD, FACP, AAHIVS, chair of the AAHIVM Board of Directors. “Under this plan, young HIV patients with high health costs and low incomes could be left with less financial assistance than older healthier individuals. A plan for subsidizing insurance costs should be based on financial and medical need, not arbitrary number games.”
At the same time, the plan would allow insurers to charge older individuals up to five times more than younger individuals for the cost of their coverage. Under the Affordable Care Act, plans could charge older enrollees no more than three times that of younger enrollees.
“The population of older HIV patients is growing rapidly in this country and they should be protected from additional costs,” continue Dr. Hoffman-Terry.
As the Republican plan works its way through consideration in the House, AAHIVM encouraged lawmakers to keep in the provision stating that people with pre-existing conditions may not be disqualified for insurance coverage.
“For too many years, people living with HIV were denied access to insurance until it was made available through the ACA,” stated Friedman. “We are pleased to see this benefit retained in the new plan. However, we cannot support a proposal that would reduce overall access to medical care and medical treatment for patients with long-term life-threatening medical conditions. Ultimately, a replacement plan should be better for Americans in all ways than the one it replaces—rather than conform to political philosophy. ”
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The American Academy of HIV Medicine is a professional organization that supports the HIV practitioners and promotes accessible, quality care for all Americans living with HIV disease. Our membership of HIV practitioners and credentialed providers give direct care to the majority of HIV patients in the US.
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