Thousands of Americans will die unnecessary deaths if AHCA becomes a reality

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Thirty years ago AIDS activists used the slogan, Silence = Death to convey the urgency of responding to HIV. Thanks to vocal activists and others willing to take a stand, including some working within federal agencies, many people with HIV today can live long, healthy lives.

As members of the President’s Advisory Council on HIV/AIDS, Infectious Diseases physicians, and healthcare consumers, we cannot be silent following the release of the president’s budget proposal and the House’s passage of the American Health Care Act. 

{mosads}Last week, in a scenario that’s not uncommon in the South, a woman with diabetes came to an Infectious diseases clinic for follow-up care of her HIV infection and complained of a recent foot injury.


Her HIV infection is doing well, thanks to effective HIV medicines, but her diabetes is not: She works every day at a low wage job but recently lost her health insurance, and because she lives in North Carolina, a state that has refused to expand Medicaid, she has been unable to pay for her diabetes care.

Her foot injury was not bad enough for her to go to the emergency room, but because foot injuries can have serious consequences for people with diabetes, she went to an orthopedic urgent care clinic. When she arrived, however, she was told that because she had no insurance, she would have to pay $100 up front before she could be seen. She did not have $100 — if she did, she probably would have had health insurance — so she left that clinic without receiving care for her injury.

This all too common scenario will become even more common — and thousands of Americans will die unnecessary deaths — if the president’s budget proposal and the American Health Care Act become a reality.

The president’s budget, despite boasting the title, A New Foundation for American Greatness, would leave our country’s poorest citizens without access to basic healthcare. His vision for greatness includes dismantling the Medicaid Program, a lifeline for 68.9 million Americans (based on enrollment figures for March 2017 posted on the Centers for Medicare and Medicaid Services website), including an estimated 42 percent of patients with HIV.

The House-passed American Health Care Act that would cut 14 million from the Medicaid Program by capping and cutting federal Medicaid funding by $834 billion did not go far enough for the Administration. The president’s Medicaid proposal would abandon even more poor and disabled Americans by increasing total cuts to the Medicaid Program to an estimated $1.3 trillion over the next decade.

These cuts are on top of deep cuts to other healthcare, housing and social service programs that help to level the playing field for people with HIV, and many others who have challenging life circumstances that leave them grateful for the basic necessities that many of us take for granted. 

Our vision of creating a foundation for greatness includes extending healthcare access to all Americans and ending the AIDS epidemic in the US by combating stigma and discrimination, increasing access to HIV screening and prevention tools such as condoms, pre-exposure prophylaxis and sterile syringes, and ensuring access to the comprehensive treatment that keeps patients healthy and by doing so reduces their risk of transmitting the virus to others to near zero. 

The radical and regressive policies championed by the new Administration have dimmed, but not extinguished, our hope of making progress towards a country and world free of the AIDS epidemic. For people with HIV, and others with chronic serious conditions, silence will equal death if they are cut off from healthcare. We cannot be silent. We cannot stand by as our country compromises its basic values and humanity.  

Adaora A. Adimora, MD, MPH, FACP is Professor of Medicine and Epidemiology at the University of North Carolina at Chapel Hill and an Infectious Diseases physician and a member of the Presidential Advisory Council on HIV/AIDS.

Michelle Collins-Ogle, MD, FAAP is the Clinical Director, Warren-Vance Community Health Center, Inc. and a member of the Presidential Advisory Council on HIV/AIDS.

The views expressed are those of the authors and do not necessarily represent those of the Presidential Advisory Council on HIV/AIDS.

The views expressed by contributors are their own and are not the views of The Hill.

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