Phil Wilson Announce Retirement founder of Black AIDS Institute!

Black AIDS Institute Launches Bold Vision for the Future: Announces Retirement of Longtime Leader Phill Wilson, New Board Members, New Staff, New Partnerships, New Programs

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Posted in: News, News 2018

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Phill Wilson, founder of the Black AIDS Institute.

 

 

 

 

 

 

 

As part of a new strategic plan to prepare for the next generation of Black HIV/AIDS response, the Black AIDS Institute is announcing several changes within the organization, including the retirement of its longtime president and CEO, Phill Wilson, later this year.

Wilson launched the Black AIDS Institute in 1999 with a clear mantra (“Our People, Our Problem, Our Solution”) and mission: to stop the AIDS pandemic in Black communities by engaging and mobilizing Black leaders, institutions and individuals in efforts to confront HIV from a uniquely and unapologetically Black point of view.

“In order for a movement to endure, there must be a plan for the future,” said Wilson in a statement. “Stepping down as the president and CEO of the Institute, where I have had the privilege of serving for the last 19 years, is bittersweet for me. I have been involved in this fight for almost my entire adult life.

“In 1983, when I started doing this work, none of us could have imagined this mysterious new disease, first identified at UCLA Medical Center, would become the defining health issue of our generation. We are at a turning point. Are we going to build on the remarkable advances we have made over the last decade and continue to push forward and finally end the HIV/AIDS epidemic, or are we going to go back to the dark days of despair and death?

“The Institute is committed to doing everything in its power to end the HIV/AIDS epidemic, especially in Black communities. The time is right. The organization has the infrastructure and capacity to do the changes set forth by the board to prepare for a new generation of capacity building, advocacy, mobilization and service delivery. I am very proud of the work we have done over the last 19 years and of the organization’s commitment to new leadership. That commitment is more important now than ever before.”

Pursuing new executive leadership is part of a larger effort on the part of the Institute to prepare for the next generation of HIV/AIDS response in Black communities.

Ahead of the Curve

From the African American HIV University and Black Treatment Advocates Network to the groundbreaking “State of AIDS in Black America” reports and acknowledgments of Black excellence at the annual Heroes in the Struggle Gala Reception and Awards Celebration, the Institute has been relentless in its focus on Black communities.

The organization enlisted traditional Black institutions—such as the NAACP, Black fraternities and sororities, Black journalists in mainstream media and Black-owned publications—to commit to raising awareness, fighting stigma, increasing HIV/AIDS literacy and mobilizing Black people. It launched the Black Hollywood Task Force on HIV—currently co-chaired by Jussie Smollett, star of the Fox musical drama Empire, and veteran actress and humanitarian Vanessa Williams—to leverage the power of celebrity to amplify messages about prevention, testing, treatment and ending stigma.

“We have always been ahead of the curve in understanding HIV/AIDS and how it relates to the Black community,” says Institute board chair Grazell Howard. “This change is a continuation of that legacy. The search for new executive leadership is a part of a new strategic plan. We have brought on new board members like former Rep. Donna M. Christensen, Dr. David Cook, David Munar and Gina Brown to help us expand our policy work, expand our clinical services and add Black-women programs. We’ve also re-energized our Black Hollywood Task Force on AIDS with new ambassadors and supporters like Ledisi, Karamo Brown, Taraji P. Henson, Alfre Woodard and Van Jones.”

Munar, president and CEO of the Howard Brown Health Center in Chicago, says, “Almost every milestone in the fight against AIDS domestically and, in some cases, internationally has been paved by the Black AIDS Institute, and that’s a credit to the Institute and its many supporters and affiliates across the country.”

Codifying Wilson’s Vision

Wilson leaves the Institute well positioned to take on the challenges of future.

The organization is staffed by the next generation of HIV/AIDS activists and organizers, whose work embodies the Institute’s commitment to helping Black communities save themselves through their lived experience. “Every day is Black AIDS Awareness Day at the Black AIDS Institute,” says Raniyah Copeland, the Institute’s director of programs. “Our staff are of the communities we serve. We are Black men and women. We are Black people living with HIV/AIDS or at high risk of infection. We live, work, pray and play in the communities we serve. We don’t need to do ‘outreach’ because we are there 24-7.”

The Institute recently brought on new staff members to strengthen its capacity, like Maxx Boykin (previously with the AIDS Foundation of Chicago), to work on a new advocacy-and-policy initiative; Maya Merriweather, to work on mobilization; and Saron Selassie, to strengthen the Institute’s monitoring and evaluation work. On World AIDS Day 2017, the Institute launched a new website and a redesigned Black AIDS Weekly, the organization’s electronic newsletter, to more effectively reach people who use smartphones to access health information.

Jesse Milan Jr., president and CEO of AIDS United and chair emeritus of the Institute’s board, notes that the Institute has also been developing programs to help end the epidemic through its Los Angeles-based direct-service efforts. On this Feb. 7, National Black HIV/AIDS Awareness Day, the Institute, in partnership with St. John’s Well Child & Family Center, a federally qualified community-health center in Los Angeles, will launch the first Black PrEP (pre-exposure prophylaxis) clinic in Los Angeles. Later this spring, the partnership will open a Black men’s primary care clinic in the Leimert Park area of L.A. A Black gay men’s drop-in center will launch in Compton during the fall. “The PrEP clinic, the men’s primary care clinic and the Black gay men’s drop-in center will help us achieve a new dimension of our mission,” says Milan.

“We are proud to build on Phill’s bold and unapologetic legacy through direct service, new policy, initiatives to address Black women and HIV, and other efforts that will codify Phill’s vision of ending AIDS,” Copeland says.

Rather than resting on past successes, the Black AIDS Institute is “going where the epidemic’s trajectory is calling it to go,” says Munar, who calls the new initiatives “excellent examples” of how the organization is transforming in ways that will allow it to thrive without Wilson at the helm. “It’s exactly what every community needs to be doing. The Institute wants to do it first in its own backyard, then help others across the country replicate similar strategies.”

“Such approaches are particularly important in the South,” National Capacity Building Manager Leisha McKinley-Beach says. “The Institute has become one of the driving force for ending the AIDS epidemic in America due in part to its work in Southern states, where most Blacks live, and awareness-raising about what’s happening there. We have been on the front line of training and capacity building in the South. I am particularly excited that we are going to be housing our policy and advocacy work in the South, and looking forward to having Max join me in Atlanta.”

“We can’t achieve our goals in the HIV/AIDS epidemic nationally unless we work harder in the South to reduce new infections, bring more people into care, and eliminate stigma and discrimination,” says Milan. “The statistics and reality in the South are dire, especially for African Americans, and we must focus on them now.”

Passing the Mantle

“For those of us who have been doing the work and standing with Phill shoulder to shoulder for many years, it will be hard to imagine this work without him,” Munar says. “But this transition is not about Phill Wilson; it’s really about a mission, a vision, a commitment to mobilize a community, to leverage influence wherever we can, to eliminate AIDS and make this world a better place for people who are affected by HIV.”

“It is with great pride and role modeling that the Black AIDS Institute shows that you can have an organization that can grow a budget; have a vibrant and fully engaged board of directors; and be founded by a brilliant, courageous, creative man who knows when it is time to pass the mantle,” Howard says.

“This is an important moment,” Munar says. “Phill is passing the baton on to a newer generation. He’s leaving the organization on a strong footing so that it can continue to march forward.”

Freddie Allen is editor-in-chief of the NNPA Newswire and BlackPressUSA.com. Allen is also a frequent contributor to the Black AIDS Weekly. You can follow him on

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Cuts that Hurt: What the President’s FY18 Budget Proposal Means for HIV services and people of color

 

 

 

 

 

President Trump’s FY18 budget proposal included several cuts that would directly impact people of color (POC) living with or vulnerable to HIV. It is important to remember that the President’s budget recommendations are only the start of the budget process. Congress makes the final decision on funding for the government.

YOU CAN HELP: It is very important that our elected officials hear from us to save our services for HIV prevention and care. Please join us for this year’s HIV/STD Action Day on September 6 2017, the day before the start of the 2017 United States Conference on AIDS, and speak to your Member of Congress directly or organize an effort in your own local district.

Secretary’s Minority AIDS Initiative Fund (SMAIF)

The President’s FY18 budget request eliminates funding at this critical time in the SMAIF’s existence. Each year, the SMAIF provides over $50 million to support a wide range of activities designed to support communities of color (including, but, not limited to projects that: (1) get and keep people of color in care; (2) build leadership among people of color at the local level who are either living with or affected by HIV, and (3) address Hepatitis C in those living with HIV).

  • POC  IMPACT:  The  proposed  elimination  of  the  SMAIF  would  remove  a  key  resource  that promotes innovative and cost-­effective programs specifically tailored for communities of color and that influence HIV related programs across the entire Department of Health and Human Services.

Cuts to the Ryan White HIV/AIDS Program will
↑ Increase health inequities
↓ Reduce support services for persons living with HIV

Although  praised  by  the  Administration,  the  President’s  FY18  budget  request  decreases funding for the Ryan White program by $59 million (eliminating funding for  the  AIDS  Education  and  Training  Centers  (AETC)  which  train  medical  professional and Special Projects of National Significance (SPNS) programs).

  • POC IMPACT: The proposed cuts to the AETCs will reduce access to important training programs that help the healthcare workforce prepare to meet the needs of clients seeking HIV-related services – particularly, people of color.
  • POC IMPACT: The proposed cuts to the SPNS will stall: (1) evaluation of treatment models; (2) dissemination and replication of successful interventions; (3) capacity-­building in the health information technology systems of the Ryan White program.

Cuts to HIV Prevention will likely cause
Community-­Based Organizations (CBOs) near you to lose funding or close
+30,000 more Americans will become HIV-­positive
‐ 1,000,000 fewer HIV tests will be performed

The President’s FY18 budget request reduces the Centers for Disease Control and Prevention (CDC) funding for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Infections and Tuberculosis by $186.1 million. The proposed cuts to CDC would scale-­down local HIV prevention activities  that  have  just  started  to  reach  communities  of  color,  including  support  for  pre-­exposure  prophylaxis (PrEP) as well as efforts around treatment as prevention which would deeply harm the communities most vulnerable to HIV.

  • POC IMPACT: The proposed cuts to CDC threaten the existence of CBOs as cuts to their HIV prevention funding would greatly reduce services including testing, linkage services, prevention campaigns, and health education programs. Thousands more people will be unaware of their HIV status and those who need care will not be linked to life‐sustaining services.

Cuts to Medicaid will likely cause Millions to lose their Medicaid Coverage

The President’s FY18 budget request cuts $610 billion (over 10 years) to this joint federal/state program that provides healthcare services for people with limited income and resources. Medicaid remains one of the largest payers of insurance for people living with HIV.

  • The proposed cuts to Medicaid would especially impact communities of color and put their health and well-­being at-­risk since they will lose their access to HIV prevention and treatment services.

Cuts to National Institutes of Health (NIH) will Adversely impact the Office of AIDS Research (OAR)

The President’s FY18 budget request reduces funding by nearly $5.8 million. Such a large cut would likely harm researchers’ ability to find new prevention strategies and to make sure treatment options meet the needs of those on treatment.

  • POC IMPACT: The President’s FY18 budget request proposes the elimination of the Agency for Healthcare Research and Quality (AHRQ). With an emphasis on health disparities experienced by persons of color when they access healthcare services, AHRQ produces the annual National Healthcare Quality and Disparities Report as well as periodic updates on the National Quality Strategy.
  • POC IMPACT: The proposed cuts to NIH greatly undermine current long­‐term research on HIV vaccines and the hunt for a cure for HIV. Both Black and Latinos continue to be disproportionately affected by HIV and in need of HIV-­related services.

Cuts to the Housing Opportunities for Persons with AIDS (HOPWA) Program will likely cause more than 33,000 homeless People Living with HIV (PLWH) to lose housing support services

Despite being praised by the Administration, the President’s FY18 budget request proposes cutting HOPWA by approximately $26 million dollars.

  • POC IMPACT: The proposed cuts to HOPWA would reduce funding to below FY16 levels (although the 2016 levels were deemed inadequate and the HOPWA formula was updated by the Housing Opportunity through Modernization Act (HOTMA) in 2016).
  • POC IMPACT: The proposed cuts to HOPWA would reduce funding to below FY16 levels (although the 2016 levels were deemed inadequate and the HOPWA formula was updated by the Housing Opportunity through Modernization Act (HOTMA) in 2016). Several thousand fewer homes will be available for homeless or housing unstable PLWH.

Cuts to the Substance Abuse and Mental Health Services Administration (SAMHSA) will
‐ Reduce the SAMHSA Minority AIDS Initiative Funds by $17.7 million

The President’s FY18 budget request decreases SAMHSA funding by $374 million.

  • POC IMPACT: The proposed cuts to SAMHSA would directly impact communities of color since, in 2015, 65% of those who identified injection drug use as the mode of HIV transmission were people of color.
    • Specifically, the SAMHSA Minority AIDS Initiative Funds will reduce the resources available for substance use-­related HIV prevention and treatment programs focused on engaging people of color.

GOOD NEWS→

The President’s FY18 budget proposal is just a recommendation to Congress and only the first step in the Federal Budget Process:

Step 1: The President’s Budget Request

  • The President submits a detailed budget request for the coming fiscal year, which begins on October 1.

Step 2: The Congressional Budget Resolution

  • Congress usually holds hearings to question Administration officials about federal agency funding requests
  • Congress usually holds hearings to question Administration officials about federal agency funding requests
  • The federal House and Senate Budget Committees then develops its own budget resolution (which are supposed to be filed by April 15th)
  • The full House and Senate then vote on its own budget plan (only a majority vote is required to pass)

Step 3: Enacting Budget Legislation

  • The federal House and Senate Appropriations Committees determine program-­by-­program funding levels in 12 separate bills
  • The federal House and Senate Appropriations Committees determine program-­by-­program funding levels in 12 separate bills
  • Most HIV related programing is determined in the Labor­-Health and Human Services­-Education and Related Agencies appropriations bill

TAKE HOME MESSAGE→ The final distribution of funds is ENTIRELY in the hands of Congress

AIDS United Responds to Fiscal Year 2017 Omnibus Appropriations Bil

 

AIDS United acknowledges that the Fiscal Year 2017 omnibus appropriations bill, released last night, provides continuity of HIV funding for most domestic programs. This is an important development for maintaining our progress towards the national goals and priorities of reducing new HIV infections, increasing access to care and improving health outcomes for people living with HIV, and reducing HIV-related health disparities.

While most HIV programs will see level funding in the budget, AIDS United is concerned that a $4 million cut to Ryan White HIV/AIDS Program Part C clinical providers and a $5 million cut affecting the budget to fight sexually transmitted infections will diminish our response to HIV and health care, particularly given the increasing cases of sexually transmitted infections, such as syphilis, among men who have sex with men.

“Knowing that Congress plans to keep funding intact for most HIV efforts is reassuring, but we urge Congress to also ensure that Part C clinical providers and our response to sexually transmitted infections are fully funded,” said AIDS United President & CEO Jesse Milan, Jr.

AIDS United is particularly appreciative that Congress listened to the voices of people living with and affected by HIV in increasing funding for the Housing Opportunities for People With AIDS (HOPWA) program by $21 million. “Housing is fundamental to ensuring that people living with HIV live longer and healthier lives and we thank Congress for recognizing the importance of this program by securing its current stability,” said Milan.


About AIDS United: AIDS United’s mission is to end the AIDS epidemic in the U.S., through strategic grant-making, capacity building, formative research and policy. AIDS United works to ensure access to life-saving HIV/AIDS care and prevention services and to advance sound HIV/AIDS-related policy for U.S. populations and communities most impacted by the epidemic. To date, our strategic grant-making initiatives have directly funded more than $104 million to local communities, and have leveraged more than $117 million in additional investments for programs that include, but are not limited to HIV prevention, access to care, capacity building, harm reduction and advocacy. aidsunited.org

House and the Administration Begin to Show Their Hands

February 23, 2017

House Republicans Unveil a Health Care “Policy Menu”; Trump Department of Health and Human Services Proposes First Major Health Care Regulation

 

Although there is still no specific ACA repeal and replace proposal from the hill, both Congressional Republicans and the Trump Administration released documents last week articulating their approach to replacing the ACA and addressing concerns with the Marketplaces in the meantime. Congressional Republicans released a Health Care Policy Brief that is intended to serve as a menu of potential elements for a forthcoming ACA replacement bill. This Brief includes elements that have been found in previous ACA replacement proposals and that present concerns for access to care. Further, the Department of Health and Human Services (HHS) released a proposed rule entitled “Patient Protection and Affordable Care Act; Market Stabilization” (proposed rule), which is intended to help stabilize the Marketplaces until an ACA replacement is completed. Unfortunately, some of its changes may limit access to care for vulnerable individuals and make the Marketplaces less friendly to those living with chronic illnesses and disabilities. Advocates should be sure to understand both documents as well as send comments on the proposed rule to HHS by March 7, 2017.

Advocates Should:

1. Review the Health Care Policy Brief released by House Republicans last week to better understand which ideas are popular among Congressional Republicans and likely to make it into any ACA repeal and replace proposal.

2. Understand the proposed Market Stabilization regulation released by the Department of Health and Human Services and how it will impact access to care in the 2018 qualified health plans.

3. Submit comments on the proposed rule to HHS urging them to consider the impact the proposed regulations will have on access to care for vulnerable individuals.

House Republicans Unveil Health Care Policy Brief

On February 16, 2017, after a closed-door meeting, House Republicans unveiled a policy brief and resource document to explain major elements of their plan to repeal and replace key programs and protections of the ACA. House Leadership is terming this strategy “repeal plus.” The policy brief should not be considered an actual legislative proposal but rather a “menu” of replacement ideas such as tax credits for purchasing health care, health savings accounts, and high risk pools. Part of the intention of this document is to encourage Congressional Republicans, who have found it difficult to coalesce around a health care policy strategy, to find consensus on these issues. Unfortunately, many of the components of this “repeal plus” strategy would curb access to care for vulnerable individuals, including those living with chronic illnesses and disabilities.

 

When The HIV Community Speaks, Congress Better Learn to Listen

 

If the Republican majority in Congress, emboldened by its control of both chambers and the White House, thought it would be easy to roll back health reform and other progressive gains, they have begun to learn a lesson taught to Obama early on, that it is easier to articulate hope than it is to affect change. Over the first few weeks of Mr. Trump’s presidency, a massive and in many ways spontaneous resistance movement has formed all across the country, with millions of people taking to the streets to express their unwillingness to tolerate a White House and a Congress that pursues policies that are anti-woman, anti-immigrant, anti-Muslim, and would turn our social safety net to tatters.

One of the policies that has received some of the most vocal and passionate opposition has been the repeal and as-yet-unspecified replacement of the Affordable Care Act Repealing the ACA is a policy goal that served as the Republican Party’s white whale under the Obama administration, but one which their rhetoric and desire to implement have lagged in recent weeks. The lack of enthusiasm to promptly repeal the ACA is due to congressional Republican’s inability to design a replacement plan that doesn’t strip 18 million Americans of their health insurance in a year’s time and, perhaps more importantly, the fear of the collective outrage of millions of Americans should their health care be taken from them.

Over the past few weeks, numerous stories have been circling around both traditional and social media, showing Representatives going to extreme measures to avoid the wrath of a public that is rightfully incensed by plans to block grant Medicaid and tear apart the ACA with no concrete plans on how to sufficiently replace it. Whether it’s sneaking out of an event via a side exit or simply refusing to engage in town halls due to the anger of their constituents, members of Congress are clearly unnerved by the breadth and the intensity of the protests that have greeted them in their home districts. In fact, House Republicans were so shaken by the backlash against the prospect of ACA repeal that they convened a closed-door meeting this past Tuesday to discuss how to “protect themselves” from protesters.

It may not feel like it at times, but the power of collective resistance and protest is proving unparalleled in affecting change. If we are to save the ACA, or at least ensure that its most vital  benefits survive in a replacement plan, people living with HIV and those who advocate alongside them are going to have to engage in sustained, vocal opposition to any politician who tries to snatch our health care from us. This means suiting up and showing up to town halls and rallies, even when we don’t feel like going. It means calling your members of Congress at their offices and refusing to take no for an answer when you’re told a line is busy or a mailbox is full. The HIV community’s opposition to the destruction of the ACA must be unrelenting because the only way our elected officials will act in our best interest is if they are provided with no alternative.

Yes, changing the will of Congress may seem daunting, but each individual action on the road from where we are to where we aim to be is one step closer. One of the first steps you can take is to commit to meeting with your members of Congress and letting them know the repeal of the ACA is unacceptable. For the week beginning February 20, both the Senate and the House will be out of session and in their home districts and states. Many of them will be hosting town halls or have open hours for visiting and we must make sure that our presence is acutely felt. It is important to remember that they are beholden to us and that the amount of power they wield is indirectly proportional to degree to which we are politically engaged.

If you click here, you will find a substantial, but by no means comprehensive spreadsheet that lists the office hours and scheduled events for many members of Congress in their home districts and states in the near future. Use this list and any other resources you can find to plan an action during Presidents’ Day weekend and the days that follow. Make sure that, whether it’s in person or over the phone, your members of Congress are incapable of ignoring the needs of people living with HIV and all Americans living with chronic diseases.

Question them.
Tell your story.

Share your concerns and ensure that your voice is heard and that the provision of quality health care is nonnegotiable if they want to keep their job for long. And, if you want to continue with your HIV advocacy after the actions around Presidents’ Day, there’s no better way to do so than to register for AIDSWatch, the largest annual HIV/AIDS advocacy event in America. This year, AIDSWatch is more important than ever and we need your help more than ever if we’re going to make Congress recognize the possibility and importance of ending the AIDS epidemic and protecting the policies that allow people living with HIV to get access to quality, affordable care.

Posted By: AIDS United, Policy Department – Thursday, February 09, 2017

Repeal Without Replace: Senate Starts Undoing Obamacare With No Replacement

In the wee hours of the morning on Thursday, the Senate took the important first step toward repealing the Affordable Care Act, narrowly approving a budget resolution that lays the groundwork for the undoing of much of President Obama’s signature health care law. The 51-48 vote fell almost entirely along party lines, with Senator Rand Paul (R-KY) being the only Republican to vote against the resolution and no Democrats voting for it. Having passed in the Senate, the budget resolution has been transferred over to the House where it could be voted on as early as this Friday or later, depending on how successful Speaker Ryan is at bringing together an often-fractured House GOP.

If the House passes the Senate resolution, reconciliation instructions will be sent out to the Senate Finance Committee; the Senate Health, Education, Labor and Pensions Committee; and to the House Ways and Means and Energy and Commerce committees. These instructions are designed to get the committees to report legislation that would reduce the federal deficit by at least $1 billion over the next decade. In practice the legislation will be used to repeal certain aspects of the ACA with only a 51-vote majority in the Senate and without having to face the risk of being filibustered by Democrats. This means that the GOP will be able to repeal major provisions of the ACA that affect the federal budget and will have to introduce other legislation to repeal the other provisions, including those that reform health insurance practices.
For people living with or at risk of contracting HIV, the changes that could be made through this reconciliation process will be immense and potentially deadly. Through reconciliation, Congress will be able to repeal the individual mandate to buy coverage, take away the ACA’s insurance premium subsidies and, perhaps worst of all, roll back Medicaid expansion. Medicaid is the single largest source of insurance coverage for people living with HIV, covering more than 40% of all people with HIV who are in care. Add to that the fact that Medicaid expansion by itself was responsible for putting an addition 14 million Americans on health insurance, and it is not hard to understand just how much of an impact this reconciliation process could have on the HIV community.

The Senate vote on the budget resolution was the climax of nearly 7 hours of rapid-fire voting known as “vote-a-rama”, a tradition whereby Senators—in this case, mostly Democrats—are allowed to propose roll call votes on amendments to a budget resolution in quick succession with the aim of getting their colleagues on the record with votes concerning politically volatile issues. On Wednesday night, Democrats put forth a number of amendments regarding some of the popular aspects of Obamacare as both an act of defiance and a way to put pro-repeal Senators on-the-record for the elimination of well received ACA provisions.

For their part, Republicans in the Senate chose in most instances to vote as a unified block even when such a vote went against the wishes of their constituencies. Over the course of the evening, the Senate rejected 19 different amendments along party lines, many of which would have served to protect access to quality, affordable health care for all Americans. Of particular interest to people living with or at risk for contracting HIV were amendments put forth by Senate Democrats aimed at preventing health insurers from discriminating against people based on pre-existing conditions, allowing children to stay on their parents’ health insurance until the age of 26, prohibiting insurers from denying health insurance or raising rates on women because of their gender, and not making any cuts to Medicaid funding. None of these amendments were accepted, but they did provide good indication of what aspects of the ACA would be vulnerable under a full ACA repeal.

Perhaps the most important vote of the night—aside from the final approval of the budget resolution—was one that didn’t happen at all. An amendment put forth by Senator Bob Corker (R-TN) and four other GOP Senators that would have extended the January 27th deadline to come up with repeal legislation by an additional 5 weeks was withdrawn late on Wednesday night. The amendment was initially brought up by Senator Corker and some of his Republican colleagues in light of legitimate fears that their party would not have a replacement plan in place when they repealed the ACA. And, while nothing happened over the course of the evening that would have given Senator Corker and his amendment’s supporters reason to believe a replacement plan was any nearer than before, they would all go on to vote in favor of the budget resolution at the end of the night, continuing down a path of repeal without replacement.

Most of America had long since gone to sleep and likely won’t remember when or exactly how it happened, but history with certainly note that, if the Affordable Care Act is indeed dismantled, that Congress began to do so when no one was watching.

Replacing Obamacare: A Look At Competing Conservative Health Care Proposals

 

The chances that the Affordable Care Act (ACA) is still the law of land at this point next year are somewhere between slim and none. With that being said, there is very little consensus around what will take its place. Despite the charged rhetoric from President-elect Trump, a full repeal of the ACA, as promised in his Contract With The American Voter, is unlikely for a number of pragmatic reasons. For starters, a complete repeal of the ACA would require at least 60 votes in the Senate, which isn’t likely given that the GOP will only hold 52 Senate seats. And, should the 60 vote hurdle be cleared, Congressional Republicans and the Trump administration would be forced to confront the fact that replacement plans created by GOP leaders and conservative think tanks are more conceptual than practical, proving thin on implementation instructions.

For his part, President-elect Trump doesn’t have a fully-formed health care plan of his own. Throughout the campaign and well into his presidential transition, both Mr. Trump’s personal and professional views on health care reform have been somewhat murky. At various times, President-elect Trump has promised to both fully repeal and keep major portions of the ACA, praised Planned Parenthood while also pledging to defund it, and said that he will “take care of everyone” while releasing a health care plan that would leave an estimated 21 million people without insurance. However, if his current platform and conservative cabinet picks are any indication, it does not appear that his administration’s health care policy will deviate too much from the GOP norm. It is very likely that any health care plan pushed by Trump will include the repeal of much of the ACA. What Trump and Congressional Republicans end up replacing it with is less certain, but the shape of reforms to come can be seen in previous proposals from Republican leadership and how closely they align to the health care page of Trump’s transition website.

Of all the existing Republican proposals, two are currently positioned to serve as blueprints for whatever Congressional Republicans and the Trump administration agree on as a replacement for the ACA. The first proposal and frontrunning proposal was put forth by House Speaker Paul Ryan (R-WI) this past summer as part of his “A Better Way” platform, is the closest thing the Republican Party currently has to a comprehensive vision of what conservative health care policy should look like. The second proposal, the Empowering Patients First Act of 2015, is the latest in a series of legislation proposed by Representative Tom Price (R-GA), who was recently nominated by President-elect Trump to be Secretary of the Department of Health & Human Services. A Tea Party conservative and former orthopedic surgeon, Price currently serves as chairman of the House Budget Committee and has been one of the most vocal opponents of the ACA in Congress. Ryan’s A Better Way plan incorporates many of the health care reform mechanisms that are included in the Empowering Patients First Act of 2015 and, given their leadership roles within the House and HHS, there’s good reason to believe that any ACA replacement plan formulated by the Trump Administration and Congress will borrow heavily from them.

There is plenty of nuance and detail to be sifted through in their health care proposals, but the defining characteristics of both are that they benefit those who are young, healthy, and well-to-do at the expense of those who are old, sick, and poor. Like the policy listed on President-elect Trump’s transition site, both the Ryan and Price plans shift the burden of providing Americans with health insurance from the Federal government and society at large to the States and individual citizens. The Republican plans replace the much maligned individual mandate to purchase health insurance and the comprehensive, need-based subsidies provided through the ACA with free-market approaches that emphasize health savings accounts and the ability to purchase insurance across state lines while doling out tax credits based on age rather than income.

On the surface, the Ryan and Price plans continue to bar insurance companies from raising rates and denying coverage due to pre-existing conditions, but a closer look shows that their proposals would only prohibit insurers from raising rates on sick people if they maintain “continuous coverage.” In layman’s terms, this means is that if someone loses their coverage for any reason after the ACA had been repealed and replaced, the insurance companies would then be allowed to hike up their rates based on any pre-existing conditions.

As for the 14 million people who were able to receive insurance though the ACA’s Medicaid expansion, most or all of them would no longer be covered by the leading Republican contenders to replace Obamacare. One of the few concrete proposals that Trump mentioned on the campaign trail was transitioning Medicaid into a block grant program. Currently, Medicaid is funded as an entitlement program where the federal government is obligated to assist states with coverage costs no matter how many people have qualified for the program. Through a block grant, states would be given a set amount of money by the federal government at the beginning of the year and would be forced to make do with what they had regardless of how many people were eligible for coverage. While theoretically not a bad thing, the purpose of transitioning the Medicaid funding to a block grant in the Ryan and Price plans is to reduce the federal contributions to the program and create more flexibility for state to adjust benefit design. There is no detailed breakdown of what effect the Medicaid block grant system would have in Price’s plan, but an analysis of a Medicaid block grant proposal in Ryan’s 2012 budget by the Kaiser Family Foundation estimates that that between 14 and 20 million people would lose coverage.

There are certainly a number of different directions for health care policy to go in the next 4 years, but—whether the end product looks more like Ryan’s plan, Price’s plan, or something else entirely—the HIV advocacy community and those who fight for quality, affordable health care for all Americans will have their work cut out for them.

Posted By: AIDS United, Policy Department – Friday, December 02, 2016
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