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Last week, six members of the Presidential Advisory Council on HIV/AIDS (PACHA) resigned in protest of the Trump administration, saying that the administration has no strategy to address HIV/AIDS, and not only hasn't sought input from the council when formulating policy, but is also pursuing legislation that would harm people living with HIV and halt or reverse important progress made in the fight against the disease.In short, they quit because they think Donald Trump doesn't care about HIV. As Scott Schoettes, counsel and HIV project director at Lambda Legal, wrote in an op-ed for Newsweek on Friday:
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But Schoettes and his colleagues wrote that the "final straw for us—more like a two-by-four than a straw—is President Trump's handling of health care reform." That is, the hyperpartisan effort to repeal and replace the Affordable Care Act.The group noted that the ACA was hugely beneficial to people living with HIV, and supported efforts to fight the HIV/AIDS epidemic as more people had health coverage and received treatment. Under the ACA, people with HIV who didn't have health insurance through work could buy coverage through the marketplace; insurers could no longer charge them prohibitive amounts for having a preexisting condition.The ACA also expanded Medicaid eligibility up to 138 percent of the federal poverty line, allowing more lower-income people to get health insurance. Medicaid is the largest insurer of people with HIV/AIDS as of 2016 but, of course, the Republican healthcare bill would roll back the Medicaid expansion entirely. (The House bill did, and we think the Senate bill would, except no one knows what's in it.)And if states are allowed to define their own essential health benefits, a provision the Senate bill is rumored to include, the people who'll face the most harm are those in the South and in rural and underserved areas, many of them people of color and low-income people. "It will be people who become newly infected in an uncontrolled epidemic, new cases that could be prevented by appropriate care for those already living with the disease," he wrote.The group urged the administration to listen to health experts when making health policy—what a concept. "Experts with real facts, grounded in science, must be in the room when healthcare policy decisions are made," Schoettes wrote. "Those decisions affect real people and real lives. If we do not ensure that US leadership at the executive and legislative levels are informed by experience and expertise, real people will be hurt and some will even die."Read This Next: Trump Could Undo All the Progress We've Made on AIDS
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PACHA was formed in 1995 by President Bill Clinton to advise the White House on treating, preventing, and curing HIV and AIDS; President George W. Bush renewed its charter in 2001. The council can carry as many as 25 members but there were 18 before this group resigned, which means it has shrunk by a third of its size. Schoettes, who is HIV positive, wrote on behalf of himself and the five other council members who resigned: Lucy Bradley-Springer, Gina Brown, Ulysses W. Burley III, Grissel Granados, and Michelle Ogle.Schoettes writes that resigning from government service is not a decision any of them take lightly, but they could no longer ignore the "many signs that the Trump administration does not take the on-going epidemic or the needs of people living with HIV seriously." First, the website for the White House Office of National AIDS Policy was removed the day Trump took office and hasn't been replaced, but more importantly, Trump has not appointed anyone to lead the office. By contrast, President Barack Obama appointed a director 36 days into his term, and the person in that post held a seat on the Domestic Policy Council with other advisors.As advocates for people living with HIV, we have dedicated our lives to combating this disease and no longer feel we can do so effectively within the confines of an advisory body to a president who simply does not care.
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Watch more from Tonic:
But Schoettes and his colleagues wrote that the "final straw for us—more like a two-by-four than a straw—is President Trump's handling of health care reform." That is, the hyperpartisan effort to repeal and replace the Affordable Care Act.The group noted that the ACA was hugely beneficial to people living with HIV, and supported efforts to fight the HIV/AIDS epidemic as more people had health coverage and received treatment. Under the ACA, people with HIV who didn't have health insurance through work could buy coverage through the marketplace; insurers could no longer charge them prohibitive amounts for having a preexisting condition.The ACA also expanded Medicaid eligibility up to 138 percent of the federal poverty line, allowing more lower-income people to get health insurance. Medicaid is the largest insurer of people with HIV/AIDS as of 2016 but, of course, the Republican healthcare bill would roll back the Medicaid expansion entirely. (The House bill did, and we think the Senate bill would, except no one knows what's in it.)And if states are allowed to define their own essential health benefits, a provision the Senate bill is rumored to include, the people who'll face the most harm are those in the South and in rural and underserved areas, many of them people of color and low-income people. "It will be people who become newly infected in an uncontrolled epidemic, new cases that could be prevented by appropriate care for those already living with the disease," he wrote.The group urged the administration to listen to health experts when making health policy—what a concept. "Experts with real facts, grounded in science, must be in the room when healthcare policy decisions are made," Schoettes wrote. "Those decisions affect real people and real lives. If we do not ensure that US leadership at the executive and legislative levels are informed by experience and expertise, real people will be hurt and some will even die."Read This Next: Trump Could Undo All the Progress We've Made on AIDS