Fenway Policy Brief Outlines Ways Trumpcare Would Harms LGBTs, PLWHAs and Black/Latinx Americans
Today, The Fenway Institute of Fenway Health released a policy brief outlining how the American Health Care Act (AHCA), the Trump Administration's proposed replacement for the Affordable Care Act (ACA), could impact LGBT people, people living with HIV (PLWH), and Black and Latino Americans.
"This bill holds potentially devastating consequences for low-income LGBT people, people living with HIV, and Black and Latino people," said Sean Cahill, PhD, Director of Health Policy Research for The Fenway Institute at Fenway Health. "The rates of uninsurance among LGBT people and people living with HIV have dropped dramatically since 2013, when the Affordable Care Act's Medicaid expansion was implemented. While people of all races benefitted from the expansion of insurance access, on a per capita basis Black and Latino people benefitted disproportionately. Those gains could be completely erased if this bill becomes law."
Between 2013 and 2015, the rate of uninsurance among lesbian, gay, and bisexual people decreased from 22 percent to 11 percent. The percentage of people living with HIV who lacked any kind of health insurance coverage was 22 percent in 2012 and dropped to 15 percent in 2014.
The Fenway Institute analysis also notes that while the ACA has benefitted Americans of all racial/ethnic backgrounds, reducing uninsurance rates among Whites by 42 percent from 2012 to 2014 (from 12 percent uninsured to 7 percent uninsured), the repeal of the ACA would disproportionately hurt Black and Latino Americans. On a per capita basis, Black and Latino people are overrepresented in the 20 million who have newly accessed insurance. Uninsurance among Blacks was nearly cut in half, from 19 percent to 11 percent, from 2012 to 2014. Over time, this expansion of insurance to Black Americans could play a key role in reducing health disparities affecting Black people.
Four provisions in the AHCA would impact low-income LGBT people and PLWH, in particular:
All of these changes would affect LGBT people of color and PLWH who are Black and Latino, in particular. Black and Latino men who have sex with men experience the highest HIV burden among all sub-populations, and transgender women of color have disproportionately high rates of HIV and other sexually-transmitted infections.
The AHCA would make no changes to the many insurance industry reforms enacted under the ACA, such as the ban on insurance companies denying coverage to people with preexisting health conditions that has been life-saving for PLWH. In order to pass the AHCA with a simple majority vote in the Senate, the bill can only make changes that would impact the federal budget. Sixty votes are required to make more substantive changes, such as rescinding reforms to the insurance industry enacted under the ACA.
The policy brief, What the American Health Care Act means for LGBT people and people living with HIV, can be read here.