By Julia Belluz<\/p>\n
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There\u2019s just one big problem with Trump\u2019s grand strategy: Since taking office in 2016, his administration has been undercutting the fight against the virus \u2014 most notably by sabotaging the Affordable Care Act and encouraging states to introduce work requirements for Medicaid.<\/p>\n
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To put it simply, the ACA was a \u201cwatershed moment in the [HIV] epidemic\u2019s history,\u201d as the Kaiser Family Foundation\u2019s director of global health and HIV policy, Jennifer Kates, told me in 2017. The law was designed to get more people access to health care, including those who were traditionally denied coverage because of \u201cpreexisting conditions\u201d like HIV, or who were driven out of the marketplace because their health care was unaffordable. And so under the law, the disease was no longer a barrier to health insurance.<\/p>\n
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The law also expanded access to Medicaid, the government health insurance plan for low-income Americans. And remember: More than half of people living with HIV in the US are low-income.<\/p>\n
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So it\u2019s no surprise that the insurance rate for people living with HIV increased under the ACA, according to the Kaiser Family Foundation, in states that expanded Medicaid. The death rate from the virus also declined in those states.<\/p>\n
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But while the Trump administration hasn\u2019t successfully repealed the health law, it has managed to undermine it. And this slow sabotage of Obamacare is expected to subvert the fight against HIV, said Kates, who is currently working on an analysis of the data. \u201cThe ACA has driven increased coverage [for people with HIV],\u201d she said, \u201cso the extent that it\u2019s scaled back or restricted, it\u2019ll likely affect coverage.\u201d<\/p>\n
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