Trump’s DOJ attack on affordable healthcare

Earlier this week, the Trump Administration’s Department of Justice (DOJ) officially asked the Fifth Circuit Court of Appeals to strike down the Affordable Care Act (ACA) in its entirety as unconstitutional. In its unexplained shift in position, the DOJ effectively said that it will no longer defend any part of the ACA in the courts.

What’s at risk if the ACA falls?

Access to affordable health care for all, protections for pre-existing conditions, and a prohibition against discrimination in care and coverage for LGBTQ+ patients. 

Central to the success of the ACA’s core mission—providing equitable access to affordable healthcare to everyone—is its protections for pre-existing conditions, something that one in every two Americans has. Additionally, and particularly of concern for Equitas Health, the ACA has helped address health equity issues by prohibiting discrimination against LGBTQ+ patients in certain health programs and activities.

Also at risk are the Medicaid expansion programs in 37 states—including in Ohio—that have been crucial to people living with HIV and LGBTQ+ people, particularly in communities of color.

Medicaid expansion programs extended health care to groups of people previously ineligible for coverage. Additionally, Medicaid expansion gives people living with HIV coverage without first requiring them to have an AIDS diagnosis.

Through the implementation of Medicaid expansion programs, thousands of LGBTQ+ people and people living with HIV gained insurance coverage that they otherwise wouldn’t have had. This includes many of Equitas Health’s own patients.

Without the transformative policies embodied in the ACA, any hopes of ending the HIV epidemic are dashed.

You may remember seeing our statement following President Trump’s State of the Union address during which he announced his Administration’s national plan to end the HIV epidemic by 2030. Without the ACA and Medicaid expansion programs, any plan to end the HIV epidemic is DOA.

Not only will we not be able to end the epidemic, we will run the risk of further worsening it by restricting access to affordable and nondiscriminatory healthcare for people living with or at risk of contracting HIV, meaning we will see an increase in new infections, a decline in public health, and an exacerbation of health disparities related to HIV.

Like we said in our earlier statement, if the Trump Administration is serious in joining our combined efforts to end the HIV epidemic, we welcome it. But moves like this send a clear message that the Administration is not, in fact, committed to this laudable goal.

If the ACA is struck down by the courts, there will be far-reaching, disastrous impacts on the lives of millions of Americans, including our patients, and it will unleash utter chaos on our healthcare system.

Since its enactment, 20 million Americans—including almost 1.5 million Ohioans—have gained access to affordable and nondiscriminatory healthcare. Equitas Health unequivocally supports the protection and retention of the transformative policies embodied in the ACA, particularly those aimed at ensuring nondiscrimination in the healthcare setting and maintaining access to and coverage of essential healthcare services.

As this case moves forward in the Fifth Circuit, we will send you updates. We’ll also send updates on how Ohio would fill the hole left by the ACA if it’s struck down—Gov. DeWine has pledged to maintain protections for the nearly 2 million Ohioans who have pre-existing conditions.

In the meantime, keep an eye out for our Advocacy Alerts from Katy Shanahan, Advocacy Manager, about how we’re working with congressional leaders to ensure that our access to healthcare and essential safety net programs is protected and about how you can help us.

Thanks for all you do, and we’ll see you in the fight!

Daphne Kackloudis, Chief Public Policy and Strategy Officer, Equitas Health, March 30, 2019