The United States Senate has introduced its second attempt at “repealing and replacing” The Affordable Care Act, also known as Obamacare. We are not going to go into great detail about this bill because it is not the new law of the land yet, Republicans have held no hearings, public or private, and the plan is changing almost daily but we wanted you to know some key issues at stake and how they may effect your gay male life.  You can read the full 142 page text of the bill HERE.

However you might feel about the Affordable Care Act, it did provide health insurance coverage to tens of millions of Americans that did not have it, as well as created laws cover those with pre-existing conditions, LIKE HIV, as well as expanded Medicaid for those in lower income brackets. The latest Republican offering does none of the above and creates cuts in funding.  Let’s take a look by state.

Over all there will be, at least:

22 million less insured


$800 Billion less spent on Medicaid

South Florida Gay News reports that “Medicaid is the primary source of insurance coverage for people with HIV in the United States. According to the Kaiser Family Foundation, in 2014, 42 percent of U.S. residents in medical care for HIV were on Medicaid, a figure that rose from 36 percent in 2012 thanks to the expansion of Medicaid in states that opted to do so under the ACA. (Compared with the highly restrictive traditional state Medicaid programs, expanded state Medicaid programs have a simple cutoff for admission: having an income below 138 percent of FPL, or $16,643 for an individual.) By comparison, 30 percent of those in HIV care were privately insured in 2014, 14 percent were uninsured, 8 percent had Medicare, and 6 percent had some other form of health coverage.”

“The House health care plan would also forbid any new states from receiving federal matching for expanded Medicaid programs (32 states plus Washington, DC, have adopted expanded Medicaid since 2014). And starting in 2020, the federal government would cease providing matching funding to states for new enrollees to existing expanded Medicaid programs. Meanwhile, participation in such programs would likely ultimately wither under attrition because federal matching would end for any enrollee who experienced a gap in expanded Medicaid coverage of a month or more.”

and, of course,

Huge spike in Premium costs.

Some other terrible possibilities are the effects to employer sponsored healthcare insurance plans as well as the simple fact of leaving so many Americans worried about the future state of their healthcare and the possible debt associated with a sudden or long term illness. These changes will drastically effect gay males, those living with HIV and people of colour the most.

All of this, and Donald Trump is now floating the idea of simply repealing the Affordable Care Act entirely and then creating a replacement.

This is a developing story and we will keep you posted. 

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