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Change We Can’t Believe In: AIDS Advocates Question Obama on Healthcare, Discretionary Spending Cuts

Posted by , January 29, 2010 at 1:35am

Change We Can’t Believe In: AIDS Advocates Question Obama on Healthcare, Discretionary Spending Cuts

An AIDS advocate protests Obama’s proposed cuts to discretionary spending Wednesday

Many AIDS advocates are expressing concern about President Barack Obama’s commitment to combating the epidemic, on the heels of a State of the Union that downplayed the urgency of federal health care reform and proposed freezing much government discretionary spending.

While Obama pushed for the passage of health care reform, the ask was buried 31 minutes into his speech. That timing felt ominous, given that on Wednesday Nancy Pelosi suggested passing health care reform in pieces. There has been some talk of only passing the popular parts of health care reform, such as regulations on the private insurance industry. But AIDS advocates say that would be horrendous news for people with AIDS and other disenfranchised people.

“We’re not the popular provisions,” said Robert Greenwald, executive director of the Treatment Access Expansion Project. “There’s no question that this comprehensive package is the best we’ve seen in 50 years. We need to remove barriers to Medicaid and Medicare. I don’t think many of those things will happen if what we just see is incremental reform.”

Housing Works Vice President for National Advocacy and Organizing Christine Campbell agreed. “The majority of this bill takes us strides above where we are. Democrats and Republicans in Congress just need to do their jobs.”

People with AIDS in the United States are poorer than the general population and also less likely to have adequate health care. Forty-five percent of people with HIV/AIDS in the United States have incomes under $10,000 a year, and 50 percent lack regular medical coverage. The situation is even more dire for people with hepatitis C, who aren’t co-infected don’t have access to the Ryan White CARE Act safety net.

Campbell and AIDS advocates are recommending the House pass the Senate version of the bill, as imperfect as it is. The Senate bill doesn’t include a public option so people who purchase health care must go through an insurance company. The Senate version also includes a provision to appease anti-abortion supporters that would require people to purchase specific abortion-only coverage separately from their regular premiums.

Gregg Gonsalves, a longtime AIDS activists who has been critical of Obama’s policies, said that even though he thinks there are parts of the Senate health care reform bill that “stink”, he thinks it should still be passed.

“The bill is terrible compared to what it could be but it’s better than nothing basically,” Gonsalves said. “I think they should pass this with a reconciliation fix.”

Gonsalves expressed concerned with Obama’s commitment to the issue. “He said we can’t give up health care now. But he’s taken the backseat.”

The HIV Healthcare Access Group sent a letter to House leadership calling on them to pass health care reform that includes a largely federally funded expansion of Medicaid to low income individuals; an exchange or regulated marketplace for the uninsured and the under-insured to purchase health insurance; generous subsidies to make coverage affordable for those who need it; stricter regulations that govern the private market preventing discrimination; an investment in reorienting our health system to focus on prevention and public health and critical measures to address primary care and public health medical workforce shortages.

Discretionary spending

Another problematic part of Obama’s agenda was his call for a three-year freeze in spending that wasn’t related to national security, Medicare, Medicaid, and Social Security. A freeze could impact housing, federal aid, health care and other programs essential to poor people with HIV/AIDS, and other disenfranchised people.

“This is a hare-brained idea,” Gonsalves said. “Obama’s throwing a bone at Kent Conrad on the backs of poor people.”

Although although Obama mentioned global AIDS in his State of the Union Address in the context of U.S.‘s global committment, he has already essentially flatfunded global AIDS spending, even though Congress authorized $50 billion for PEPFAR over five years.

A rally was organized by Health GAP Wednesday near the White House calling on Obama to rethink this proposal, as well as a Campaign to End AIDS-organized phone zap of the White House.

After some listserv chatter questioning whether a protest was necessary, Housing Works President and CEO Charles King defended the “preemptive strike,” saying, “The truth is that the Obama administration is already not delivering on global AIDS and we have no idea whatsoever what their intentions are on the domestic front. They have done a good job of collecting information and making people feel like they have been heard. We still don’t know that they have been really listening, and we probably won’t know until the budget is out.”

Although some advocates speculated there may be some efforts to shield HIV/AIDS programs from some of the cuts, broader hits to the social services will be devastating both to people with HIV as well.

“There may be some efforts to carve out HIV from the freeze,” said David Munar, Vice President for Policy and Communications at AIDS Foundation of Chicago. “But any cuts to health and human services programs, be it Head Start or cuts to the CDC budget, will be harmful for people with HIV.”

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