Since efforts to dismantle or repeal Obamacare imploded in September, the Republicans – who control the White House, U.S. Senate and House of Representatives – have focused on tax reform. A wide variety of priorities and proposals have been distilled into two bills, one passed by the House a few weeks ago and one passed by the Senate last week. A conference committee featuring House and Senate members must now hammer out the differences between their two bills to produce a single piece of legislation that can be passed by both chambers and signed into law by President Trump.
Since details of the legislation began emerging several weeks ago, many prominent AIDS Service Organizations (ASOs) have come out against the bill. On December 2nd, AIDS United, NASTAD, the National Coalition of STD Directors, NMAC, and The AIDS Institute collectively released a joint statement expressing opposition to the Senate version of the bill.
The most prominent point of contention is that the Senate bill would repeal the individual mandate, the law that requires all Americans to have health insurance coverage. It is estimated that without the individual mandate, premiums could skyrocket, especially for people who have pre-existing conditions like HIV/AIDS. The non-partisan Congressional Budget Office estimates that repealing the individual mandate would effectively take insurance away from 13 million Americans in the next decade.
The other reason this bill is opposed by many ASOs is that it will significantly increase the deficit if it is passed. Many speculate, and some Republican lawmakers have said outright, that an increase in the deficit will spur Congress to enact deep spending cuts in the future to offset the cost of the tax cuts. This could include Medicaid, Medicare, and HIV research and funding, all of which are deeply important to people living with HIV.