How Trumpcare, or its Senate component, may affect the LGBT community

By : Billy Manes
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“This is a funeral procession. When we get to Sen. Marco Rubio’s office, we’ll have speakers and then we’ll have a die-in,” was the rallying call on June 28 as protesters took to the streets to march against the competing Republican agendas meant to “repeal and replace” the Affordable Care Act. The march, which started at Orlando City Hall and ended up across the street at Rubio’s home away from home, was blotted by rain and was suitably somber.

“What do we want? Healthcare. When do we want it? Now,” was the refrain as dozens of people walked the street in favor of coverage for those with pre-existing conditions and those who were simply blocked out of coverage by Florida’s refusal to expand Medicaid to nearly one million people caught in the coverage gap. Likewise, others just saw the crumbling pieces of the nation’s healthcare conundrum, currently being argued between the U.S. House and U.S. Senate regarding a complete overhaul of medical care in the United States.

“13 old white guys want Americans to die,” one sign read. A mother, with her disabled son in a wheelchair, carried a sign that read “Dying for Trumpcare,” while her son held a sign that said “1 of the 22 million.” Others carried coffins while wearing black clothes and veils before lying down in the rain outside of Rubio’s office.

The reference, of course, was to what is being called “Trumpcare,” or the American Healthcare Act (AHCA), but the possible affects are far more dire than affordability, most say.

“It’s sickening is what it is. You have people that are part of the LGBTQ community, which is just happenstance, but they deserve health. They’re threatening to cut millions from state coverage,” Hope and Help community development director Joshua Myers says. “The media is currently portraying the country as a very divided nation. Our president is very uncouth. It’s very apparent that he is nearly completely aloof about how politics work. During his campaign he promised a repeal and replace plan. It failed. When you look at the facts, the health bill would cut 40 million, the senate’s version even more. They essentially signed a death certificate for millions of Americans. Now for our clients, we’re praying that things go well; it just puts us all in jeopardy.”

Hope and Help early intervention specialist David Rodriguez likewise takes a downcast view.

“As far as professionally, I don’t have a full understanding of what’s going on. But as a client for Hope and Help, our funding is going down drastically. There’s a lot of fear, and it’s definitely changed people’s mindsets,” Rodriguez says. “It’s becoming a lot more real for everyone. The clients every week come in and say, ‘What can happen?’”

The reason for the fear he says is that Florida is number one in the nation and Orange County is number six in the nation for new HIV/AIDS cases.

“The biggest problem is there are very few champions of the Republican proposals,” said Alex Conant, a former spokesman for Sen. Marco Rubio (R-Fla.) to NBC in June. The conservative senators who currently don’t support the legislation will never be inclined to support it if they don’t feel pressure from Trump’s base, and only Trump can rev up his own base.”

A May report by the Kaiser Family Foundation quickly raised the hackles of those living in the federal medical machine:

“Prior to the ACA, under federal law, individuals could not qualify for Medicaid based on income alone. Enrollees had to be both low income and fall into another category, known as ‘categorical eligibility,’” the report reads. “Such as disability, pregnancy or being parents. This excluded most low-income childless adults from coverage and created a particular ‘catch-22’ for many low-income people with HIV who could not qualify for Medicaid until they were already quite sick and disabled, often as a result of developing AIDS, despite the availability of recommended medications that could prevent such disease progression.”

The report goes on to indicate that both the American Health Care Act passed by the House and the Better Care Reconciliation Act, released by Senate Republicans on June 22, would equally repeal the Medicare payroll surtax for the wealthy, meaning the wealthy will shave off taxes while the poor will suffer in uncertainty about whether they are covered at all.

“According to the Congressional Budget Office, the provision in the AHCA and the BCRA to repeal the Medicare payroll surtax would reduce revenue for Part A benefits by $58.6 billion between 2017 and 2026,” the report reads. “Proposed changes to the ACA’s marketplace coverage provisions and to Medicaid financing in both bills would also increase the number of uninsured, putting additional strain on the nation’s hospitals to provide uncompensated care. As a result, Medicare’s ‘disproportionate share hospital’ (DSH) payments would increase, leading to higher Part A spending between 2018 and 2026 of more than $40 billion, according to [the Congressional Budget Office].”

This isn’t just a political battle of rubric and judgment; it’s a real human conundrum. Angel Santiago, one of the survivors of the Pulse massacre in 2016, is clued into what is going on while his health lies in the balance. He may have walked away, but the challenge stays with him.

“This left me with two choices: either remain uninsured, or pay $400 or more a month for health insurance, and that to me wasn’t economical, so I decided to remain uninsured, because it is just not affordable at this point to be insured, so that’s my situation right now. The reason I’m not working is because I’ve decided to got to school full-time and have decided to pursue that while I have the opportunity, so at this point if anything happens to me about my health, I don’t know what I would do.”

So, for now, he’s functioning on instinct and on personal motivation.

“Well I started at Valencia just to do prerequisites for nursing, but my plan is to go to a university for health sciences, one which is affiliated with Florida Hospital, which is actually the hospital I stayed at during my recovery,” he says. “So as far as any health insurance, I obviously don’t have any, but Two Spirit Health Services has been good in the sense of being able to provide very minimal level healthcare, which I don’t want to call it that, but I went there, got blood work done and they didn’t charge me any premium or co-pay because I was affected by Pulse. But if I were to get the flu or, say, break my leg or something like that, I don’t have any way out.”

On June 13, dozens of organizations, including Equality Florida, the Human Rights Campaign, Lambda Legal and the Trevor Project issued a statement to the U.S. Senate opining on the near-certain attack on LGBTQ rights. This is just part of it:

“The American Health Care Act will have a detrimental impact on the positive trend of health coverage for LGBTQ people and so many other vulnerable populations. The Congressional Budget Office has projected that the provisions of the legislation will result in 14 million. Americans losing their health insurance by 2018. That number skyrockets to 23 million by 2026. These projections foreshadow an unacceptable growth in the uninsured rate and an equally unacceptable exacerbation of healthcare disparities,” the statement reads. “The American Health Care Act fundamentally changes the healthcare safety-net program we know as Medicaid, imposing a per capita cap funding structure that is estimated to cut $880 billion in federal funding from state Medicaid programs. The magnitude of the lost funding will have a swift, stark, and devastating impact on the most vulnerable among us: women and children, the elderly, people with disabilities, and persons living with HIV. The legislation also strips the requirement to cover essential health benefits under the Medicaid expansion, leaving millions without access to the critical benefits that often save lives, such as substance abuse treatment and mental healthcare services,” it reads.

The date of the vote remains uncertain.

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