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President Trump Wants to End HIV, but New Administration Guidance Undermines Plan to End the Epidemic


APLA Health today warned that new Trump Administration guidance on Medicaid would likely undermine the Administration’s own Plan to End the HIV Epidemic.

“The President said last night in the State of the Union speech that his Administration would end AIDS in this decade,” said APLA Health CEO Craig E. Thompson. “But this latest guidance encourages states to constrict or cap care for exactly those populations most at risk of HIV. This makes no sense.”

The Centers for Medicare and Medicaid Services (CMS) issued the new guidance last week. It encourages states that expanded their Medicaid programs under the Affordable Care Act (ACA) to cap care or benefits to the expansion population.

California expanded its Medi-Cal (Medicaid in California) Program to some four million individuals under the ACA. Significantly the expansion population includes young single low-income men for the first time ever. Previously, single men often needed to become disabled by HIV or another condition to qualify for Medicaid.

“Medi-Cal expansion changed the universe for the HIV community,” Thompson said. “The program provides full care and drug treatment to people living with HIV, and covers PrEP (pre-exposure prophylaxis) and medical care for those most at risk of HIV.”

Treatment as prevention — treating people with HIV so that their viral levels become undetectable — and PrEP or pre-exposure prophylaxis which protects HIV negative individuals are the two main pillars of the President’s Plan to End HIV. Low-income gay and bi-sexual men of color continue to report the highest rates of HIV.

“Comprehensive well-managed care, treatment and prevention are the most cost-effective ways to curb healthcare costs and end HIV,” Thompson said. “The Administration’s continuing efforts to constrict coverage through Medicaid will only hinder efforts to end HIV and if implemented would likely result in more new HIV infections, worse health outcomes and ultimately increased costs to public healthcare programs.”

California state officials responded negatively to the new guidance but in the current political environment the state is unlikely to cap coverage for any portion of its Medi-Cal population.

For more comment on Administration efforts that conflict with the Plan to End HIV, follow this link to the national Act Now: End AIDS Coalition Statement.