News
Trumpcare appears defeated, but LGBT opponents remain wary
‘I don’t think we’ve heard the last from the GOP on healthcare’


President Trump poses in cab of firetruck on day GOP support for Trumpcare crumbles. (Image courtesy of C-SPAN)
After Republican support crumbled for Trumpcare, LGBT advocacy groups that sought to preserve the Affordable Care Act are quietly confident it will remain in place — although they say they’re keeping a watchful eye.
Late Monday night, two Republicans — Sens. Mike Lee (R-Utah) and Jerry Moran (R-Kansas) — announced they’d vote “no” on the latest version of the Better Care Reconciliation Act proposed by Senate Majority Leader Mitch McConnell (R-Ky.). With Sens. Susan Collins (R-Maine) and Rand Paul (R-Ky.) already opposed to the bill, the defections of Lee and Moran assured defeat of the bill if it came to the floor.
David Stacy, government affairs director for the Human Rights Campaign, said despite the apparent failure of Trumpcare, now is not the time to rest.
“While we’re glad to see the Trump/McConnell plan to strip health care from millions of Americans has failed up until this point, by no means are we claiming complete victory,” Stacy said. “The ACA provides unprecedented access to health care for LGBTQ people and we simply cannot afford for this access to be taken away. HRC will continue to engage our millions of members across the country and keep the pressure on Congress to reject any proposals to dismantle our health care system.”
LGBT groups like the Human Rights Campaign oppose Trump’s effort to repeal and replace the ACA on the basis that many LGBT people gained insurance as a result of President Obama’s signature legislative achievement and because the measure would deny Medicaid reimbursements to Planned Parenthood, which touts its health services for LGBT people.
McConnell has pledged to bring to the floor legislation in the coming days that would repeal Obamacare without offering any replacement — a move that in addition to eliminating health care for millions of people would explode the deficit.
Even though the same bill passed the chamber in 2015, it’s unlikely to pass this time around without assurance of a presidential veto. Key Republicans — Sens. Lisa Murkowski (R-Alaska) and Shelly Moore Capito (R-W.Va.) — have said they’d vote “no.” Collins voted “no” in 2015 and said she’d do so again.
Mara Keisling, executive director of the National Center for Transgender Equality, nonetheless cautioned “cynical efforts to hurt Americans for political purposes” may still be on the way despite projections Trumpcare is dead.
“We are not confident that efforts to defund Planned Parenthood are dead,” Keisling said. “We are not confident that efforts to take healthcare away from trans service members and veterans are dead. We will continue to fight side-by-side with so many allies to make sure our healthcare system is improved and not dismantled and made accessible only to the wealthy. We are extremely confident that our side will fight harder and with solidarity to protect people’s lives than the powers that be will fight to hurt us.”
After the loss of GOP support for the Better Care Reconciliation Act, President Trump took to Twitter to lambast lawmakers, blaming the failure on “all of the Democrats and a few Republicans.”
“Most Republicans were loyal, terrific & worked really hard,” Trump tweeted. “We will return!”
The White House has maintained Trump made phone calls to lawmakers and met with them to encourage their support for the Senate health care bill. On Wednesday, Trump was set to hold a working lunch at the White House State Dining Room with Republican members of Congress to discuss health care.
Nonetheless, the general perception is Trump has been disengaged from efforts to repeal Obamacare — a signature promise during Trump’s presidential campaign. On Monday, the same day GOP support for Trumpcare crumbled, Trump posed for a photo-op in the cab of a firetruck parked on the White House lawn for “Made in America” week.
White House Deputy Principal Press Secretary Sarah Huckabee Sanders blamed Democrats on Tuesday for the failure of Trumpcare, even though they’re in the minority in Congress and weren’t responsible for GOP withdrawal from the bill.
“They’re responsible for passing Obamacare,” Sanders said. “They’re responsible for creating the mess that we’re in. They’re responsible for being unwilling to work with Republicans in any capacity to help fix a system that they know is completely flawed and have publicly said so. I think that it’s pretty clear, and I think the responsibility lies on their shoulders.”
Gregory Angelo, president of Log Cabin Republicans, said contrary to expectations that Trumpcare is dead, he wouldn’t rule out Republican efforts to reform health care law.
“I don’t think we’ve heard the last from the GOP on healthcare,” Angelo said. “Whether it’s repeal, replace, reform, or some combination thereof, the continuing collapse of Obamacare, spikes in premiums and insurer exits from exchanges will necessitate that Republicans act sooner or later.”
Trump himself may take unilateral action. On Tuesday, he told reporters “we’re probably in that position where we’ll let Obamacare fail” in the aftermath of crumbling support for the bill.
“We’re not going to own it. I’m not going to own it,” Trump said. “I can tell you the Republicans are not going to own it. We’ll let Obamacare fail and then the Democrats are going to come to us and they are going to say ‘how do we fix it, how do we fix it’ or ‘how do we come up with a new plan?’”
Trump’s position for some time has been that Obamacare is a dead program, but his remarks raise questions about whether the Trump administration would seek to administratively undermine the Affordable Care Act, such as by denying subsidies to health care recipients who qualify for them.
At the White House, Sanders wouldn’t commit the president to support the subsidies and the executive sustenance required under the Affordable Care Act.
“As has been the case since we got here, we’ll continue to keep you posted as decisions and changes are made, or if they’re not,” Sanders said.
Meanwhile, bipartisan talks on health care are happening. Sen. Tom Carper (D-Del.) told the Daily Beast a bipartisan group of senators spoke Tuesday night about possible fixes to Obamacare that don’t involve repealing the law.
“Democrats, Republicans, and I think one independent slipped in as well,” Carper was quoted as saying. “I’m more encouraged at this point than I’ve been in quite some while that we might somehow be able to find a road, a path together.”
A major criticism from LGBT groups — as well as HIV/AIDS advocacy groups — was the inclusion in GOP plans to replace Obamacare of a provision to undo the Medicaid expansion under the Affordable Care Act. That rose the income level to qualify for care under that program to 133 percent of the poverty level — provided the states agreed to it.
An estimated 40 percent of people with HIV — a disease that still disproportionately affects LGBT people — received coverage under Medicaid.
Carl Schmid, deputy executive director of AIDS Action, said he expects Obamacare to remain the law and is “greatly relieved,” but nonetheless noted the need for change of the health care system.
“There is much that the administration can do through regulation to alter health care — private insurance plans and Medicaid — and [we] expect them to do that, actually they have started to make changes as well,” Schmid said. “As they make changes, we want to make sure they do not restrict access and benefits and loosen important patient protections. Legislative fixes are still needed, premiums and patient cost-sharing are too high, and we hope that they can happen on a bi-partisan basis.”
National
FDA approves new twice-yearly HIV prevention drug
Experts say success could inhibit development of HIV vaccine

The U.S. Food and Drug Administration (FDA) on June 18 approved a newly developed HIV/AIDS prevention drug that only needs to be taken by injection once every six months.
The new drug, lenacapavir, which is being sold under the brand name of Yeztugo by the pharmaceutical company Gilead Sciences that developed it, is being hailed by some AIDS activists as a major advancement in the years-long effort to end the HIV/AIDS epidemic in the U.S. and worldwide.
Although HIV prevention drugs, known as pre-exposure prophylaxis medication or PrEP, have been available since 2012, they initially required taking one or more daily pills. More recently, another injectable PrEP drug was developed that required being administered once every two months.
Experts familiar with the PrEP programs noted that while earlier drugs were highly effective in preventing HIV infection – most were 99 percent effective – they could not be effective if those at risk for HIV who were on the drugs did not adhere to taking their daily pills or injections every two months.
“Today marks a monumental advance in HIV prevention,” said Carl Schmid, executive director of the D.C.-based HIV + Hepatitis Policy Institute, in a statement released on the day the FDA announced its approval of lenacapavir.
“Congratulations to the many researchers who spent 19 years to get to today’s approval, backed up by the long-term investment needed to get the drug to market,” he said.
Schmid added, “Long-acting PrEP is now not only effective for up to six months but also improves adherence and will reduce HIV infections – if people are aware of it and payers, including private insurers, cover it without cost-sharing as a preventive service.”
Schmid and others monitoring the nation’s HIV/AIDS programs have warned that proposed large scale cuts in the budget for the U.S. Centers for Disease Control and Prevention by the administration of President Donald Trump could seriously harm HIV prevention programs, including PrEP-related efforts.
“Dismantling these programs means that there will be a weakened public health infrastructure and much less HIV testing, which is needed before a person can take PrEP,” Schmid said in his statement.
“Private insurers and employers must also immediately cover Yeztugo as a required preventive service, which means that PrEP users should not face any cost-sharing or utilization management barriers,” he said.
In response to a request by the Washington Blade for comment, a spokesperson for Gilead Sciences released a statement saying the annual list price per person using Yeztugo in the U.S. is $28,218. But the statement says the company is working to ensure that its HIV prevention medication is accessible to all who need it through broad coverage from health insurance companies and some of its own support programs.
“We’ve seen high insurance coverage for existing prevention options – for example, the vast majority of consumers have a $0 co-pay for Descovy for PrEP in the U.S. – and we are working to ensure broad coverage for lenacapavir [Yeztugo],” the statement says. It was referring to the earlier HIV prevention medication developed by Gilead Sciences, Descovy.
“Eligible insured people will get help with their copay,” the statement continues. “Gilead’s Advancing Access Copay Savings Program may reduce out-of-pocket costs to as little as zero dollars,” it says. “Then for people without insurance, lenacapavir may be available free of charge for those who are eligible, through Gilead’s Advancing Access Patient Assistance Program.”
Gilead Sciences has announced that in the two final trial tests for Yeztugo, which it describes as “the most intentionally inclusive HIV prevention clinical trial programs ever designed,” 99.9 percent of participants who received Yeztugo remained negative. Time magazine reports that among those who remained HIV negative at a rate of 100 percent were men who have sex with men.
Time also reports that some HIV/AIDS researchers believe the success of the HIV prevention drugs like Gilead’s Yeztugo could complicate the so-far unsuccessful efforts to develop an effective HIV vaccine.
To be able to test a potential vaccine two groups of test subjects must be used, one that receives the test vaccine and the other that receives a placebo with no drug in it.
With highly effective HIV prevention drugs now available, it could be ethically difficult to ask a test group to take a placebo and continue to be at risk for HIV, according to some researchers.
“This might take a bit of the wind out of the sails of vaccine research, because there is something so effective in preventing HIV infection,” Time quoted Dr. David Ho, a professor of microbiology, immunology, and medicine at New York’s Columbia University as saying.
National
Activists rally in response to Supreme Court ruling
‘We won’t bow to hatred: we outlive it’

Politicians, LGBTQ activists, and allies gathered at the Lutheran Church of the Reformation in the Capitol Hill neighborhood of Washington, D.C. on Wednesday following the ruling by the United States Supreme Court in the case of U.S. v. Skrmetti. The Supreme Court upheld a Tennessee ban on gender-affirming healthcare for transgender adolescents in a 6-3 decision.
A rally outside the U.S. Supreme Court was called for by the American Civil Liberties Union, Lambda Legal and other organizations following the high court ruling on Wednesday. However, due to a thunderstorm and flood watch, the scores of activists who were to attend the rally were directed to a Lutheran church down the street from the court. Undeterred, activists and community leaders were joined by U.S. Senators Ed Markey (D-Mass.) and Jeff Merkley (D-Ore.) for an indoor rally at the church.
“We know that freedom is not inevitable,” Markey told the crowd. “It is fought for by people who said ‘no’ in the face of health cuts, ‘no’ in the face of discrimination, ‘no’ in the face of invasive laws that ban life-saving and life-affirming healthcare and ‘no’ to this anti-justice, anti-freedom agenda.”
Also speaking at the rally was Deirdre Schifeling, chief political advocacy officer of the National ACLU.
“We believe transgender rights matter,” Schifeling stated. “Transgender kids matter and deserve love, support and the freedom to shape their own futures. I am still processing how the Supreme Court could disagree with such an obvious truth.”
“Today’s ruling shows us that unfortunately these attacks on our freedom will not end here,” Schifeling continued. “The Trump administration and extremist politicians across the country are continuing to target our right — our human right — to control our own bodies.”
“If politicians think that we are going to sit back and be defeated, that we are going to let them strip our rights and freedoms away without a fight, they’ve got another think coming,” Schifeling said. “We will never back down. We will never back down or give up. We will organize, we will mobilize and we will fight to protect trans rights in our communities, in our legislatures, in our elections, and in court rooms across the country.”

“Today, the highest court in this land decided that the bodily autonomy of trans youth, specifically trans youth of Tennessee and states with bans harming youth across the country do not matter,” said trans advocate Hope Giselle-Godsey.
“The opponents of trans equality think that today is a victory, but history will remember it as a moment that sharpened us and not silenced us,” Giselle-Godsey continued.
“So yes, today we grieve for the people in those states where those bans exist, but we grieve in motion,” Giselle-Godsey said. “To the system that thinks that it won today, just like every other time before: you will lose again. Because we won’t bow to hatred: we outlive it. We out-organize it. We out-love it. We are still here and we are not finished yet.”


The Washington Blade’s second day of Pride on the Pier at The Wharf DC ended with a fireworks show on Saturday, June 7. The fireworks show was presented by the Leonard-Litz LGBTQ Foundation.
(Washington Blade photos by Michael Key)
















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