The GOP Healthcare Repeal Will Kill My People

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By Ramon Gardenhire & Matthew Rose

Do Black gay lives matter to GOP Members of Congress? With all the discussion of repealing and replacing the Affordable Care Act, legislative action that would have destructive effects on minorities, it certainly seems like they don’t. And as variations of repealing and replacing the landmark reform move through the Senate, a more specific question comes to mind: Not only were we wondering if Blacks lives matter to the GOP Congress, but in particular—the lives of Black gay men?

As Black gay men working in the HIV policy field, we are surrounded by the realities of the modern HIV/AIDS epidemic and its devastating effects. Overall the epidemic has a disproportionate impact on the Black community, with the Centers for Disease Control and Prevention (CDC) estimating that 1 in 2 Black gay men will be diagnosed with HIV in their lifetime.

Working in the policy arena we are well aware of the realities and imperfections of the legislative process, but even we are stunned by the indifference towards these facts by some members of Congress. Nothing personifies this callousness more than the repeal of the ACA, which directly impacts the lives and wellbeing of tens of thousands of Black gay men in this country.

The ACA has afforded Black gay men comprehensive insurance coverage on par with their white counterparts for the first time. According to Kaiser Family Foundation, Black uninsured rates declined from 12 percent to 7 percent in a short two years. For the first time in generations, there was a significant way for Black people to gain access to tools that can proactively improve their health and wellness—and Congress cannot strip us of those tools by repealing the ACA.

“How is this different from previous systemic acts of aggression against people of color?”

The answer is that the conditions of our community are different and the opportunities to better those conditions, though narrow, can have profound effects to move our community forward. At an increasing rate, there are more people that look like us leading the movement, fighting to have our voices heard and engaging in the fight to stop the rising rate of HIV infections in our community through policies like the ACA. The more we can help shape policies that seek to erode the historical trend of HIV infections within the Black gay community, the better we will be.

If the ACA is repealed it will further deepen the systemic, socio-economic and racial inequalities that continue to manifest in this country and result in more HIV diagnosis among Black gay men. This fight is about all of us as a community, and collective action is what’s needed to turn the tide. Put bluntly, the Black community, and in particular Black gay men, are being ravaged by HIV and AIDS. As the CDC reports:

  • HIV rates are highest among young gay and bisexual Black men. A recent report highlights that a young Black gay man becoming sexually active today at the age of 18 has about a 60 percent chance of being HIV positive by the age of 40.
  • Only 54 percent of Blacks living with HIV are receiving continuous care, according to newly released data. 
  • Blacks account for 54 percent of new HIV cases in the South,.
  • In addition, a recent study suggests that 66.7 percent of Blacks between the ages of 18 and 65 years old have never been tested for HIV.

What does all this tell us? It’s a reminder that not all successes have been shared equally, that progress made with HIV has yet to reach every community, and that troubling racial disparities exist within our domestic HIV epidemic. There is a saying that when white America catches a cold, black America gets pneumonia. This sentiment never rang truer than right now, as it relates to HIV transmissions.

If the GOP successfully dismantles the ACA, given the alarming rates of HIV transmission in the Black gay community, there is no doubt this will culminate in the perfect storm of magnifying existing socioeconomic and health disparities, resulting in the deaths of Black gay men in the United States.

The ACA has improved healthcare access to millions of Americans, especially to members of our community. Prior to the ACA’s implementation, LGBTQ people had among the lowest insured rates of any U.S. population. Between 2013 and 2015, the percentage of LGBT adults without insurance decreased from 21.7 percent to 11.1 percent. However, we still have some headway to make to ensure we address the needs of Black gay men living with HIV.

The ACA, while not perfect, represents a significant step toward helping this country eradicate the virus and achieve full health equity.

It’s time that we contact our leaders in the House and Senate to demand they demonstrate that gay Black lives matter.

Ramon Gardenhire is Vice President of Policy for the AIDS Foundation of Chicago.

Matthew Rose is Policy and Advocacy Manager for the National Minority AIDS Council (NMAC).

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