While federal legislators stall on large-scale health care reform, state houses are taking the matters into their own hands—particularly in Republican-controlled states leveraging the Trump Administration’s willingness to alter federal health regulations in programs like Medicaid, which covers approximately 40% of people living with HIV currently in care. See an update of current state-level actions on Medicaid below.


The Trump Administration has approved a waiver from Tennessee to “block grant” their Medicaid program, meaning that instead of cost-sharing between the federal and state governments, the state will receive only a to-be-determined amount of funding to cover Medicaid expenses. This formula essentially institutes a cap on enrollment, as Tennessee will only provide coverage for a set number of people as opposed to working with the federal government to cover all who are eligible.


Governor and presidential candidate Steve Bullock signed into law earlier this month a renewal of the state’s Medicaid expansion, first enacted in 2015. However, in this new iteration of the law that extended health coverage to 96,000 additional people in the Treasure State, state Republicans insisted on including work requirements – an alteration that is expected to kick between 4,000-8,000 of those off of their insurance again. 


Despite Governor Tony Evers winning voter approval in major part due to his proposal to expand Medicaid in the 2018 midterm elections, Medicaid expansion in Wisconsin has been rejected by Republican state lawmakers who consider the program fiscally unsustainable. The latest blow to the health coverage proposal comes after months of these same legislators defying the will of the people and unilaterally limiting the powers of the Democratic governor and attorney general.


President Trump has reportedly directed Health and Human Services (HHS) Secretary Alex Azar to work with the Florida state government – including for their Medicaid program – on a proposal to wholesale import FDA-approved drugs from Canada. Though not supported by many Republicans in the federal government, including Azar himself, the plan seeks to reduce prescription drug prices for consumers. 

For the rights to care and treatment of people living with HIV, AIDS United stands firmly against actions on state Medicaid programs that will reduce coverage, including the implementation of work requirements, block grants, or rejection of the people’s will in neglecting expansion. Check back to the AU Policy Update regularly for the latest info on the programs, funding, and legislation that support people living with HIV.