Latest news with #LindseyDawson
Yahoo
16-04-2025
- Health
- Yahoo
Health care could get more expensive for transgender people under a new Trump rule
Health care costs for transgender Americans could increase starting in 2026, if a recently proposed rule from the Centers for Medicare & Medicaid Services (CMS) is finalized. The agency wants to stop insurance sold on the individual and small-group marketplace from including gender-affirming care — a change that would affect coverage for trans people with marketplace plans. Doing so means that insurers could drop coverage for trans people entirely or that trans patients could see higher out-of-pocket costs, experts say. Although the rule would not ban coverage of gender-affirming care outright, it would disrupt care for a vulnerable population that faces disproportionate risks of living in poverty, being low-income and having greater medical needs. The proposed rule would affect 'essential health benefits,' services that individual and small-group marketplace plans are required to cover. Essential health benefits refer to basic care, like hospitalization, mental health services and prescription drugs, as mandated by the Affordable Care Act. Under the proposed CMS rule, insurers would be barred from covering those services as essential health benefits when provided to trans people as gender-affirming care. Experts say this new rule will raise health care costs for transgender people and possibly encourage health insurance companies to deny claims involving gender-affirming care, since the Trump administration is taking so many actions to oppose it. Carving out these restrictions would also burden health insurance companies, since gender-affirming care involves hospitalizations for surgery, mental health screenings and picking up hormone prescriptions: all services that count as essential health benefits. 'If plans don't cover gender-affirming care, it would of course impact anybody with marketplace coverage,' said Lindsey Dawson, director of LGBTQ Health Policy at KFF. 'They would allow plans to cover these services, but not allow it to be captured in cost-sharing reductions or premium tax credits. So basically it would lead to an increase in cost.' But, the proposed CMS rule also has the potential to impact even more people. 'There is a world in which this could raise out-of-pocket costs for trans people even on employer plans,' said Katie Keith, director of the Health Policy and the Law Initiative at the O'Neill Institute for National and Global Health Law at Georgetown University. The amount of money that trans people have to pay toward their deductible may go up, as well as out-of-pocket maximums. Even if a patient's gender-affirming care was covered by an employer plan, this policy would remove the spending cap required by the Affordable Care Act to keep those costs low, she said. Ultimately, this means that transgender patients would face higher costs than cisgender patients for many of the same treatments, Keith said. In the proposed rule, CMS acknowledges that some medical conditions, including precocious puberty, require the same medical treatment as gender-affirming care. The agency, which is located within the Department of Health and Human Services (HHS), is considering defining explicit exceptions to permit the coverage of such care as essential health benefits when it is for cisgender patients. 'They fully acknowledge these are general health care services that anybody could need, and they only want to limit them as essential health benefits for the purpose of treating gender dysphoria. It's extremely targeted at trans people,' Keith said. CMS argues that sex-trait modification is not typically included in employer plans and therefore cannot legally be covered as an essential health benefit. But coverage of gender-affirming care services in employer plans is fairly common, according to KFF. The health policy nonprofit found in a 2024 survey that about 24 percent of employers with 200 or more workers cover gender-affirming hormone therapy, while 50 percent of the largest companies in the country — those with with 5,000 or more workers — offer this coverage. Additionally, more than half of insurers providing silver plans — the most popular category in the ACA marketplace — currently cover medical treatments for gender dysphoria, according to a recent report from Out2Enroll, which reviews ACA plans for LGBTQ+ inclusion. Even the 24 states that explicitly prohibit transgender exclusions in health insurance could be affected under the new CMS rule. The proposal says that if any state requires coverage of gender-affirming care outside of a plan's essential health benefits, then that state will have to take on the extra cost. Olivia Hunt, director of federal policy at Advocates for Trans Equality (A4TE), said she sees this new proposal as part of the Trump administration's goal to undermine nondiscrimination protections for transgender people within the Affordable Care Act. The language of the proposal also seems to be designed to sow confusion as to what should be covered, she said. CMS refers to gender-affirming care as 'sex-trait modification,' citing President Donald Trump's executive orders that inaccurately describe gender-affirming care as 'chemical and surgical mutilation.' 'It's intended to further the messaging of this administration that well-attested medical care for trans people is somehow not a valid form of medical care,' Hunt said. In the past few months, the Trump administration has tried to restrict trans Americans' access to gender-affirming care by withholding federal funds to hospitals. Meanwhile, the White House has signaled its opposition to gender diversity as a whole and directed the National Institutes for Health to study regret rates of trans people who receive gender-affirming care. CMS is also telling states that they should not use Medicaid funds for gender-affirming care for minors. If finalized, this new CMS rule could cause legal issues related to the Affordable Care Act's Section 1557, which prohibits discrimination on the basis of race, color, national origin, sex, age or disability by health programs that receive federal funding. Specifically, those issues could arise if gender-affirming care is covered as an essential health benefit for cisgender people instead of trans people. The proposed policy is just one small piece of a larger proposal from CMS that, by one estimate, could cause up to 2 million people to lose their health care coverage in 2026. Experts have said that patients across the country could see higher premiums and out-of-pocket costs if the rule goes into effect. The post Health care could get more expensive for transgender people under a new Trump rule appeared first on The 19th. News that represents you, in your inbox every weekday. Subscribe to our free, daily newsletter.
Yahoo
20-03-2025
- Health
- Yahoo
Trump administration weighs deep cuts to CDC's HIV prevention program
Donald Trump's administration is reportedly mulling cuts to a public health program that accounts for nearly all federal spending on HIV prevention efforts, reaching thousands of people a year. With no other programs to replace them, cuts to the Centers for Disease Control and Prevention's HIV Prevention Division could jeopardize progress in addressing the nation's HIV epidemic and potentially cost lives, according to public health experts and LGBT+ advocacy groups. More than $1 billion was appropriated for HIV prevention efforts this year, and the agency spent roughly $1.3 billion on the prevention of HIV and sexually transmitted infections within the previous fiscal year. About three-quarters of that spending supports state and local health departments and nonprofit groups working to prevent HIV in their communities. In 2022, more than 22 million HIV tests were performed by 60 CDC-funded state and local health departments and community organizations, which connected roughly 8,000 people newly diagnosed with HIV to healthcare they may have otherwise not received. CDC support is 'extremely significant in terms of funding efforts' for HIV prevention, according to Lindsey Dawson, associate director of HIV policy and director of LGBTQ health policy with nonprofit health research and news organization KFF. 'The role of the CDC prevention funding is to provide states, local jurisdictions and community-based orgs with funding to do surveillance [and] HIV testing to help shore up prevention … including linking people to care,' she told The Independent. Threats to that funding follow declining numbers of new infections in the United States, which saw a 12 percent drop between 2018 and 2022. Those declines were even more dramatic in jurisdictions that received additional federal funding. Eliminating those funds will 'jeopardize' continued success and potentially lead to an increase in new infections, Dawson told The Independent. During his first term in office, Trump announced an initiative that sought to end the nation's HIV epidemic by 'focusing resources in the 57 jurisdictions where they're needed most.' The president's target date for 'Ending the HIV Epidemic in the U.S.' was set for 2030. Eliminating funding to combat the epidemic would make that virtually impossible. 'The success of the 'Ending the HIV Epidemic' initiative is in peril,' according to Colleen Kelley, chair of the HIV Medicine Association's board of directors. 'Not only will we not end the HIV epidemic with the current administration's policies, we could reverse these gains and go back to the dark days of the '80s when people died from HIV every day,' she said in a statement. LGBT+ advocacy groups fear those impacts would be particularly acute among LGBT+ Americans. 'An effort to defund HIV prevention by this administration would set us back decades, cost innocent people their lives and cost taxpayers millions,' according to Kelley Robinson, president of the Human Rights Campaign, the nation's largest LGBT+ civil rights group. 'This is not just a policy debate — it is a direct assault on the 1.2 million people living with HIV in the United States and countless others who are vulnerable to HIV,' she said. 'The LGBTQ+ community still carries the scars of the government negligence and mass death of the HIV/AIDS epidemic. We should be doubling down on our investment to end the HIV epidemic once and for all, not regressing to the days of funeral services and a virus running rampant.' A spokesperson for the Department of Health and Human Services — now under the direction of Secretary Robert F. Kennedy Jr — stressed to The Independent that a final decision on the CDC's HIV prevention efforts has not been made, and a timeline for a decision is unclear. 'HHS is following the Administration's guidance and taking a careful look at all divisions to see where there is overlap that could be streamlined to support the President's broader efforts to restructure the federal government,' deputy press secretary Emily G. Hilliard told The Independent. 'This is to ensure that HHS better serves the American people at the highest and most efficient standard,' she said. 'No final decision on streamlining CDC's HIV Prevention Division has been made.' If HHS does cut the program, that work would be continued elsewhere within the agency, according to a statement from an HHS official speaking on background about the administration's plans. But it's unclear where the agency could continue that work, and other agencies and programs focused on HIV are statutorily obligated to administer other forms of medical care, not prevention efforts, according to KFF. If that funding is wholly eliminated, the burden for prevention efforts would fall on state and local governments and cash-strapped community groups facing their own budget constraints against a shrinking pool of federal grant opportunities, forcing public health officials across the U.S. to make difficult decisions.
The Independent
19-03-2025
- Health
- The Independent
Trump administration weighs deep cuts to CDC's HIV prevention program
Donald Trump 's administration is reportedly mulling cuts to a public health program that accounts for nearly all federal spending on HIV prevention efforts, reaching thousands of people a year. With no other programs to replace them, cuts to the Centers for Disease Control and Prevention 's HIV Prevention Division could jeopardize progress in addressing the nation's HIV epidemic and potentially cost lives, according to public health experts and LGBT+ advocacy groups. More than $1 billion was appropriated for HIV prevention efforts this year, and the agency spent roughly $1.3 billion on the prevention of HIV and sexually transmitted infections within the previous fiscal year. About three-quarters of that spending supports state and local health departments and nonprofit groups working to prevent HIV in their communities. In 2022, more than 22 million HIV tests were performed by 60 CDC-funded state and local health departments and community organizations, which connected roughly 8,000 people newly diagnosed with HIV to healthcare they may have otherwise not received. CDC support is 'extremely significant in terms of funding efforts' for HIV prevention, according to Lindsey Dawson, associate director of HIV policy and director of LGBTQ health policy with nonprofit health research and news organization KFF. 'The role of the CDC prevention funding is to provide states, local jurisdictions and community-based orgs with funding to do surveillance [and] HIV testing to help shore up prevention … including linking people to care,' she told The Independent. Threats to that funding follow declining numbers of new infections in the United States, which saw a 12 percent drop between 2018 and 2022. Those declines were even more dramatic in jurisdictions that received additional federal funding. Eliminating those funds will 'jeopardize' continued success and potentially lead to an increase in new infections, Dawson told The Independent. During his first term in office, Trump announced an initiative that sought to end the nation's HIV epidemic by 'focusing resources in the 57 jurisdictions where they're needed most.' The president's target date for 'Ending the HIV Epidemic in the U.S.' was set for 2030. Eliminating funding to combat the epidemic would make that virtually impossible. 'The success of the 'Ending the HIV Epidemic' initiative is in peril,' according to Colleen Kelley, chair of the HIV Medicine Association's board of directors. 'Not only will we not end the HIV epidemic with the current administration's policies, we could reverse these gains and go back to the dark days of the '80s when people died from HIV every day,' she said in a statement. LGBT+ advocacy groups fear those impacts would be particularly acute among LGBT+ Americans. 'An effort to defund HIV prevention by this administration would set us back decades, cost innocent people their lives and cost taxpayers millions,' according to Kelley Robinson, president of the Human Rights Campaign, the nation's largest LGBT+ civil rights group. 'This is not just a policy debate — it is a direct assault on the 1.2 million people living with HIV in the United States and countless others who are vulnerable to HIV,' she said. 'The LGBTQ+ community still carries the scars of the government negligence and mass death of the HIV/AIDS epidemic. We should be doubling down on our investment to end the HIV epidemic once and for all, not regressing to the days of funeral services and a virus running rampant.' A spokesperson for the Department of Health and Human Services — now under the direction of Secretary Robert F. Kennedy Jr — stressed to The Independent that a final decision on the CDC's HIV prevention efforts has not been made, and a timeline for a decision is unclear. 'HHS is following the Administration's guidance and taking a careful look at all divisions to see where there is overlap that could be streamlined to support the President's broader efforts to restructure the federal government,' deputy press secretary Emily G. Hilliard told The Independent. 'This is to ensure that HHS better serves the American people at the highest and most efficient standard,' she said. 'No final decision on streamlining CDC's HIV Prevention Division has been made.' If HHS does cut the program, that work would be continued elsewhere within the agency, according to a statement from an HHS official speaking on background about the administration's plans. But it's unclear where the agency could continue that work, and other agencies and programs focused on HIV are statutorily obligated to administer other forms of medical care, not prevention efforts, according to KFF. If that funding is wholly eliminated, the burden for prevention efforts would fall on state and local governments and cash-strapped community groups facing their own budget constraints against a shrinking pool of federal grant opportunities, forcing public health officials across the U.S. to make difficult decisions.
