Back in 2013-2014, I had the incredible opportunity of working as the lead coordinator of a team of Arkansas In-Person Assister Guides (IPAs) during the roll out of Patient Protection and Affordable Care Act (ACA) in the state. I personally witnessed how the ACA changed the landscape of healthcare access in Arkansas and health literacy among every day Arkansans. In fact, the Natural State had the largest drop in uninsured people nationwide, plunging from 22.3 percent of the general population to 10.2 percent, according to Gallup. Some 360,000 Arkansans gained access to health care coverage, 250,000 of which through the state’s innovative Medicaid expansion program, the Private Option.

Arkansas’ new model for Medicaid expansion, the Private Option, allowed people who earned too much for Medicaid (around $12,000 for a single individual), but too little to qualify for subsidies offered under the federal market place (below 138 percent of the federal poverty level or $16,000 for a single individual) to access Medicaid through private insurance carriers.  Closing that gap alone meant that a quarter of a million people gained healthcare coverage. Among them were hundreds of the 5,584 HIV+ Arkansans who were able to get full coverage for anti-retroviral medication for the first time.  Many had been wait-listed for Ryan White Programs and the AIDS Drug Assistance Program (ADAP).  Many had been denied coverage due to pre-existing conditions. Many simply could not afford the exorbitant cost of their medications.

Now, with the impending repeal and replacement of the ACA with President Trump’s health care plan, many Arkansans could lose life-saving preventive health care, taking them back to square one. One population that is likely to be hit hardest is African American men who have sex with men (MSMs) aged 13-24. While this group represents a mere 3 percent of the state population, it accounts for 50 percent of new infections. Under the House and Senate repeal bills, immediate treatment after a HIV diagnosis could become elusive, as their plans rely heavily on refundable tax credits and prohibit Planned Parenthood from participating in essential public health programs. To learn how the new health care bill could affect the LGBTQ community nationwide, visit hrc.im/Healthcare.