'Engine of retribution': Analyst says SCOTUS case could tee up Trump to wreck HIV care

A new Supreme Court case attacking the Affordable Care Act may not put the core provisions of the law in danger — but if the litigants get their way, it would give President-elect Donald Trump a new mechanism to cripple HIV care in the United States, wrote Charlotte Kilpatrick for The New Republic.

The case challenges the recommendations of the U.S. Preventative Services Task Force, which added coverage for a number of preventative procedures to insurance coverage requirements, including the HIV prevention medication PrEP — which right-wing Christian business owners in Texas don't want to cover. They argue the task force's recommendations are unconstitutional because its members weren't confirmed by the Senate.

These treatments save lives — and save the health care system money in the process, Kilpatrick wrote.

"Not only is it the humane thing to do, it also saves health insurers a lot of money. Just as it’s far cheaper to conduct a pap smear and catch cervical cancer in its early stages than it is to provide end-of-life care for those about to succumb to the disease, so too does preventative care lessen the burden of HIV on patients, doctors, and insurers."

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If the Supreme Court rules in favor of the business owners, Trump will get to re-appoint the board to issue new recommendations, she said — and it's unlikely they will keep the care requirements at issue.

"With public health potentially falling under the auspices of noted vaccine-cynic RFK Jr., parents with immune-compromised children will have another reason to worry that their child’s classmates aren’t up to date with their vaccines," she continued. "A woo-woo 'wellness'-obsessed Department of Health and Human Services secretary could also decide that mental illnesses, such as anxiety and depression, are best treated with meditation and the like, and cut mental and behavioral health services from the preventative care requirement. But the fallout from this change in command may fall most cruelly on those who live with HIV."

All of this harkens back to the bitter fights of the 1980s over HIV care, back when AIDS was effectively a death sentence and heavily associated in the public mind with the LGBTQ community — leading right-wing lawmakers like Sen. Jesse Helms (R-NC) to block federal funding for HIV prevention programs like Gay Men's Health Crisis.

"It is impossible to count just how many people of all backgrounds died from HIV as a result of Helms and the moral cowardice of 95 of his fellow senators," Kilpatrick wrote.

"HIV provided the perfect opportunity for politicians like Jesse Helms to further marginalize an already vulnerable population," she concluded. "'We’ve got to call a spade a spade,' he said to his fellow senators, 'and a perverted human being a perverted human being.' With a new administration openly beating their chests about transforming the federal government into an engine of retribution against disfavored groups, it’s simultaneously frightening to think how little has changed since the late 1980s, and how much could — very quickly — change again."