Health Care Access

California bill would create statewide plan to address HIV, Hepatitis C, and other STIs

California Senator Scott Wiener introduced a bill, SB 859, which would require California to develop and implement a statewide masterplan to end new cases of HIV, the hepatitis C virus (HCV), and other sexually transmitted infections (STIs). The bill would require the Secretary of California Health and Human Services and the Chief Officer of AIDS to do three main things: 1) create and work with a Stakeholder Advisory Committee to develop and implement the plan, 2) work with agencies across the state to set attainable targets to end HIV, HCV and other STIs, and 3) identify recommended programs, policies, strategies, and funding to help achieve these targets.

If it passes, this would be the first comprehensive statewide plan to address HIV, HCV and STIs in the nation. In April 2019, more than 100 groups, including PWN, signed a statement calling for Governor Newsom to endorse a statewide strategy to end the HIV, HCV, and STI epidemics. So far, Newsom has not responded, but Senator Wiener’s bill could create more pressure on the state to develop a nuanced, strategic, and comprehensive plan.

Sexual and Reproductive Health, Rights, and Justice

Artwork by Micah Bazant for Forward Together

Department of Health and Human Services abortion billing rule could cause people to lose coverage

This month the Department of Health and Human Services (HHS) finalized a rule that will make it more complicated and burdensome for health plans to cover abortion care. The rule requires health care plans on the Affordable Care Act (ACA) marketplace to send patients two separate bills if their plan covers abortion services – one bill for the part of the premium that pays for abortion services and another for the rest of the coverage.

Federal funds cannot cover abortion services except in the limited cases of rape, incest, or life endangerment because of a measure known as the Hyde Amendment. States, however, can choose to fund the abortion care that pregnant people need. As of January 2020, five states require ACA marketplace plans to cover abortion; others have at least one marketplace plan that does so. In total, the rule will impact at least sixteen states and more than 3 million people across the county.

The rule is dangerous. It stigmatizes abortion care, making it seem separate from other reproductive health care services. It could raise the cost of abortion coverage for those who want it if others decide to not pay the separate bill. Additionally, the administrative and reporting burden could lead to health insurance plans dropping abortion coverage all together. The separate billing requirement will go into effect June 27, 2020.

Trump Administration allows Texas to silently “defund” Planned Parenthood

The Trump Administration has taken another step to cut off access to safe and qualified reproductive health care for people who need it. This case involves the Texas Medicaid family planning program. The Texas program lost federal funding in 2012 because it tried to stop certain qualified reproductive health care providers, most notably Planned Parenthoods, from participating.

On the 47th Anniversary of Roe v. Wade, the administration reinstated funds to Texas’ Medicaid family planning program and approved the state’s request to bar health care providers that perform abortions or are affiliates of abortion providers from the program. In effect, the state of Texas drastically slashed access to Planned Parenthood and put patients at risk. The development is particularly troubling because it is the first time a request to exclude qualified providers from a state Medicaid family planning program has been approved and could pave the way for more states to follow suit.


Ending Criminalization

The U.S. plans to collect and indefinitely hold DNA from people in immigration custody

An agency within the U.S. Department of Homeland Security (DHS) began a pilot program to force non-U.S. citizens detained at the border to go through DNA testing. Customs and Borders Protection (CBP) will collect DNA from people ages 14 to 79 who are apprehended and processed in the Detroit Sector (at the U.S.-Canada border) or the Eagle Pass Port of Entry (at the U.S.-Mexico border) and subsequently detained. The genetic data will then be sent to and retained by a Federal Bureau of Investigations (FBI) database, which holds forensic data from past and for future law enforcement investigations.

The 90-day pilot program will test the “operational impact” of an October 2019 DOJ proposed rule, which would require DHS to collect DNA samples from almost any non-U.S. citizens detained by government agencies. Put simply, this pilot program is a way to test whether the U.S. can eventually operationalize the mass collection and indefinite retention of genetic data from hundreds of thousands of detained people in a national criminal database. The potential indefinite genetic surveillance is xenophobic, suggesting that undocumented immigrants are more likely to commit crimes, and redoubles the violation of privacy of the original search.

Three House Democrats called on the Department of Homeland Security to stop the invasive DNA collection, calling it a “serious human rights issue” and raising concerns that it could be used to surveil American citizens and their family members.

Artwork by Repeal Hyde Art Project


New laws going into effect to help decrease incarceration rates

New Year. New laws. In January 2020 a host of new and exciting laws went into effect. Although this update will not cover them all, here are a few that will help address some of the flaws in the U.S. criminal justice system.

  • In California, SB 439 went into effect. The law protects minors under the age of 12 who commit non-violent offences from being prosecuted in juvenile court, instead requiring that they be released to a parent or guardian. This change aligns California with the United Nations Convention on the Rights of the Child.

  • Illinois became the eleventh state to legalize marijuana and the first state to do so through legislation rather than ballot initiative. The day before legalization went into effect, Illinois Governor Prtizker announced that his office would pardon 11,017 people previously convicted of low-level marijuana convictions. This is the first step to clearing the records of hundreds of thousands of people in the state who have low-level marijuana charges.

  • A New York law eliminating pretrial detention and cash bail for people convicted of most misdemeanors and nonviolent offenses went into effect. The Vera Institute of Justice estimates that 90 percent of all arrests statewide will be subject to mandatory release without money bail. People charged with crimes will now either be released on their own recognizance or with conditions such as pre-trial supervision. This is an important change in New York. Cash bail systematically discriminates against people of color, poor and low-income people, and has resonating consequences, often upending the lives of those who can’t afford bail while they await trial.

LGBTQ Rights, Safety and Justice

Proposed rules attack religious freedom and the right to non-discrimination for those accessing social service programs

On January 17, 2020, the Trump Administration published a trove of proposed rules that threaten greater faith-based discrimination in a wide array of social programs. The rules were posed by to the Department of Education, Labor, Health and Human Services, Homeland Security, Justice, Veteran Affairs, Agriculture, and the Agency for International Development (USAID). A similar proposed rule for the Department of Housing and Urban Development is expected.

The proposed rules would change existing regulations that apply to partnerships between the government and faith-based social service providers, such as Catholic Charities or the Salvation Army. In 2016 the Obama administration added important protections for people who uses those social service programs. These protections include written notice to beneficiaries of their rights; a prohibition on providers forcing beneficiaries to participate in religious activities; and a requirement that providers take reasonable steps for find an alternative provider if the beneficiary objects to the religious character of the provider.

The new rules would strip away some of the Obama-era religious freedom protection, including removing the written notice requirement and the alternative provider requirement. These rules put the interests of taxpayer-funded entities ahead of the needs and rights of people seeking critical services. People should never be forced to choose between accessing basic services and retaining their civil and religious protections. All eight proposed rules are open for public comment until February 18, 2020.

California affirms the rights and dignity for transgender youth in foster care

Landmark legislation affirming transgender rights went into effect in California this month after being passed in 2018. The bill, AB 2119, guarantees that youth in foster care will have access to health care that respects, affirms, and is consistent with their gender identity, including access gender-affirming health care, behavioral health, and mental health services. Providing young people of trans experience quality, culturally relevant, and non-stigmatizing gender-affirming care is not only the prevailing medical standard; it saves lives. The law is the first of its kind in the nation.


South Dakota bill would criminalize essential health care for transgender youth

On the other end of the spectrum, a bill in South Dakota, HB 1057, would criminalize health care for transgender minors in the state. The bill would make it a felony for medical providers to provide gender affirming care to transgender youth. HB 1057, unfortunately, is not the first of its kind in the nation. No similar bills have passed, but the spread of such anti-transgender bills are a dangerous attempt to stigmatize people of trans experience, deny access to necessary health care, and contravene best medical practice. The bill was introduced on the first day of legislative session and has passed out of committee.

Groundbreaking research documents how states collect gender identity information in HIV programs

A new report was released from the Southern AIDS Strategy Initiative (SASI). The report, called The Transgender Surveillance Report: Identification and reporting of gender identity among individuals diagnosed with HIV in the Deep South, documents how HIV surveillance programs in the Deep South collect gender identity information and the barriers to collecting the information. In many Deep South states, the current method for documenting gender identity is outdated and binary, resulting in incomplete and inaccurate information and hampering the appropriate allocation of resources for transgender people living with HIV. The report, however, suggests possible solutions and specific recommendations to improve HIV surveillance reporting.

Other Updates!