Medicaid on the chopping block

HIV advocates are urging people to contact their members of the U.S. House Representatives to tell them to vote against the proposed federal budget approved Tuesday morning by the Senate. The Republican budget plan would cut nearly $1 trillion from Medicaid and other health programs.

“More than 40% of adults with HIV rely on Medicaid to cover their healthcare,” said AIDS United in a statement following the Senate vote. “And in states that have adopted Medicaid expansion, more than half of adults with HIV have gotten coverage that way. Medicaid is critical to keeping rural hospitals open and is the backbone of our entire healthcare system.”

On Tuesday the Senate voted 50-50, with Democrats and Republicans evenly split, leaving vice president JD Vance to cast the tie-breaking vote. The Senate version has even more drastic cuts than what was first passed by the House; the budget plan has gone back to the House as a “reconciliation bill,” which Republican leaders, headed by House Speaker Mike Johnson (R-Louisiana), vow to get approved by July 4, the deadline set by president Donald Trump.

HR-1 (Trump has called it, “the big beautiful bill”) would make permanent income tax cuts that were passed under Trump’s first term and create new tax breaks—such as for tips and overtime pay—which he had promised during the 2024 presidential campaign.

To pay for these tax cuts, Republicans propose a major cut in Medicaid. As a result, nearly 12 million people will lose their health care coverage, estimates the nonpartisan Congressional Budget Office. 

“Now is the time for everyone to reach out to your Representative and urge them to vote ‘no’ on cutting Medicaid and ‘no’ on HR-1,” said Rachel Klein, deputy executive director of The AIDS Institute. “The most effective way to communicate with Representatives is [phone] calls, but don’t discount sending an email or posting on social media—especially if you can ‘tag’ your Representative in your post. The most important thing is that they hear from you, your friends, family, neighbors and colleagues right away, and every day, until this bill is defeated.”

To find the U.S. Representative from your district and the U.S. Senators of your state, go to ballotpedia.org/Who_represents_me.

Call the Capitol Switchboard at (202) 224-3121 and ask for your Senator and Representative by name.

“Lead with your story; tell them how this is going to impact your life,” said Barb Cardell, director of leadership development at Positive Women’s Network - USA (PWN-USA). “Our voices are needed now. If you have never made calls to your elected representatives and need help, reach out to me.” Cardell offered her email address: barb@pwn-usa.org.

“At 74, I have been fortunate to receive the healthcare benefits afforded to me by federally sponsored programs,” said Jessi Mona Cartwright-Biggs, co-chair of PWN-USA’s Greater Houston Area chapter. “As a long-term thriver of living with HIV for decades, medication has literally sustained my health! Without health insurance I cannot live long!”

To Trump and Republicans, she added: “Your [so-called ‘big beautiful bill’] is literally killing me! Where do I go from here? Stop the bill! I need my pills!”

“This is a moment of truth,” said Klein of The AIDS Institute. “The evidence is clear: this bill will increase uninsurance, worsen health outcomes, and ruin our chances of ending the HIV epidemic in the U.S. It will cost health care providers more than $1 trillion, resulting in job losses and economic upheaval, especially in rural communities. We are calling on every member of the House to reject this dangerous legislation and stand with the people they were elected to serve.”

AIDS United offers a fact sheet and resource page for contacting members of Congress: aidsunited.org/action/policy-action-center/house-medicaid/.

“People living with and affected by HIV have powerful voices—and now is the time to use them,” said Terri L. Wilder, HIV and aging policy advocate at SAGE. “Call your U.S. Senators and Representatives and urge them to protect Medicaid and other life-saving programs. Ask five friends to make calls too. Write a letter to the editor or a short op-ed for your local paper sharing why these programs are vital to your health and your community. Our stories and our advocacy can stop harmful cuts. We’ve fought too hard to go backwards.”

While advocates urged people to reach out to all House members, they acknowledged that lists were circulating on Capitol Hill that highlight key House Republicans, including:

Don Bacon (Nebraska, 2nd Dist.)

Rob Bresnahan (Pennsylvania, 8th Dist.)

Juan Ciscomani (Arizona, 6th Dist.)

Brian Fitzpatrick (Pennsylvania, 1st Dist.)

Andrew Garbarino (New York, 2nd Dist.)

Jeff Hurd (Colorado, 3rd Dist.)

Dave Joyce (Ohio, 14th Dist.)

Jen Kiggans (Virginia, 2nd Dist.)

Young Kim (California, 40th Dist.)

Nick LaLota (New York, 1st Dist.)

Mike Lawler (New York, 17th Dist.)

Nicole Malliotakis (New York, 11th Dist.)

Mariannette Miller-Meeks (Iowa, 1st Dist.)

Dan Newhouse (Washington, 4th Dist.)

Zach Nunn (Iowa, 3rd Dist.)

David Valadao (California, 22nd Dist.)

Jefferson Van Drew (New Jersey, 2nd Dist.)

Rob Wittman (Virginia, 1st Dist.)

Activists and advocacy groups have organized under the #SaveHIVFunding campaign, a coalition led by PrEP4All, a D.C.-based PrEP advocacy group for HIV prevention, in collaboration with AVAC and the HIV Medicine Association, with guidance from the People Living with HIV Caucus and Positive Women’s Network - USA. To join the coalition or keep up to date on its actions via the group’s weekly Zoom calls, go savehivfunding.org.