Trump Promises to End AIDS and Protect Preexisting Conditions. Seriously?

By | February 6, 2020
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For the second year in a row, President Trump mentioned HIV/AIDS and health care coverage in his State of the Union (SOTU) address. But this is the same president that The Washington Post claims “made 16,241 false or misleading claims in his first three years.” Can you believe his statements? Let’s parse his claims, with help from the country’s leading AIDS advocates, in the form of their tweets about the SOTU.

Last night, February 4, Trump promised the nation that “we will eradicate the AIDS epidemic in America by the end of the decade.” Trump also promised this: “I have also made an ironclad pledge to American families: We will always protect patients with preexisting conditions—that is a guarantee. And we will always protect your Medicare and your Social Security.”

And he bragged that last year “for the first time in 51 years, the cost of prescription drugs actually went down.”

First, the good news. Yes, it is feasible to end the AIDS epidemic in America by 2030 (this is not the same as having zero cases of HIV). In fact, after last year’s SOTU, Trump launched the “Ending the HIV Epidemic: A Plan for America” initiative. POZ readers are familiar with treatment as prevention, Undetectable Equals Untransmittable, and prevention methods such as pre-exposure prophylaxis (PrEP), all of which make ending the epidemic a realistic goal.

Leading HIV organizations working together as Partnership to End HIV, STIDs and Hepatitis, released this statement after Trump’s SOTU:

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“We welcome the President’s commitment to this issue and stand ready to work with the Administration to end the HIV epidemic in the United States by 2030. The progress we’ve made as a country is encouraging, but we know the most difficult work still lies ahead. We have the tools to end HIV once and for all, but we must back it up with sound and sensible policies that expand access to stigma-free care, lift up vulnerable populations like our Black and Latinx communities, protect LGBTQ individuals from discrimination, and address rising STD and viral hepatitis rates. Only then will we rise to the challenge and truly eradicate this epidemic.”

The problem with Trump’s AIDS initiative is best summed up in this recent headline from Mother Jones: “Trump Promised to Eradicate HIV at Last Year’s SOTU. So Far, His Results Are Meh: Probably because he keeps rolling back other vital health care for vulnerable communities.”

NPR fact-checked Trump’s speech and underscored Mother Jones’s point:

“Congress just fully funded the first year of the president’s plan to end the HIV epidemic by 2030—it allocated about $ 291 million. Not a whole lot has happened related to that plan yet, since the funding came through only a few weeks ago. Public health experts say that the plan to end the HIV epidemic is well crafted and promising but that other actions taken by the administration—including proposing changes to Medicaid that could lead to cuts and removing a variety of LGBTQ discrimination protections—could end up undermining those efforts.”

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The issue of protecting preexisting conditions is easier to deem true or false. As CNN’s fact-checking article puts it:

“Trump’s claim about protecting those with preexisting conditions is false. Though Trump says he would do this, his administration has consistently taken steps to undermine the Affordable Care Act—including joining a lawsuit aimed at striking down the law—without presenting alternative plans that would offer similar benefits.”

Regarding generic meds and health care insurance, Trump boasted:

“Before I took office, health insurance premiums had more than doubled in just five years. I moved quickly to provide affordable alternatives. Our new plans are up to 60 percent less expensive, and better.

“My administration is also taking on the big pharmaceutical companies. We have approved a record number of affordable generic drugs, and medicines are being approved by the FDA [Food and Drug Administration] at a faster clip than ever before.”

In sizing up those claims, NPR writes:

“The cheaper plans Trump refers to are association health plans and short-term health plans that don’t have to offer the 10 essential benefits required in insurance plans by the Affordable Care Act. These “skinny” plans often do have low premiums but can cost people in other ways: For instance, you might pay only $ 70 a month in premiums but have a deductible that’s $ 12,500, so if you get really sick or get into an accident, you could be in serious financial straits.

“The Trump administration’s Food and Drug Administration has been approving lots of new and generic drugs. However, many newly approved generics have not come to market, meaning they can’t drive prices down.”

CNN adds this about Trump’s claim that the cost of prescription drugs dropped for the first time in 51 years:

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“That’s not quite true. The President was citing the 12-month change in the consumer price index for prescription drugs for December 2018, when it dropped 0.6%. That was the largest (but not the first) decrease since April 1973, not in 51 years. At last year’s State of the Union he said drug prices experienced their single largest decline in 46 years.

“More importantly, recent data shows that drug prices have continued to rise by several measures.

“The list price of brand-name drugs rose 3.2%, on average, over the 12 months ending in September 2019, after adjusting for inflation, according to SSR Health, a consulting firm that captures about 90% of these medications sold in the U.S.

That’s similar to the increase for drugs sold at the pharmacy and through mail order. The annual change in the consumer price index for prescription drugs was 3% in December, the third straight positive reading and its highest rate since June 2018, according to Altarum, a nonprofit.”

For more insight into plans to end the HIV epidemic, check out this excellent VOX article “Trump Called for an End to AIDS in the US by 2030. It’s Totally Realistic,” in which seven HIV experts weigh in on his SOTU pledge.

And don’t miss the POZ overview “Plans to End the HIV Epidemic at Home and Abroad.”

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