Access to healthcare is an essential part of my work advocating for LGBTQ+ communities and all people living with HIV/AIDS. My advocacy began at the height of the HIV/AIDS epidemic in the 1980s, and one important lesson of that work, among many, is that early screening and access to care save lives.
That’s why I’m so concerned about what could happen to over a million Georgians if Congress doesn’t act ahead of open enrollment. The enhanced premium tax credits that make Marketplace health insurance affordable are set to expire at the end of 2025. Without them, premiums are expected to jump by thousands of dollars, putting coverage out of reach for many hardworking families, including Georgia’s most vulnerable.
At Georgia Equality, our mission is to advance fairness, safety and opportunity for LGBTQ+ communities and our allies, including all people living with HIV/AIDS, across Georgia. At every step, one thing has been clear: When people have access to care, they live healthier, more stable and more dignified lives. If Congress allows these tax credits to sunset, they’ll be limiting access to care for more than 1.2 million Georgians – including those with chronic conditions and living in rural areas. According to recent figures, one in four people with chronic conditions across the country could lose access to care if the enhanced premium tax credits are not extended.
We all know healthcare is expensive. But for people with chronic illnesses like cancer, diabetes, heart disease or HIV, losing affordable coverage isn’t just a financial burden, it can be a matter of life and death. Without insurance, people are more likely to skip doctor visits, delay important screenings or ration their prescriptions. For the more than 60,000 Georgians living with HIV, missing doses of medication can mean the difference between managing the virus and facing devastating health consequences.
Regular screenings and early diagnoses save and improve lives, a universal truth for nearly all medical conditions. This is particularly true for those with HIV, who can protect both themselves and their partners by having access to antiretroviral medications that can help them maintain an indetectable viral load and therefore have effectively no risk of transmitting the virus. A loss of insurance could mean that individuals are no longer able to afford their medications, and for HIV, that means losing access to the tool that has stopped the spread of the virus.
The impact of allowing the enhanced premium tax credits to expire would be felt hardest in rural communities, where insurance premiums are often significantly higher. Rural residents are much less likely than their urban counterparts to have access to most kinds of healthcare services, and one in eight eligible men already live in HIV preexposure prophylaxis (PrEP) deserts. As a result, disparities in morbidity and mortality are widening. The enhanced premium tax credits allow rural Georgians to access the affordable healthcare they need. A reduction in federal support would further starve rural providers and could worsen the rural-urban health disparities.
I’ve seen firsthand how expanded access to care changes lives for the better. Georgia has come too far to turn back. We need to continue building a future where healthcare is within reach for every family, regardless of who they are, where they work or what health challenges they face.
