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The Dictatorship

HIV is no longer a death sentence. Trump could change that.

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HIV is no longer a death sentence. Trump could change that.

NBC News reported this week that President Donald Trump’s administration is thinking about getting rid of the Center for Disease Control and Prevention’s division that focuses on HIV prevention and giving those responsibilities to the Department of Health and Human Services. There’s apparently another potential plan, a source told NBC News, that would cut up to $700 million from the CDC’s HIV division.

As a person who was diagnosed with HIV and AIDS in 2006, I’m dreading what comes next.

As a person who was diagnosed with HIV and AIDS in 2006, I’m dreading what comes next. Just how far will any of this go or end? When I was diagnosed, I was prescribed antiretrovirals, and, within months, my viral load dropped to undetectable levels. The virus has remained undetectable since then, and I am now healthy and thriving. I’ve come a long way from the opportunistic infections I was constantly dealing with at the time of my diagnosis.

Then, I was barely insured and terrified that I might never recover. Within months, my insurer rescinded my health insurance policy. How was I going to pay out of pocket for the costly medications I needed to keep me alive?

I soon learned about the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. It provides HIV primary care, treatment and supportive services for low-income people living with HIV. The law provides a safety net  that covers the copays for my HIV prescription, which would otherwise cost about $4,000 a month. This is stabilizing for my physical and mental health.

People living with HIV work very hard to suppress the virus so that it cannot be detected in our blood because if the virus is undetectable, then it is “untransmittable.” That is, it cannot be passed on to others through sex. In short, treatment is everything, and treatment is prevention.

Knowing we cannot expose our partners to HIV and pose no threat to others is affirming and liberating. It allows us to safely have pleasurable relationships with others and make babies.

The Trump administration has already worked to eliminate USAID and hamper PEPFAR (President Emergency Plan for AIDS Relief), which is credited with saving more than 26 million lives in 55 countries since its creation in 2003. Now, the CDC may be eliminating funding for HIV prevention or incorporating it into HHS’s Ryan White program. I and others in my community are nervous for the future of HIV treatment and the future of HIV prevention.

Treatment is everything, and treatment is prevention.

State and local health departments and community-based nonprofits depend on the CDC’s HIV division for HIV testing, HIV education, funding for the pre-exposure prophylaxis, or PrEP, funding and technical support in public health efforts. Removing funding for this could potentially fuel new cases. PrEP, when used correctly, can stop someone from acquiring HIV during intimate encounters.

Shoehorning HIV prevention services into the Ryan White HIV/AIDS program, which provides HIV care, could overburden the program. Resources to serve the 1.2 million people living with HIV in the U.S. are already stretched thin. Resources can be even scarcer in the Deep South, especially in its rural and urban areas.

At the same time, House Republicans seem bent on slashing Medicaid.

Many low-income or disabled people living with HIV depend on Medicaid for health care.

I am more concerned than ever about the unraveling of safety nets that wrap around not only people living with HIV but anyone with a chronic health condition. Some days, everything seems under threat.

Trump’s flurry of executive orders against DEI pose a particular danger to people like me, a Black person and member of the LGBTQ community. Many HIV prevention and treatment programs focus on LGBTQ people (sometimes trans people in particular), Black people and women. These programs for treatment and prevention may not be in alignment with Trump’s anti-DEI agenda.

Until this week, there was not a lot of talk from leaders in the HIV-positive community about preparing people living with HIV for potential service interruptions. In their defense, they didn’t have a crystal ball to predict this, and they have received no guidance from federal funding agencies. Nevertheless, that failure to plan or consider contingencies does not help clients or patients sleep better at night.

We can see from PEPFAR the consequences of reduced services or zero funding. Millions of lives are affected and rationing of medication and care has started in Africa.

When might we need to start to rationing medication or care in the U.S.? I could probably last a couple of months but what then? Being undetectable and healthy is great. We’re living long lives now and getting old.

Too many have fought hard to get the science where it is and to get the funding where it is.

Even though I am trying to remain hopeful that any reshuffling of the CDC or Ryan White will be minimal, I realize hope is not a strategy. Too many have fought hard to get the science where it is and to get the funding where it is.

Last year, I traveled to the southwest corner of France and noticed that many of the road signs were turned upside down. I was told farmers did that to protest government policies they opposed.

It seems to me that now’s the time to turn some things upside down in this country and fight back. We cannot let Trump make HIV a fatal disease again.

Dorian-gray Alexander

Dorian-gray Alexander is an opinionated person who muses about health, HIV and humanity.

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The Dictatorship

Justice Jackson chides ‘oblivious’ Supreme Court conservatives…

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Justice Jackson chides ‘oblivious’ Supreme Court conservatives…

WASHINGTON (AP) — Supreme CourtJustice Ketanji Brown Jackson has delivered a sustained attack on her conservative colleagues’ use of emergency orders to benefit the Trump administration, calling the orders “scratch-paper musings” that can “seem oblivious and thus ring hollow.”

The court’s newest justice, Jackson delivered a lengthy assessment of roughly two dozen court orders issued last year that allowed President Donald Trump to put in place controversial policies on immigration, steep federal funding cuts and other topics, after lower courts found they were likely illegal.

While designed to be short-term, those orders have largely allowed Trump to move ahead — for now — with key parts of his sweeping agenda.

Jackson spoke for nearly an hour on Monday at Yale Law School, which posted a video of the event on Wednesday.

Last week, Justice Sonia Sotomayor similarly talked about emergency orders in an event Tuesday at the University of Alabama that also took issue with the conservatives’ approach.

Jackson has previously criticized the emergency orders both in dissenting opinions and in an unusual appearance with Justice Brett Kavanaugh last month. But her talk at Yale, addressing the public rather than the other eight justices, was notable.

She referred to orders, which often are issued with little or no explanation as “back-of-the-envelope, first-blush impressions of the merits of the legal issue.”

Worse still, she said, was that the court then insists that “those scratch-paper musings” be applied by lower courts in other cases.

The orders suffer from an additional problem, she said, a failure to acknowledge that real people are involved, making them “seem oblivious and thus ring hollow.”

She also pushed back on the court’s assessment that preventing the president from putting his policy in place also is a harm that often outweighs what the challengers to a policy might face.

“The president of the United States, though he may be harmed in an abstract way, he certainly isn’t harmed if what he wants to do is illegal,” Jackson said during a question-and-answer session with law school dean Cristina Rodriguez.

The court used to be reluctant to step into cases early in the legal process, she said. “There is value in avoiding having the court continually touching the third rail of every divisive policy issue in American life,” Jackson said.

While she said she couldn’t explain the change, “in recent years, the Supreme Court has taken a decidedly different approach to addressing emergency stay applications. It has been noticeably less restrained, especially with respect to pending cases that involve controversial matters.”

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Jackson, often joined by Sotomayor and Justice Elena Kagan, has frequently dissented.

There have been conversations about emergency orders among the justices, Jackson said, but she decided to speak publicly with the goal of being “a catalyst for change.”

Also on Wednesday, Sotomayor issued a rare public apology to another justice, Kavanaugh, for what she termed “hurtful comments” she made last week during an appearance at the University of Kansas law school.

Referencing an opinion Kavanaugh wrote in an immigration case where the court granted an emergency order sought by the administration, Sotomayor said her colleague “probably doesn’t really know any person who works by the hour.” Her remarks were reported by Bloomberg Law.

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The Dictatorship

Trump threatens to fire Powell if the Fed Chair remains with central bank after his term ends

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Trump threatens to fire Powell if the Fed Chair remains with central bank after his term ends

WASHINGTON (AP) — Federal prosecutors made an unannounced visit this week to a construction site at Federal Reserve headquarters that is the focus of an investigation into a $2.5 billion renovation projectaccording to two people familiar with the visit.

Two prosecutors and an investigator from U.S. Attorney Jeanine Pirro’s office were turned away on Tuesday by a building contractor and referred to Fed attorneys, one of the people said. The two people familiar with the visit spoke on condition of anonymity because they weren’t authorized to publicly discuss an ongoing investigation.

The visit underscores that the Trump administration is not backing down from its investigation of the Fed and its chair, Jerome Powell, even though the probe has delayed the confirmation of a new chair nominated by President Donald Trump. The investigation is focused on cost overruns and brief testimony about the project last summer by Powell. Trump confirmed in an interview that aired Wednesday on Fox Business that he wants to continue the probe.

Last month, during a closed-door hearing before a federal judge, a top deputy from Pirro’s office conceded that they hadn’t found any evidence of a crime in their investigation of the headquarters project.

Robert Hur, an attorney for the Federal Reserve board of governors, sent an email to Pirro’s prosecutors about their visit and their request for a “tour” to “check on progress” at the construction site. Hur’s email, which The Associated Press has viewed, noted that U.S. District Judge James Boasberg concluded that their interest in the Federal Reserve’s renovation project was “pretextual.”

AP AUDIO: Prosecutors sought access to Federal Reserve building as Trump threatens to fire Powell

AP Washington correspondent Sagar Meghani reports on more drama surrounding a federal probe of a massive construction project at the Federal Reserve’s headquarters.

“Should you wish to challenge that finding, the courts provide an avenue for you; it is not appropriate for you to try to circumvent it,” Hur wrote.

Republican Tillis is key vote

Sen. Thom Tillis, a North Carolina Republican who is a key member of the Senate Banking Committee, has vowed to vote against Kevin WarshTrump’s nominee to replace Powell as Fed chair, until the investigation is dropped. With the committee closely divided on partisan lines, Tillis’ opposition is enough to block Warsh from receiving the committee’s approval.

Tillis on Wednesday criticized the investigation as “bogus, ill-timed, ill-informed” and repeated that seven Republican members of the banking panel have said they do not believe Powell committed a crime when he testified last June.

Tillis also said there aren’t enough votes on the committee or in the broader Senate to do an end-run around the committee and get Warsh confirmed some other way.

“There really is no path,” he told reporters, adding that Pirro and her aides were “asleep at the switch” because the investigation has essentially delayed Powell’s departure from the Fed, despite Trump’s obsessive criticism of the Fed chair. Powell has now said he won’t leave until the investigation is resolved.

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Tillis suggested Pirro blindsided the White House with her investigation. “They should have consulted with the White House, because I’m sure if they would have, (the White House) would have said, ‘no, we can wait,’” until Powell steps down.

But Kevin Hassett, the Trump administration’s top economist, said Wednesday that the Justice Department got involved because “the president wanted to investigate the cost overrun,” Axios reported.

The Banking panel said Tuesday that it will hold a hearing on Warsh’s nomination April 21. Powell’s term as Fed chair ends May 15, but Powell said last month he would remain as chair until a replacement is named.

Powell is serving a separate term as a member of the Fed’s governing board that lasts until January 2028. Chairs typically leave the board when their terms as chair end, but they can remain on the board if they choose. Powell has said he won’t leave until the investigation is resolved. If he remains it would deny Trump the opportunity to appoint someone else to the seven-member board.

Late Tuesday Tillis posted a link on social media to The Wall Street Journal’s article on the visit below an image of the Three Stooges and wrote, “The U.S. Attorney’s Office for D.C. at the crime scene.”

Investigation centers on building renovations

The investigation centers on an appearance by Powell before the Banking Committee last June, when he was asked about cost overruns on the renovations. The most recent estimates from the Fed suggest the current estimated cost of $2.5 billion is about $600 million higher than a 2022 estimate of $1.9 billion.

“It is probably corrupt, but what it really is, is incompetent,” Trump said. “Don’t you think we have to find out what happened there?”

The president’s support for the investigation threatens a timeframe set out by Sen. Tim Scott, a South Carolina Republican who chairs the Banking Committee. Scott said Tuesday on Fox Business that he believed the investigation would be “wrapped up in the next few weeks,” allowing Warsh to be confirmed soon after.

Threat to fire Powell

News of the unannounced visit by prosecutors comes as Trump has again threatened to fire Powell, if the Federal Reserve Chair decides to stay on the central bank’s governing board after his term as chair expires next month.

“Well then I’ll have to fire him, OK?” Trump said.

Trump has for months wanted to remove Powell, saying he has been too slow in orchestrating interest rate cuts that would give the U.S. economy a quick boost. Powell has said the investigation is a pretext to undermine the Fed’s independence to set rates.

Sen. Josh Hawley, a Missouri Republican, said Trump can only fire Powell “for cause,” meaning some kind of misconduct, “so that’s a pretty tall order.”

Supreme Court weighing another Trump removal

Trump’s threat to fire Powell comes as the Supreme Court is weighing the president’s effort to remove another central bank governor, Lisa Cook. Lower courts have so far allowed Cook to remain in her job while her legal challenge to the firing continues. The Supreme Court also seemed likely to keep her on the Fed when the court heard arguments in January. A decision could come any time.

The issue in Cook’s case is whether allegations of mortgage fraud, which she has denied, is a sufficient reason to fire her or a mere pretext masking Trump’s desire to exert more control over U.S. interest rate policy.

The Supreme Court has allowed the firings of the heads of other governmental agencies at the president’s discretion, with no claim that they did anything wrong, while also signaling that it is approaching the independence of the nation’s central bank more cautiouslycalling the Fed “a uniquely structured, quasi-private entity.”

___

AP Writers Seung Min Kim, Mark Sherman, Paul Wiseman, Alanna Durkin Richer, and video journalist Nathan Ellgren contributed to this report.

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The Latest: US blockade of Iranian ports ‘fully implemented’ as Trump says war is near end

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The Latest: US blockade of Iranian ports ‘fully implemented’ as Trump says war is near end

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