Uganda’s LGBTQ law poses dilemma for Biden

The ideas and innovators shaping health care

Jun 05, 2023 View in browser   By Carmen Paun, Ben Leonard and Erin Schumaker WORLD VIEW LGBTQ Ugandans face dire punishment under a new law. | AP Uganda’s passage of a law threatening to put LGBTQ people to death has created a moral quandary for President Joe Biden: whether to leverage U.S. foreign aid in protest. The President’s Emergency Plan for AIDS Relief, or PEPFAR, allocated some $400 million to Uganda in 2022. A no-go: But cutting some or all of that funding to try to convince the Ugandan government to repeal the law would deny access to treatment and care to the same people the law discriminates against: those living with or at high risk of contracting HIV, activists say. “We have 1.4 million people who are HIV positive who need lifesaving medication. So that support is very important and should continue,” said Richard Lusimbo, a Ugandan LGBTQ activist. Where it could hurt: Speaking to Carmen from Uganda, Lusimbo called on Biden to review U.S. funding that directly supports the Ugandan government. Last year, PEPFAR’s Uganda funding included $16 million that went directly to the government. “I’m certainly not saying all that should be cut, but it’s an important place to reassess government support,” said Beirne Roose-Snyder, senior policy fellow at the Council for Global Equality, a Washington-based group advocating for LGBTQ communities globally. Second time around: In 2014, when Uganda implemented a different anti-gay law, the Obama administration redirected part of its financial support for the country’s health ministry to nongovernmental organizations working in the country. It also reallocated nearly $3 million for a planned public health institute to another African country, barred Ugandans involved in LGBTQ rights violations from entering the U.S., halted support for Uganda’s community policing program and canceled a military aviation exercise. Uganda’s Constitutional Court annulled that law in August 2014. What’s next? Biden is considering visa restrictions and potential trade measures against Uganda. Asia Russell, the executive director of the Health GAP, which works to increase access to HIV treatment and prevention, said that any U.S. funding of organizations supporting the new law should be redirected. The law also could make PEPFAR’s activities in Uganda illegal, she said. That’s because they could be considered promotion of homosexuality, punishable with up to 20 years in prison.   DON’T MISS POLITICO’S HEALTH CARE SUMMIT: The Covid-19 pandemic helped spur innovation in health care, from the wide adoption of telemedicine, health apps and online pharmacies to mRNA vaccines. But what will the next health care innovations look like? Join POLITICO on Wednesday June 7 for our Health Care Summit to explore how tech and innovation are transforming care and the challenges ahead for access and delivery in the United States. REGISTER NOW.     WELCOME TO FUTURE PULSE Norris Geyser Basin, Yellowstone National Park | Sam Oates This is where we explore the ideas and innovators shaping health care. Your workplace wellness challenge might make you better at your job. Exercising today could improve your job performance tomorrow, Harvard Business Review reports. That may be because physical activity is linked to better sleep, decreased body pain and more focus. Share any thoughts, news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com, Carmen Paun at cpaun@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, host Katherine Ellen Foley talks with POLITICO’s Michael Schaffer about an unfounded claim by Steve Bannon, former adviser to President Donald Trump, that Florida Gov. Ron DeSantis is autistic — and the reaction from the autistic community to Bannon’s baseless attack that's reinforcing discriminatory attitudes about people with disabilities. TECH MAZE The Biden administration is pushing forward with a new system for sharing health records. | Christopher Furlong/Getty Images Secure sharing of patient records would likely improve care and avert medical errors, the Biden administration believes. So a new survey of hospital executives has good news: There’s a lot of enthusiasm about joining the Trusted Exchange Framework and Common Agreement, HHS’ effort to make record-sharing routine. Fifty-one percent of respondents said they’ll join TEFCA, according to an American Hospital Association study touted by HHS’ national coordinator for health information technology. Just 1 percent said they were aware of the project but didn’t plan to take part. Twenty-three percent said they knew about TEFCA but were unsure they’d join, while a quarter were uaware of it. HHS’ plan: Under TEFCA, organizations can become qualified health information networks — which allows them to share patient health data electronically — by signing a data-sharing agreement and adopting necessary infrastructure. The initiative also aims to expedite data-sharing among health care organizations and accelerate public health agencies’ information exchange with doctors, hospitals and other health care providers. Even so: Digging deeper into the survey data reveals disparities in awareness of TEFCA. Close to half of independent and critical-access hospitals didn’t know about it. That means less than a third of those hospitals said they planned to take part. Why it matters: If critical-access hospitals — which serve rural areas — and other organizations without enough resources lag behind, it could exacerbate health disparities by impeding continuity of care. “A key goal of TEFCA is to shrink this digital divide by shining a light on these gaps, lowering the cost and complexity of interoperability, and identifying resources to support broader access to nationwide interoperability networks,” the Office of the National Coordinator for Health IT said in a blog post. The office said it will continue to craft educational resources about the project and expects qualified networks will “engage in significant outreach” to boost awareness.   GET READY FOR GLOBAL TECH DAY: Join POLITICO Live as we launch our first Global Tech Day alongside London Tech Week on Thursday, June 15. Register now for continuing updates and to be a part of this momentous and program-packed day! From the blockchain, to AI, and autonomous vehicles, technology is changing how power is exercised around the world, so who will write the rules? REGISTER HERE.     WASHINGTON WATCH A House committee will consider Walberg's telehealth bill tomorrow. | Getty Images It’s a big week in Congress for telehealth. Two high-profile committees, the Ways and Means and the Education and the Workforce panels, are set to mark up virtual care legislation, Ben scooped. On Tuesday, the Education and Workforce Committee will mark up the Telehealth Benefit Expansion for Workers Act of 2023, which would allow employers to offer telehealth services as a tax-free benefit separate from other health plans. That legislation from Rep. Tim Walberg (R-Mich.) would revive and permanently extend a pandemic provision that expired along with the public health emergency last month. Despite substantial industry support, Democrats have expressed reservations about the bill, with some raising concerns that consumers could be misled into thinking the telehealth plans are more comprehensive than they are. On Wednesday, the Ways and Means Committee is set to mark up legislation by Rep. Michelle Steel that would permanently extend another pandemic-era policy, allowing high-deductible health plans to pay for telehealth before patients hit their deductibles, according to three lobbyists. Congress recently extended that provision from the public health emergency through the end of 2024. The Steel bill has six Democratic co-sponsors, but Democrats have historically been less enthusiastic about boosting high-deductible health plans than Republicans, arguing they are a workaround to the Affordable Care Act and primarily benefit wealthier people. A Ways and Means spokesperson didn’t respond to requests for comment.   Follow us on Twitter Ben Leonard @_BenLeonard_ Ruth Reader @RuthReader Carmen Paun @carmenpaun Erin Schumaker @erinlschumaker   Follow us

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