Hillary Clinton has touched a nerve with her attacks on Bernie Sanders in a new docuseries premiering on Hulu and a subsequent interview with the Hollywood Reporter. In the docuseries, Clinton paints Sanders as an isolated career politician who failed to achieve anything meaningful in the Senate. “Nobody likes him, nobody wants to work with him, he got nothing done,” Clinton said.
While it was Clinton’s comments about “Bernie bros” and her initial reluctance to say whether she would support Sanders if he won the Democratic nomination that set off a firestorm of controversy, her comments on Sanders’s congressional record were what struck me.
Regardless of which candidate one prefers, it’s hard to deny Sanders’s record of accomplishments over the years. When I saw Clinton’s statement, I immediately thought about the extremely bloody civil war in Yemen, where US-made weapons have killed civilians. Last year, Sanders worked with Republicans to pass a historic war powers resolution to end US support for the Saudi-led coalition fighting in Yemen. It was a stinging rebuke of President Trump, who vetoed it. In 2014, Sanders worked with Republican Sen. John McCain to pass a $16.3 billion health care bill for veterans that was badly needed after years of war overseas.
But most of all, I thought about CrescentCare, the federally qualified community health center where I see my primary doctor. Established in 2014 by a local organization fighting HIV in New Orleans, CrescentCare has had a big impact on the lives of many people in my community — and my own.
Sanders has slipped funding for community health centers in several health care bills over the years, but his biggest achievement came in 2010 as Congress was nearing the end of a bitter battle over the Affordable Care Act (ACA). After a series of high-stakes political negotiations, Sanders secured $11 billion in funding for these federally subsidized clinics that, by law, must operate in communities considered medically underserved due to poverty, elevated health risks, and a shortage of health care providers. Thanks to that funding and the ACA’s expansion of Medicaid, community health care clinics across the country were able to expand and new ones opened their doors, including CrescentCare.
For Sanders, supporting community health centers was one way to partially fulfill the dream of a health care system for everyone, because these centers provide care for lower-income people and underserved communities who otherwise might simply go without it. The centers often serve recipients of Medicaid, the government insurance system for lower-income people. However, they also serve people with private insurance or no insurance who have underserved medical needs. I have private insurance subsidized by my employer, but I chose CrescentCare because it’s the first and only LGBT-positive health care provider I have ever had.
Sanders’s funding also struck a chord among some conservatives, because so many community health centers are the only affordable, quality source of primary care for many people living in rural, lower-income areas. In 2015, the Intercept obtained letters from congressional Republicans praising the ACA funding for the clinics because they are so vital to people living in their districts. In this way, Sanders effectively bridged a deep ideological divide.
By 2016, federally qualified community health centers were serving 25.9 million children and adults — more than one in twelve people — in over 10,400 urban and rural locations, according to the Kaiser Family Foundation. Community health centers have been around for decades and have steadily grown due to their proven track record of improving health in underserved communities. They are run by local residents and patients, and each center has its own mission shaped around local needs.
New Orleans fit the definition of a medically underserved community, particularly in the years after Hurricane Katrina devastated its most economically vulnerable. By 2014, New Orleans and Baton Rouge were at the top of the national list for new HIV diagnoses, and southern Louisiana was widely seen as “ground zero” for the HIV epidemic.
Even in high-risk populations, HIV is very preventable and very treatable when the right medical tools are available. However, that availability has never been a given. HIV rates have long been particularly high among lower-income gay and bi black men and transgender women of color, who are at particular risk of HIV but often have trouble accessing consistent reproductive care due to social stigma and a dearth of LGBT-friendly health care providers. Access to health care in a supportive atmosphere is crucial for containing HIV, and if sky-high HIV rates are any evidence, lower-income people in New Orleans were not getting that supportive access.
CrescentCare was founded in 2014 by the New Orleans AIDS Task Force, a pro-LGBT group that has battled HIV for thirty years. While the clinic provides a range of services from mental health care to dental to anyone who walks in, preventing and treating HIV is a major part of its mission. The clinic has championed the distribution of PrEP, a drug that prevents HIV infections. CrescentCare also runs a harm-reduction clinic with a syringe exchange, which is considered the gold standard for preventing HIV. The clinic’s staff have built a welcoming and inclusive atmosphere, because they know social stigma around HIV and LGBT identities can be a significant barrier to health care access.
Nobody enjoys getting tested for sexually transmitted diseases; it can be uncomfortable and nerve-wracking. But when I walk into CrescentCare for my regular screening, the walls are covered in art created by my friends in the local LGBT community. Staffers wear stickers stating their preferred gender pronouns, and posters referencing local hip-hop culture are subtle but affirming signs that everyone is welcome. For the first time, I can talk openly with my doctor about my queer lifestyle and sexual practices without fear of judgment. It’s hard to put into words how much this has improved my life, and I’m a cis white man. For an injection drug user or a transgender woman of color living on the margins, access to medical care free of stigma and judgment can mean the difference between life and death.
Last year, new HIV diagnoses hit a record low in Louisiana, with fewer than one thousand people diagnosed in the entire state. Experts credited the state’s decision to expand Medicaid, which gave more people access to STD screenings and HIV medications that keep patients healthy and prevent the virus from spreading. There’s still plenty of work to do in New Orleans, where new HIV diagnoses continue to rise — in part because more people are getting tested and receiving treatment, the first step toward containing HIV in the long-term and a central facet of CrescentCare’s mission.
Unfortunately, federal funding for Medicaid and community health clinics is on the rocks under the Trump administration and the GOP-controlled Senate. Uncertainty about federal funding has forced community health centers nationwide to consider hiring freezes and delay expansions and improvements in infrastructure, and if Congress fails to act by a May 22 deadline, clinics may be forced to scale down crucial services. Along with other progressive Democrats, Bernie Sanders and Elizabeth Warren are at the forefront of the fight to continue providing community health centers with robust federal support.
Incidentally, back in 2016, Hillary Clinton’s presidential campaign announced a plan to expand funding for community health centers. Clinton was in the thick of an intense primary run-off against Sanders, and the proposal was seen as an attempt to peel progressive voters away from the socialist from Vermont. If her latest attacks on Sanders are any evidence, the memory of Sanders’s push to make more clinics like CrescentCare possible has since slipped from her mind. But those of us benefitting from these clinics’ crucial services have not forgotten.