We have watched with horror and concern as the President of the United States and the U.S. House of Representatives have taken steps to strip millions of people of their access to both preventative health care and medical treatment. They have disregarded the physical and mental health of those who would otherwise go uninsured, impinged on the rights of women, people with HIV, and LGBQ\T communities, and threatened to put access to even basic health services out of reach for many survivors of sexual and domestic violence. Make no mistake: this is not just a health care issue, this is a civil rights and social justice issue. The American Health Care Act (AHCA), a bill that if codified into law, would strike a massive blow to the U.S. health care system and cause irreparable harm to countless survivors of gender-based violence across the country and here in the Commonwealth. Survivors of sexual and domestic violence are at high risk for long-term health consequences such as anxiety, depression, sleep deprivation, reproductive issues, and high blood pressure, to name a few. Survivors already face tremendous barriers to receiving services for myriad reasons, including stigma and lack of resources. The AHCA would make seeking medical help even more unrealistic for many survivors, as they could be denied coverage for seeking services in the aftermath of violence, lose coverage for essential health services, or lose their health care if Medicaid is drastically changed. As the Massachusetts Coalition Against Sexual Assault and Domestic Violence, JDI strongly condemns the passage of the AHCA and calls on all Massachusetts elected officials and community members to oppose this dangerous bill. Specifically, by attempting to repeal the Affordable Care Act (ACA) provision that prevents insurers from denying coverage or charging higher premiums for individuals with “pre-existing conditions,” survivors sexual or domestic violence could be denied coverage or charged more for necessary health care that they seek for issues resulting from past violence. The AHCA would also allow states to opt out of ACA provisions that require insurers to cover a minimum set of essential health benefits, including coverage for necessary services like mental health support and maternity care. Survivors deserve access to the full range of high quality physical and mental health care, not higher premiums or refusal of coverage. Of equal concern, the AHCA will deepen existing inequities in the U.S. health care system, leaving low-income, immigrant, LGBQ\T, disabled, and other underserved survivors without necessary health coverage. Ending Medicaid as an open-ended entitlement system would effectively strip $880 billion from the program over the next 10 years, making health care inaccessible for low-income and disabled survivors. It would freeze funds to entities issuing safe and much needed abortion services, including Planned Parenthood, with 80% of their clients at or below 150% of the federal poverty level. Currently, people of color account for more than half of those who are unable to access any affordable health coverage. LGBQ\T sensitive health care and research are still largely unavailable and underfunded, and the legacy of the HIV/AIDS crisis and stigma surrounding the gay community keeps HIV prep costs high, and screening/treatment difficult to access. And even with Medicaid expansions that have brought uninsured rates to historic lows in the U.S., 28.5 million individuals remained uninsured in 2015, with 46% of uninsured adults reporting that they tried to get coverage, but didn’t because the options were too expensive. The AHCA will deepen these inequities, disproportionately harming underserved communities, and dramatically worsening the health care crisis in the U.S. What we need and what we demand for survivors of all backgrounds is a health care system that centers people not profit, prevention not last minute intervention. We cannot accept a policy that will strip millions of individuals of their coverage, disproportionately harming survivors and historically underserved communities. We need a system that provides culturally specific, accommodating, and affordable services to all individuals-because health care is a human right. We applaud all of the U.S. Democrat and 20 Republican Representatives who voted no on the AHCA, including the entire Massachusetts Congressional delegation. As the issue is considered in the Senate, we will work alongside Senators Ed Markey and Elizabeth Warren to improve rather than to dismantle our nation’s health care system. To advocates, organizers, teachers, students, workers, and community members everywhere: let us unite in rejecting the AHCA and demand a system that protects survivors of sexual and domestic violence, and people of all backgrounds in the U.S. Together we must fight not only against the AHCA, but continue to fight for a health care system that works for and meets the needs of all people fairly and equitably. Thank you to our Northeastern University Cooperative Students, Rebecca Green and Ash Liu, for their help in researching and drafting this statement. 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Jane Doe Inc. Statement Regarding the American Health Care Act: A matter of justice