We Will Not Be Silent—Health Care Justice Is Non-Negotiable [on H.R.1 [119th]]
July 3, 2025
Dear Community, Partners, and Supporters,
Let’s be clear: what passed in Congress is not a budget bill. It’s a declaration of disregard. It is a targeted assault on the lives, dignity, and futures of millions of people, predominantly Black, brown, LGBTQ+, and low-income communities. What they’re calling “fiscal responsibility” is, in fact, a deadly rollback of essential care and public support. Medicaid is our nation’s largest HIV care provider, a cornerstone for trans health equity, and a vital safety net. It is under attack. And we will not sit quietly.
As a Black transgender woman, a public health leader, and someone who has spent her life fighting for communities pushed to the margins; I refuse to let this moment pass without naming it for what it is: cruelty masquerading as policy. This bill will strip Medicaid from millions, destabilize the already fragile HIV care infrastructure, and deepen health inequities across this country. That’s not an oversight—it’s intentional harm.
While we successfully fought back attempts to erase transgender people from federal health protections, the harm baked into this budget is undeniable. It slashes health care, food, housing, and the bare necessities that keep our people alive and stable. It throws communities living with HIV back into crisis mode. It sends a clear message: if you are poor, if you are trans, if you are Black or brown or undocumented, your life is negotiable. Your care is conditional.
We’ve seen this before. And we’ve fought back before.
Let me remind us:
40% of people living with HIV in this country rely on Medicaid.
21% of transgender adults depend on Medicaid for life-saving care.
SNAP cuts will force families to choose between antiretrovirals and dinner.
The bill adds billions to detain immigrants while gutting every program that uplifts life.
We know the cost of policy violence. We know the names of our dead.
Here’s what else I know: our community does not go down easy. We’ve turned mourning into mobilization before and will do it again. From the HIV/AIDS crisis to the ongoing attacks on our bodily autonomy, we are still here. Still resisting. Still building. Still demanding more. This is not a moment for despair. It’s a call to action.
To our donors: your support now matters more than ever. It is the difference between reactive policy and proactive resistance. Your giving fuels the grassroots, the organizers, the policy strategists, and the programs and services that make survival possible. If you’ve ever wondered whether your donation made a difference, let me be direct: it does. It always has. And now it must.
To our community: Your voice is not just valuable—it’s vital. Contact your representatives. Flood their offices with your stories. Let them know that we are watching and documenting every vote, every betrayal, and every silence. We will hold them accountable.
I’m proud to join a long lineage of advocates who have dared to say: No more cuts, no more dehumanization, no more political theater that trades our lives for tax breaks.
We will not be silent.
We will not be polite.
We will be powerful.
Because the stakes demand it.
With rage, with love, and with unwavering commitment,
Tatyana Moaton, PhD
Director of Strategic Innovation & Partnerships
San Francisco Community Health Center