What could Trumpcare mean for PrEP users? Bad news.

The Trump administration is set to drastically reduce access to PrEP in over 30 states.

PrEP costs around $1,500 a month without insurance. But with insurance, that cost drops to anywhere between $0 to $500. Yet if the Affordable Care Act (ACA) is repealed, that could change.

House Republicans plan to eliminate the ACA’s Medicaid expansion. In doing so, access to PrEP would be cut off in 31 states and the District of Columbia by 2020.

That’s because many PrEP users rely on the drug assistance program (DAP), which “started covering PrEP after the Affordable Care Act’s Medicaid expansion began insuring people who used to go through DAP”, writes Time.

Low-income Americans, as per usual, would suffer from these cuts the most:

“It has the potential to turn the tide the other direction, where we could potentially see the spread of HIV,” Noël Gordon Jr. of the Human Rights Campaign told Time.

Close to 80,000 Americans started PrEP between 2012 and 2015.