President Obama’s proposed budget for fiscal year 2012 drew praise from AIDS advocacy groups for its inclusion of small to modest funding increases in federal AIDS programs at a time when the White House and Congress are under great pressure to cut spending.
The proposed budget calls for a $105 million increase in the AIDS Drug Assistance Program, or ADAP, over the fiscal year 2010 spending level.
AIDS and LGBT advocacy groups have pushed hard for funding increases for the federal-state ADAP program as state contributions to the program have dried up due to the national recession, resulting in waiting lists for people who rely on the program for life-saving AIDS medication.
“We realize the resources of the federal government are severely constrained,” said Carl Schmid, deputy executive director of the AIDS Institute. “While the proposed funding levels are far from what is needed to provide the necessary care and treatment for people with HIV/AIDS or to significantly reduce the number of new infections, the AIDS Institute appreciates the budget requests and now urges the Congress to show a similar level of support.”
Schmid and Frank Oldham, president and CEO of the National Association of People With AIDS, expressed concern that Republican leaders of the House of Representatives are proposing cuts of close to 20 percent in federal AIDS programs for the fiscal year 2011 budget, which Congress has yet to finalize.
“The reality of the proposed cuts is that lower-income Americans living with HIV will not have access to the antiviral drugs that keep them healthy – and also make them less likely to pass the virus along to others,” Oldham said. “More people will get sick and die, and a disproportionate number of them will be poor and of color.”
Congress was expected to vote on a final version of the FY 2011 budget within the next few weeks. Last year, after Republicans and Democrats were unable to reach an agreement on the FY 2011 budget for most federal agencies, Congress approved a measure known as a continuing resolution, which keeps the government funded at fiscal year 2010 levels.
In a telephone news briefing on Tuesday, White House Domestic Policy Council Director Melody Barnes said the administration was involved in discussions with members of Congress to address the 2011 budget at the same time that the White House promotes its 2012 budget.
“With the budget that he put out yesterday…he has articulated the values that he has around this set of issues,” Barnes said of Obama’s intentions for the AIDS budget. “So I think his budget really stands as the backdrop and as the platform from which we will be operating as we move forward.”
Barnes added, “Obviously, there will be many conversations going forward about the budget and how we bring the current year to closure. But this [FY 2012] budget really articulates the framework that he believes should be the guiding set of principles.”
During the phone briefing, Jeff Crowley, director of the White House Office of National AIDS Policy, said the 2012 budget also reflects the president’s recently released National HIV/AIDS Strategy document. Crowley noted that strategy document, among other things, calls for targeting federal AIDS funds to population groups that are affected most by the disease, especially gay and bisexual men and people of color.
“People living with HIV should not have to live in fear that their life-saving medications could be taken away from them,” Crowley said.
“By increasing the annual fund by $105 million from early fiscal year 2010, when waiting lists in ADAPs first appeared, the president is demonstrating a strong commitment to standing with people living with HIV and working with states and others to bridge the gap in access to HIV medications until insurance coverage is expanded in 2014 through the Affordable Care Act.”
Crowley was referring to the sweeping health care reform bill initiated by Obama and passed by the Democratic-controlled House and Senate in 2009. With Republicans gaining control of the House this year, the House passed legislation calling for the repeal of the Affordable Care Act. The Senate, which remains under Democratic Party control, defeated the repeal legislation.
AIDS activists have said they remain hopeful that the Affordable Care Act’s provisions expanding health insurance coverage for low-income people will greatly reduce the need for people with HIV to rely on ADAP for their medication.
The president’s fiscal year 2012 budget includes these additional proposals for federal AIDS spending:
• An increase of $5 million over FY 2010 levels for early intervention and primary care service for people with HIV/AIDS under the Ryan White CARE Act.
• An increase of $58 million over FY 2010 for the U.S. Centers for Disease Control and Prevention (CDC) as a means of helping reach the goals of the National HIV/AIDS Strategy document’s call to reduce the number of new HIV infections in the U.S.
• An increase of $750 million above FY 2010 levels for medical research at the National Institutes of Health. Of this amount, $74 million would be allocated for AIDS and HIV prevention research. Crowley said the research would focus on developing an AIDS vaccine and new microbicides to prevent the AIDS virus from infecting people and on the discovery of improved drug therapies to prolong the lives of people with HIV.
• A $325 million funding allocation for the Housing Opportunities for People With AIDS, or HOPWA, at the Department of Housing and Urban Development—the same amount approved for the FY 2010 budget. HOPWA provides rent subsidies and other assistance to low-income people with HIV/AIDS.
Republican leaders said the Obama budget for FY 2012, which calls for $3.7 trillion in spending, is far too large and vowed to make sharp cuts when the budget undergoes the review and approval process on Capitol Hill in the coming weeks.
GOP leaders didn’t initially discuss the 2012 budget’s spending proposals on AIDS programs, but Capitol Hill observers expect House Republicans to make the same proposed cuts as those made for the fiscal year 2011 budget.
“HIV programs are so small a part of the federal budget – less than one tenth of one percent – that even eliminating them entirely will not materially reduce this year’s deficit,” Oldham said in a statement.
“But the proposed cuts will contribute to deficits in years to come, as Americans whose new infections this year could have been prevented for a few dollars come back next year, needing drugs and support services that will cost far more, for years to come,” he said.
During the White House phone news briefing, Barnes said the Obama budget for FY 2012 also calls for small increases in funding at the Justice Department’s civil rights division, which enforces the Mathew Shepard and James Byrd Jr. Hate Crime Prevention Act. The act authorizes the federal government to prosecute hate crimes targeting the LGBT community.