april 18, 2011
Final fiscal year 2011 spending bill severely hampers efforts to fight HIV/AIDS and hepatitis C epidemics
Project Inform today expressed extreme disappointment in the final Fiscal Year 2011 budget bill signed into law last Thursday, calling it a compromise that makes unnecessarily large cuts to vital health programs and that fails to provide sufficient funding to fight the HIV/AIDS and hepatitis C epidemics. Project Inform also outlined reasons why it opposes a 2012 federal budget proposal offered by Rep. Paul Ryan and believes that President Obama’s values and directions on future budgets better protect the health of vulnerable Americans.
“Through his National HIV/AIDS Strategy, President Obama has set an aggressive and productive course for gaining much greater control over this still serious epidemic,” said Dana Van Gorder, Executive Director of Project Inform. “Sadly, current thinking about how to address federal deficits gravely threatens our ability to end this epidemic with its focus on reducing health care to the most vulnerable Americans while permitting some Americans to achieve vast wealth and secure protections from paying their fair share of taxes.”
The final 2011 budget slashes $600 million from community health centers, a vital component of the recently adopted health care reform law, $260 million from medical research at the National Institutes of Health (NIH), $763 million from the Centers for Disease Control and Prevention (CDC), and $45 million from the Substance Abuse Mental Health Services Administration (SAMSHSA). While these figures are a substantial improvement over the massive cuts proposed by the majority in the House of Representatives, they will result in a reduction in health and social service programs that serve the most vulnerable people in the country and will make implementation of health care reform more difficult.
The budget does, however, provide a $25 million increase for the AIDS Drug Assistance Program (ADAP), which provides HIV medications to low-income uninsured and underinsured people. ADAP is in a fiscal crisis, forcing many states to create waiting lists and other cost-containment strategies. This increase, while appreciated, is far below what is needed to make certain that people with HIV have stable access to lifesaving medications. In addition, the rest of the Ryan White Program will receive less funding than last year (a .2% cut), resulting in a reduction to primary care, dental, social service, and other vital services.
Particularly troubling is the $763 million cut to the CDC, a 6% reduction. While the specifics of the CDC cuts remain to be determined, HIV and viral hepatitis prevention programs could receive significant reductions. This would greatly harm efforts to achieve the goals of the National HIV/AIDS Strategy to decrease new HIV infections through strategic and innovative interventions. In addition, the CDC line item for viral hepatitis prevention constitutes the only funding for hepatitis C education and prevention programs, and any cut in funding will greatly hamper the nation’s ability to control this growing epidemic.
Debate began on the FY 2012 budget as soon as the 2011 budget was signed into law. Chairman of the House Budget Committee Paul Ryan (R-WI) has proposed a FY 2012 budget that begins to reduce federal spending by $6.2 trillion over the next decade. Chairman Ryan’s budget does little to address the federal deficit and preserves tax cuts for the wealthiest Americans and corporations. At the same time, it proposes cutting almost $800 million from Medicaid by capping federal contributions to the program, and transforming Medicare into a voucher program requiring patients to purchase private insurance. More than 60 percent of Americans living with HIV and AIDS rely on these programs, and adoption of the Ryan budget would devastate America’s response to the epidemic. Ryan’s proposal would also end the pending Medicaid expansion to all childless adults living at or under 133% of the federal poverty level, robbing people with HIV and hepatitis C of a significant victory under health care reform that allows access to Medicaid before they become disabled.
President Obama stepped in to the deficit debate last Wednesday and announced a framework for his plan to cut $4 trillion from the deficit over 12 years, primarily through cuts in defense funding and increased taxes on the wealthiest Americans. The President rejected fundamental changes to Medicaid and Medicare and the attempt to scale back or dismantle the coverage expansions planned under health care reform.
“Advocates must demand that the President and members of Congress stand strong in rejecting any attempts to take away essential health care from poor and middle class Americans or dismantle the hard won victory of health care reform and expansion,” said Ryan Clary, Project Inform’s Public Policy Director. “In the next month, Congress will be debating and voting on budget proposals, raising the debt ceiling, and deficit reduction plans. Each of these debates must be carefully monitored to ensure that arbitrary caps on Medicaid, Medicare vouchers and global spending caps, which would result deep cuts to health and human services, are not adopted. Elected officials must find ways to reduce the deficit, control spending and increase revenues without endangering the life and the health of low-income and middle class Americans.”
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