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The Presidents Budget Fiscal Year 2016

Middle Class Economics: Enhancing the Lives of Americans Living with HIV/AIDS, and Fighting the HIV/AIDS Epidemic

The President’s 2016 Budget is designed to bring middle class economics into the 21st Century. This Budget shows what we can do if we invest in America’s future and commit to an economy that rewards hard work, generates rising incomes, and allows everyone to share in the prosperity of a growing America. It lays out a strategy to strengthen our middle class and help America’s hard-working families get ahead in a time of relentless economic and technological change. And it makes the critical investments needed to accelerate and sustain economic growth in the long run, including in research, education, training, and infrastructure.

These proposals will help working families feel more secure with paychecks that go further, help American workers upgrade their skills so they can compete for higher-paying jobs, and help create the conditions for our businesses to keep generating good new jobs for our workers to fill, while also fulfilling our most basic responsibility to keep Americans safe. We will make these investments, and end the harmful spending cuts known as sequestration, by cutting inefficient spending and reforming our broken tax code to make sure everyone pays their fair share. We can do all this while also putting our Nation on a more sustainable fiscal path. The Budget achieves about $1.8 trillion in deficit reduction, primarily from reforms to health programs, our tax code, and immigration.

 

The Budget advances the President’s commitment to reaching an AIDS-free generation in the U.S. and around the world by:

Continuing to Support the National HIV/AIDS Strategy (NHAS) and Expanding Access to HIV/AIDS Treatment, Care, and Prevention. The Budget expands access to HIV/AIDS prevention and treatment activities and supports the goals of the National HIV/AIDS Strategy to reduce HIV incidence; increase access to care and optimize health outcomes for people living with HIV; and reduce HIV-related health disparities. By providing resources for Affordable Care Act implementation, the Budget will support increased health coverage for thousands of people living with HIV/AIDS and expand access to HIV testing for millions of Americans. The Budget makes smarter investments by prioritizing HIV/AIDS resources within high-burden communities and among high-risk groups, including gay and bisexual men, African Americans and Latino Americans. Compared to 2015, the Budget increases domestic discretionary Health and Human Services (HHS) HIV/AIDS by $118 million, including a doubling of funds for the Office of Women’s Health. Overall, total U.S. Government-wide spending on HIV/AIDS increases by nearly $1 billion from $30.7 billion in FY15 to $31.6 billion in FY16.

Supporting the Ryan White HIV/AIDS Program. The Budget invests $2.3 billion in the Ryan White HIV/AIDS Program to provide treatment and care completion services for people living with HIV, and includes $900 million for the AIDS Drug Assistance Program to ensure that people living with HIV have access to life-saving antiretroviral (ARV) treatments. By helping people living with HIV remain in care and on their medications, the Ryan White program plays a critical role in preventing the spread of the HIV epidemic, as recent research has shown that ARV treatment reduces HIV transmission by 96 percent.

Increasing Funding for HIV/AIDS Prevention and Service Integration. The Budget invests $799 million, an increase of $12.6 million, for Centers for Disease Control and Prevention (CDC) to continue implementing the goals of the National HIV/AIDS Strategy by preventing HIV/AIDS among high-risk communities using evidence-based interventions. The increase will be directed to those most at risk for acquiring HIV including youth, high risk HIV negative persons, and persons at risk for transmitting HIV, particularly those not engaged in care. CDC will continue to align prevention activities with the National HIV/AIDS Strategy and to promote high-impact prevention by focusing resources on effective, scalable, and sustainable prevention strategies along the HIV continuum of care for persons living with HIV and populations at highest risk for HIV. Part of the increase will support efforts to better link persons diagnosed and living with HIV to appropriate care and examine how new biomedical interventions are being used. Additionally, investments will be used to improve HIV prevention activities with school-aged youth. The Budget dedicates approximately $2.5 million to support States in developing integrated HIV plans to include prevention, care and treatment, and other supportive services such as substance abuse treatment and housing. This effort will help ensure that State and local health departments develop systems of prevention, care and treatment that are responsive to the needs of persons at risk for HIV infection and persons living with HIV, while also continuing the Administration’s commitment to streamlining and reducing reporting burden. The Budget also doubles funding for viral hepatitis to prevent deaths due to viral hepatitis, reduce hepatitis C among young people, and reduce mother-to-child transmission of hepatitis B.

Supporting Housing Assistance for People Living with HIV/AIDS. The Budget provides $332 million for Department of Housing and Urban Development’s (HUD) Housing Opportunities for Persons with AIDS (HOPWA) program to address housing needs among people living with HIV/AIDS and their families. The program provides States and localities with the resources to create comprehensive strategies for providing housing assistance that gives patients the stability needed for effective treatment. In partnership with Federal agencies through the HIV Care Continuum, HUD is working to improve outcomes that promote greater achievements in viral suppression through the coordination and alignment of housing support with medical care. The Administration is also proposing legislative reforms that would update HOPWA’s grant formula to distribute funds based on more robust CDC data on persons living with HIV, rather than the cumulative number of HIV cases.

Supporting Research at the National Institutes of Health (NIH). To address the critical AIDS research priorities, the Budget requests $3.1 billion for trans-NIH AIDS research, an increase of $100 million above the FY 2015 level. The Budget request reflects several shifts of funds to address the many new and exciting scientific opportunities in AIDS research, including etiology and pathogenesis that provides the underlying foundation for all HIV research; development of vaccines and microbicides; and new and innovative approaches for research toward a cure.

Increasing Support for Our Veterans Living with HIV/AIDS. The Budget includes $1.15 billion within the Department of Veterans Affairs (VA), including a $62 million increase for medical care, to ensure that veterans living with HIV/AIDS receive high quality, comprehensive clinical care, including diagnosis of their infection and timely linkage to medical care. Additionally, VA promotes evidence-based HIV prevention services and is implementing its plan to meet the goals outlined in the President’s National HIV/AIDS Strategy.

Despite Deep Spending Cuts, Congress Advances Joint Budget Resolution

2015-05-08 | Policy Department, AIDS United

The Senate joined the House of Representatives this week in approving a joint Fiscal Year 2016 budget resolution, further advancing a controversial plan whose deep cuts to non-defense spending and increases in military spending have drawn sharp criticism. HIV advocates are particularly concerned by the approved resolution’s damaging spending cuts that threaten key programs that are essential for treatment and prevention of HIV in the United States. The Senate passed the resolution by a vote of 51-48, with all Democrats and two Republicans – presidential candidates Sen. Ted Cruz (R-TX) and Sen. Rand Paul (R-KY) – voting against the plan.

In response to the passage of the joint budget resolution, President Obama warned that he would use his veto pen for any spending bill that locks in sequestration for future years or that lifts sequestration caps for defense but maintains the stifling spending caps for non-defense programs, including the Ryan White Program.

The budget resolution also opens the door for a new strategy to repeal the Affordable Care Act (ACA) using the reconciliation procedure by giving specific directives to congressional committees relating to spending, revenue, or the debt limit. The joint resolution adopts the Senate’s budget version and includes reconciliation instructions that would create a path to repealing the current health care law.

2016 Presidential Round-Up: How the Candidates Stack Up on HIV

2015-05-08 | Policy Department, AIDS

The 2016 presidential campaign is already heating up with Election Day still more than 500 days away. While the race is still in the early stretch of primary season, HIV advocates should start looking for the best candidates on HIV/AIDS issues. Several candidates have already joined the race: Hillary Clinton and Bernie Sanders seek the Democratic nomination, and the Republican field is already crowded with official announcements from with Ben CarsonCarly Fiorina, Marco RubioTed Cruz, Rand Paul, and Mike Huckabee.

Key legislation such as the Ryan White Act or the Affordable Care Act (ACA) can be fundamentally altered depending on who is in the Oval Office, impacting the ability for people living with HIV to obtain optimal medical care. There is also evidence that structural issues such as poverty, lack of housing, and HIV stigma can contribute to HIV testing rates or HIV risk behavior, all factors that can be influenced by the Executive Branch. At this point in the election cycle, it is unclear how each candidate will approach issues related to health care reform, HIV prevention and treatment, or reducing income or housing disparities in the United States. However, we can look at previous statements and actions to get a sense of candidates’ positions on important issues to our community.

During her past presidential bid and term in the Senate, Hillary Clinton has supported comprehensive HIV prevention, stating that she would increase the National Institutes of Health research budget and promote HIV prevention programs that were not limited to abstinence-only policies. Prior to the end of her tenure as Secretary of State, she released PEPFAR’s Blueprint: Creating an AIDS-free Generation, which outlined a global strategy for ending HIV transmission. Senator Sanders has stated his opposition to pharmaceutical monopolies that lead to exorbitant prices for HIV medicine. In the past, Marco Rubio has expressed concerns for federal funding cuts to PEPFAR and has noted its importance in contributing to an AIDS-free generation on his website. In contrast, other Republican potential nominees have either not revealed any definitive thoughts about current HIV policy or have past associations that may cause concern for HIV/AIDS advocates. During his 1992 Senate run in Arkansas, Mike Huckabee stated that people living with AIDS should be quarantined, and Rand Paul has been linked to a professional physician organization that has questioned the link between HIV and AIDS (although he has not publically stated his agreement with this position).

Thoughts on the ACA tend to fall along party lines, with all current Republican candidates expressing varying levels of opposition to the law. The National Journal has recently summarized how Republican candidates might approach health care reform, and it is unclear how these approaches might affect access to Medicaid, which has expanded through the ACA and increased insurance access for people living with HIV. Hillary Clinton has expressed strong support for the current health care reform law, encouraging Democrats facing challenges during the 2014 midterm elections to present the benefits of the ACA and stating that if she were “running for reelection in 2014, I would be posing a very stark choice to the voters of my district, or my state, if you want us to go back to the time when your sister with diabetes, or your husband with his heart condition, couldn’t get insurance at an affordable rate, then don’t vote for me, because I think it’s great that your sister and your husband now have insurance”. Senator Sanders voted for the Affordable Care Act but has stated that he did not think it went far enough and continues to advocate a single-payer national health care system.

Same-sex marriage, an important issue for many people living with HIV, is also a dividing point between the Democratic and Republican nominees. Both Clinton and Sanders express support for same-sex marriage, while the current Republican candidates insist that marriage should be defined as being between a man and a woman. The level of opposition varies between Republican candidates, with Huckabee stating that he would support a Constitutional amendment banning same-sex marriages if the Supreme Court ruled in favor of marriage equality, and Cruz being a proponent for a State Marriage Defense Act, which would prevent federal recognition of sex-sex marriages in states that do not currently have marriage equality. In contrast, Marco Rubio has stated that if the Supreme Court rules in favor of same-sex marriage, he “wouldn’t agree with their ruling, but that would be the law of the land that we would have to follow until it’s somehow reversed…which I don’t think is realistic or foreseeable.” Carly Fiorina was a supporter of Proposition 8, which banned same-sex marriages in California via voter amendment, but believes that same-sex couples should have civil unions.

AIDS United continues to follow all candidates as they articulate their positions on issues that are relevant to HIV/AIDS policy. There are many ways that advocates can actively stay informed, including PBS Newshour’s list of candidate positions on issues including health care, immigration, and social issues. Advocates can also volunteer with local HIV prevention and treatment organizations that have efforts focused on the upcoming presidential election or attend town hall meetings to ask candidates about their understanding of the HIV/AIDS epidemic. To stay up to speed on current HIV policy issues, such as the federal ban on syringe exchange or funding for the Ryan White program, check out materials from AIDSWatch 2015.

Your voice can help inform the future presidential nominee on the ways they can support efforts to end the HIV epidemic!