3 months after
the House passed their appropriations bill to provide next year’s funding for
the Departments of Labor, Health and Human Services, Education, and other
related agencies (L-HHS), the Senate Appropriations Committee revealed their
own this week. While the Senate Appropriations Committee has matched President Trump's funding requests around his Ending the HIV Epidemic plan, they have also mirrored many of his cuts to other programs that are vital to the health of people living with and affected by HIV. The content of the bill confirms
advocates’ concerns that we’re in for a long fiscal year 2020 appropriations
ride still.
Members of the
Senate Appropriations Committee seem well in line with the Administration’s Ending the HIV Epidemic: A Plan for America initiative,
announced by President Trump at his February State of the Union Address this
year. The Senate bill includes increases of $140 million for HIV prevention at
the Centers for Disease Control and Prevention,
$70 million for the Ryan White Program, $50 million for community health
centers, and $6 million for the Centers for AIDS Research at the National
Institutes of Health – all mirroring the President’s original budget request
for the plan. The Senate Labor-HHS appropriations numbers fall well short of
those allocated by the House earlier this year, with the House bill providing
$46.4 million more for the Ryan White Program and roughly $54 million more for
the CDC’s viral hepatitis, STD prevention, tuberculosis elimination, and opioid
related infectious diseases programs.
Unfortunately, some
Senators on the committee still stand by provisions, in this bill and others, that
are antithetical to the goal of ending the domestic HIV epidemic. In their
L-HHS bill, Senators propose maintaining a ban on the use of federal money to
purchase syringes without proof of ongoing or impending HIV or viral hepatitis
outbreak, a measure that Representatives omitted from their bill. The
committee’s Transportation, Housing, and Urban Development funding proposal
also slashed
the Housing for Persons living with HIV/AIDS (HOPWA) Program by $63 million
from its current funding level – a cut also proposed originally by President
Trump. As has been well documented, housing is essential
for folks living with or vulnerable to HIV to maintain good health and/or viral
suppression.
Just like FY19
appropriations discussions, the success or failure of any appropriations
discussions are going to come down to how Democrats and Republicans address
funding for the border wall. As Politico notes:
The most difficult piece of the upcoming funding
talks center on a small slice of the $1.4 trillion budget: the Department of
Homeland Security. That bill alone, and the related fight over the wall, was
the trigger of the longest-ever government shutdown that stretched from last
December to January.
So far this year, neither party has formally
released its opening bid on the DHS funding bill. House Democratic leaders have
said they plan to offer zero dollars for Trump’s wall, while pursuing more
restrictions for Immigration and Customs Enforcement, including fewer detention
beds.
Senate Democrats, meanwhile, have skewered
Republicans for proposing that $5 billion from domestic programs be spent on
the wall, with plans to divert another $7 billion in military construction
funds to border projects.
Lawmakers are
certainly working towards a funding solution, but a shutdown has happened over
this exact disagreement before, so no one is ruling out the possibility again –
although the potential negative politics of a shutdown during a presidential
election cycle may dampen Mr. Trump’s willingness to hold out as he did into
January of this year.
Earlier this
week, the House passed a continuing resolution (CR), extending FY19 funding
levels into FY20 – until November 21, specifically – to avert a shutdown. The
CR now heads to the Senate and is expected to be signed well ahead of the new
fiscal year’s October 1 deadline so lawmakers can continue these thorny
discussions.
Anomalies, or
carve-out increases for certain programs during the period of a CR, in the
House stopgap include continuing support for Community Health Centers, whose
funding would have expired at the end of this fiscal year, and a temporary
increase in Federal Medical Assistance Percentage for territories, including Puerto
Rico, under the Medicaid program for the period of this CR. Should this
temporary increase be included in a final CR, the federal government will match
up to 100% of the territories’ Medicaid spending, an enormous increase from the
mandated 55% match.
However, such
anomalies for any new funding streams or programs were not included for this CR
period, which means any new funding for Ending the Epidemic programs would be
on hold until at least November 21. AIDS United will continue to work with
allies in Congress to ensure the full and timely dispersion of funds for
communities and organizations working to end the domestic HIV epidemic.
Posted By: AIDS United, Policy Department - Friday, September 20, 2019
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