Congressional spending bill includes increases, but falls short of the HIV community's needs

On the evening of March 10, the U.S. Senate finally passed their fiscal year 2022 omnibus spending bill just in time to prevent the federal government from running out of funding. The legislation passed the Senate with a vote of 68-31. The bill was the result of 18 months of work by congressional Democrats to create an appropriations package that reflected the needs of the country and united the Democratic party.  While the omnibus did not include any additional COVID aid money and flat funded several pivotal programs, the bill touched on many of the HIV community's other priorities. AIDS United’s policy team breaks down the budget and its implications for people living with and impacted by HIV.

Funding for HIV services

Funding for HIV services throughout the bill largely saw incremental boosts that fell short of addressing the HIV community’s needs and demands. A few key programs, such as the Title X Family Planning Program, were flat-funded — meaning that there was no increase or decrease. Accounting for inflation, this represents a functional drop in funding for these programs. Others, like the Minority HIV/AIDS Initiative Fund, received such a small increase in funding that their capacity to serve more individuals will likely not be increased. Total funding for the Ryan White HIV/AIDS program was increased by $71 million. This is good news, but the spending levels are still well below the demands of HIV advocates.

Housing for people living with HIV

The final omnibus increases funding for the Housing Opportunities for Persons with AIDS Program by $20 million, bringing the total budget to $450 million. This increase falls $150 million short of HIV advocates’ requests, and it will, unfortunately, be a huge hit to the program’s capacity to provide housing for people living with HIV in major cities like Baltimore and Atlanta. 

Harm reduction

The omnibus spending bill provided $18 million for the Center for Disease Control and Prevention’s Eliminating Opioid-Related Infectious Diseases programs, which fund syringe services programs and other harm reduction services. While $5 million higher than the previous fiscal year, it is significantly short of the $120 million harm reduction advocates requested.  

Community health funding

The omnibus did deliver increases to several programs within the Health Resources and Services Administration, which is responsible for improving access to health care services for people who are uninsured, isolated or medically vulnerable. The bill would provide an increase of $1.3 billion for HRSA, totaling $8.556 billion in fiscal year 2022. Key increases include:

• $122 million for Community Health Centers in the Ending the HIV Epidemic Initiative, an increase of $20 million over the fiscal year 2021.
• $1 billion for programs to improve maternal and child health, which marks an increase of $43 million over the previous year, including an increase of $35 million for the Maternal and Child Health Block Grant.
• $3.2 billion for HIV/AIDS research, which is an increase of $104 million over the prior enacted level. It also includes an increase of $10 million for the Centers for AIDS Research as part of the Ending the HIV Epidemic Initiative.

So what’s next?

Although HIV services received some funding increases in this appropriations package, the general sentiment from advocates remains that we have work to do in the coming year to ensure proper funding is secured for our policy priorities. In order to end the HIV epidemic by 2030, Congress needs to ensure that we have the necessary funding to do so. This requires support from Congress to ensure critical programs like HOPWA are funded at levels that ensure that people living with and vulnerable to HIV receive the assistance they need.   And, at a time when over 100,000 Americans are dying of overdose every 12 months and the incidence of HIV and viral hepatitis transmission among people who inject drugs continues to increase, Congress’ failure to invest in harm reduction services with this bill is particularly troubling. Congress must also lift the ban on the use of federal funds for the purchase of syringes at syringe services providers, which only hurts efforts by these programs to reduce the risk of HIV and viral hepatitis transmission in injection drug use. The AIDS United Policy Department will continue to engage with legislators to ensure that federal spending meets the needs of people living with and vulnerable to HIV in the coming year.