Legislative News Archive

Federal Update — October 23, 2002

Fiscal Year 2003 Begins Without Budget for HIV/AIDS Programs

Members of Congress remain significantly stalled in efforts to approve HIV-related appropriations for the 2003 fiscal year, which started October 1, and may delay final decisions until December or early next year, making it increasingly unlikely that HIV prevention and care programs will receive any substantive funding increases.

Before recessing on October 21 for the fall election campaign season, Congress passed a continuing resolution providing federal agencies with temporary funding capped at fiscal year 2002 (FY02) levels. Election-year posturing, intense partisan debate over war with Iraq, homeland security, and spending caps derailed any efforts to pass the 13 annual appropriation bills by the September 30 deadline, as required by law. A "lame duck" Congress may resume work on FY03 appropriations when it returns after the November elections or may vote to extend continuing resolutions until the 108th Congress convenes in January. Without final funding decisions, vast sections of the federal government-including several AIDS-related programs-will be left without funding assurances and made to operate on a temporary basis. Local service planning and administrative efforts will be significantly encumbered if final decisions are not reached by the end of the year.

In July, the Senate Appropriations Subcommittee for Labor, Education, and Health and Human Services passed its FY03 funding recommendations, which included a $300 million increase for the National Institutes of Health and a $161 million increase for Ryan White CARE Act programs: $20 million for Title I cities, $17.6 million for Title II states, $100 million for the Title II AIDS Drug Assistance Program (ADAP), $11 million for Title III early intervention services, $4 million for women's and children's services through Title IV, $4.7 million for the AIDS Training and Education Centers, and $3.5 for dental reimbursement. Unfortunately, the Senate subcommittee failed to include any new funding for domestic HIV prevention programs through the Centers for Disease Control and Prevention (CDC) despite evidence that high-risk behaviors are on the rise and that the number of new, annual HIV cases has not decreased since the late 1980s. The Senate Appropriations Subcommittee for Veterans Affairs and Housing and Urban Development which determines funding levels for the Housing Opportunities for People With AIDS (HOPWA) program, proposed an additional $14.6 million for HOPWA services in FY03.

Members of the U.S. House of Representatives have made little progress determining FY03 appropriation amounts. The House Appropriations Committee voted to uphold the Senate's $14.6 million increase for HOPWA on October 9. Bipartisan disagreements over spending limits stalled other committees, including the House Appropriations Subcommittee on Labor, Education, and Health and Human Services, which sets initial funding amounts for the CDC, the Ryan White CARE Act, and the AIDS research programs at the National Institutes of Health (NIH). Contributing to the political gridlock is the House's self-imposed spending cap of no more than $759 billion in total discretionary spending, which affects all AIDS-related programs except Medicare and Medicaid. The Senate set a higher cap at $768 billion. The House spending caps conform with President Bush's proposed budget figures, which flat-fund HIV prevention and CARE Act services, and allow for virtually no new spending beyond promised funding increases for the NIH, homeland security, defense, and bio-terrorism preparedness. A group of Democrats and moderate Republicans oppose the cap because it does not allow for adequate funding for health and human service programs.

AFC encourages AIDS advocates to contact their congressional representatives and House Speaker Dennis Hastert of Yorkville (at 630-406-1114 or 202-225-2976) to rally support for lifting restrictive and unrealistic spending limits.

Given the significant delays, congressional leaders may decide to side-step discussions for each of the 13 appropriations bills and instead work on a massive appropriations package, known as an "omnibus bill," that would include funding amounts for several or all outstanding federal departments. In prior years, congressional leaders finalized stalled appropriations by negotiating the details of the omnibus bill with each other and directly with the White House in order to speed the approval process. These circumstances, noted for their behind-closed-doors negotiations, are especially unfavorable for AIDS advocates who may lack information until after the massive spending bill has been enacted.

Other federal news:

Illinois Congressmen Lane Evans (D-Moline) and David Phelps (D-Eldorado) joined seven other Illinois Members of Congress in co-sponsoring HR 3612, the Medicaid Community-Based Attendant Services and Supports Act of 2002, or MiCASSA. MiCASSA establishes a national program of community-based attendant services for people with disabilities. If enacted, MiCASSA would offer assistance to vast numbers of people with disabilities, including people with HIV/AIDS. Representatives Danny Davis (D-Chicago) and John Shimkus (R-Springfield) introduced MiCASSA, and Representatives Jerry Costello (D-Belleville), Luis Gutierrez (D-Chicago), Ray LaHood (R-Peoria), Bobby Rush (D-Chicago), and Jan Schakowsky (D-Chicago) have joined the bill as co-sponsors.

New York City's Gay Men's Health Crisis (GMHC) and Human Rights Watch held a press conference in September to denounce efforts by the Bush administration to undermine scientifically proven HIV-prevention strategies for at-risk adolescents and adults. They cited the administration's promotion of abstinence-only prevention programs, the recent CDC audit of San Francisco's Stop AIDS Project, and the upcoming comprehensive review of all AIDS prevention programs directly funded by the CDC as examples of the administration's shift away from proven prevention programs. Ana Oliveira, GMHC executive director, said, "The Bush Administration is promoting abstinence-only prevention programs, while simultaneously undermining the work of agencies that are providing honest and frank information about HIV and sexual risk." For more information, visit GMHC online.

Senator Richard Durbin (D-IL) recently became the 11th co-sponsor of Senate Bill 987, the Early Treatment for HIV Act (ETHA). Pending in both the House and Senate, the bill would allow all 50 states to provide Medicaid coverage to low-income people with HIV and would remove some of the burden on such safety-net programs as ADAP and other Ryan White CARE Act services. To learn more about the ETHA or to receive information on what advocates are doing locally to expand Medicaid for people with HIV, visit AFC's Sensible Medicaid Campaign organizing page or contact Sara Schmitt at (312) 922-2322.