Federal Update—January 31, 2003

Bush Announces Major New Investment in Global AIDS
White House Support for Domestic Efforts Against AIDS Less Clear

The AIDS Foundation of Chicago (AFC) joined a chorus of AIDS advocates in applauding President George W. Bush for committing an additional $10 billion in global AIDS relief to help African and Caribbean nations ravaged by HIV/AIDS over the next five years. How quickly new funds become available, what programs oversee the money, and whether the administration matches its global AIDS commitment with a domestic one remain to be seen.

See AFC's response to President Bush's FY04 budget request for HIV/AIDS programs and services.

President Bush's announcement—which marked the most significant financial commitment to AIDS relief by a sitting U.S. president—was contained in the state of the union address that also included calls for Medicare reform, increased substance abuse treatment funding, tax cuts, regime change in Iraq, and perseverance in the fight against terrorism.

Despite mentioning the domestic AIDS crisis, the president did not indicate whether his administration would request funding increases for U.S. AIDS programs. Over the past two years, the administration has supported virtually no funding increases for HIV prevention through the CDC, Ryan White CARE Act services, or the Minority HIV/AIDS Initiative. The administration is expected to unveil its fiscal 2004 budget request to Congress in early February 2003.

In addition to FY04 appropriations, AFC will closely watch how the administration proposes adding prescription drug coverage to Medicare as a growing number of people with AIDS today rely on the program for some or all of their healthcare coverage. Ensuring that Medicare reform proposals meet the needs of beneficiaries with disabilities, and not just seniors, is a paramount concern for AFC and other AIDS advocacy groups. AFC will also pay close attention to any legislative proposals concerning Medicaid, which, as the single largest public payer of AIDS-related healthcare, may be threatened with cost-costing proposals or other provisions designed to ration healthcare and reduce the number of beneficiaries. AIDS advocates, including AFC, have also raised concerns about the tax cut provisions of the president's economic stimulus package, which, if enacted, could result in decreased federal revenues available for an array of health, education, and social service programs, including AIDS-related programs.

FY03 AIDS Funding Still in Limbo
Two Illinoisans, House Speaker Dennis Hastert and U.S. Senator Dick Durbin, will form part of the House-Senate conference committee that will soon decide how to reconcile funding differences between House and Senate versions of the FY03 omnibus appropriations bill.

The bill is designed to determine annual funding amounts for vast portions of the federal government, including all health programs and virtually all AIDS-related programs, for the fiscal year that began October 1, 2002. A series of temporary funding measures have kept federal programs operating at FY02 funding levels for the past three months.

Among the many decisions facing the conference committee will be to determine final funding amounts for AIDS programs based on House and Senate versions of the bill. The House proposal, advanced by the Appropriations Committee directly to conferees without floor action, provides no new funding for HIV prevention and most titles of the Ryan White CARE Act except the AIDS Drug Assistance Program, which would receive a $20 million increase.

The Senate bill, which passed in late January, also fails to provide increased funding for HIV prevention programs at the CDC. The bill does, however, contain $138 million in increased funding for Ryan White CARE Act programs, including an additional $10 million for Title I cities, $17 million for Title II care services, $100 million for the AIDS Drug Assistance Program (ADAP), and $6 million for early intervention services through Title III.

The Senate bill also contains a provision for a $180 million increase for global AIDS programs, with $100 million directed to the Global Fund for AIDS, Malaria, and Tuberculosis. Senator Durbin championed the amendment for the global AIDS funding increase, which passed by voice vote on January 22, 2003.

Consistent with President Bush's funding request, the Housing Opportunities for Persons with AIDS (HOPWA) program would receive a $14.6 million increase in both House and Senate versions.

AFC encourages concerned Illinoisans to call Speaker Hastert at (202) 225-2976 and Senator Durbin at (202) 224-2152 to urge them to seek the highest possible AIDS funding amounts possible in the FY03 omnibus appropriations bill. Final conference negotiations and congressional action on the bill should conclude by mid-February.

See review of final FY03 appropriations amounts by clicking here.

AFC Lobbies Congress on ETHA, Microbicide Development Act
AFC Associate Director David Munar traveled to Washington, DC in late January to seek congressional support for the Early Treatment for HIV Act (ETHA) and the Microbicide Development Act.

If enacted, ETHA would allow states to expand Medicaid eligibility to uninsured and low-income HIV-positive people who have not yet become disabled. Current federal law prevents most low-income people with HIV from receiving Medicaid benefits until they have become disabled by the disease. ETHA would allow states to correct this cruel gap in coverage and make Medicaid benefits available to HIV-positive individuals early in their disease progression. Doing so will promote better health and productivity for low-income and uninsured people with HIV and will help states avert expensive future costs associated with emergency room care and extended hospitalizations.

The Microbicide Development Act would fund a new, integrated program at the National Institutes of Health (NIH) to speed research toward developing safe and effective microbicides. Microbicides are ingredients with anti-HIV properties that, once developed into lubricants, suppositories, or other over-the-counter products would confer protection against HIV infection when used with or without a condom. The development of effective microbicides could dramatically reduce new infections and provide individuals, and women especially, tools against infection that they can control.

Continuing its work from previous years, AFC is helping to garner congressional sponsors for both measures, which must be reintroduced in the 108th Congress. In an effort to build bipartisan support, AFC has asked several Illinois Republicans-including Reps. Mark Kirk of Deerfield, John Shimkus of Collinsville, Timothy Johnson of Pontiac, and Ray LaHood of Peoria-to consider joining both bills as co-sponsors.

AFC asks people who live in these areas to call their U.S. representative in support of ETHA and the Microbicide Development Act.