Bush's 2009 Budget Proposal Spells Bad News for HIV/AIDS Programs

Earlier this month, President George W. Bush urged Congress to adopt more funding cuts for already financially constrained health and human service programs, including HIV-related services.

Under the president’s budget plan, funding for Medicaid and Medicare—the nation’s premier insurance programs for retired workers, the disabled, and elderly—would be reduced by a whooping $30 billion. The White House also resisted congressional attempts to include additional Food Stamp and Medicaid funding for states in the recently approved economic stimulus package.

As the Centers for Disease Control and Prevention (CDC) prepares to release new data indicating a 30-50 percent increase in annual HIV infections, the White House calls for a $1 million reduction for domestic HIV prevention and surveillance activities and more cuts for viral hepatitis prevention. The budget would also cut nearly $100 million for critical substance abuse prevention and treatment programs and re-instate a federal ban on Washington, DC using local taxpayer dollars for needle exchange programs. A startling report released in November by the District of Columbia shows that 1 in 20 residents is living with HIV. For cases diagnosed since 2001, heterosexual contact (37.4 percent) was the leading mode of transmission followed by male-to-male sexual contact (25.8 percent) and injection drug use (13.2 percent).

A $6 million increase slated for the AIDS Drug Assistance Programs (ADAP) is widely considered insufficient to keep pace with increased medication costs and new client enrollment. Still, ADAP fared better in the administration’s budget than other categories of the Ryan White HIV/AIDS Treatment Act Grants to Chicago and 55 highly-affected urban areas would receive a $7.7 million reduction in Part A funding for medical and support services; Part C grants to community-based clinics—currently overwhelmed by uninsured clients needing HIV medical care—would receive no new money; and the AIDS Training and Education Centers, which are helping implement new recommendations for expanded HIV testing services, would receive $5.4 million less next year. The administration would, however, make up nearly half of the $19 million in fund recently cut for states through Part B of the Ryan White program.

The call for no new money for the Housing Opportunities for People with AIDS (HOPWA) would mean funding cuts for Chicago, Illinois, and other jurisdictions in 2009 when three new communities become eligible for HOPWA.

After defense spending, abstinence-only programs are about the only category in the Bush budget slated for significant increases of $28 million—nearly a 25 percent increase. According to federal research, abstinence-only-until-marriage programs offer young people absolutely no health benefits. Other research shows that they could actually prove harmful by increasing unprotected sexual activity, especially among gay and bisexual youth.

How Congress will deal with a controversial budget proposal from an outgoing president in an election year remains unclear. President Bush has already signals his willingness to veto funding bills again this year unless they adhere to his austere budget parameters. Stay tuned to AFC’s Statewide Advocacy Network for news regarding the 2009 federal appropriations-approval process.