14 Mar American Academy of HIV Medicine Points to Disconnect Between the Trump Administration’s Budget Proposal and “Ending the AIDS Epidemic” Plan
Micro-Increases May Be Derailed by Macro-Cuts
Washington, DC – The American Academy of HIV Medicine (AAHIVM), an independent organization of HIV specialists and other care providers dedicated to promoting excellence in HIV care, today pointed out the potential disconnect between the FY2020 Presidential budget proposal and the goals of the Administration’s “Ending the AIDS Epidemic” project announced last month at the State of the Union. According to AAHIVM, the welcomed increases to many important federal departments and HIV initiatives may be superseded by cuts and other changes to larger-scale programs and health payers.
Overall, the budget proposes a $291 million investment to combat HIV in the U.S., an 18% increase over last year’s budget, which includes $140 million in new funding for the Centers for Disease Control (CDC). This increase focuses on reducing the nearly 40,000 annual new infections through testing and prevention efforts in targeted parts of the country. Health Resources and Services Administration (HRSA) also received $120 million geared towards HIV treatment and care.
“These modest increases are certainly needed to support the Administration’s ambitious plan to end the epidemic by 2030,” stated AAHIVM Executive Director Bruce Packett. “However, the small raise in those budget line items, after years of flat funding and rescissions, are dwarfed by the misdirected macro-level cuts to larger programs.”
The President’s budget proposed an estimated $2.7 trillion in cuts over 10 years, notably by proposing steep cuts to the Medicare and Medicaid health entitlement programs along with cuts to other supportive services that impact health of people living with HIV. The plan calls for Medicaid block grants to states and giving states more control over enrollment, echoing the administration’s previous attempts to create Medicaid access restrictions.
“Of all Americans living with HIV and currently in care, one-quarter are enrolled in federally-administered Medicare and another 40% are enrolled in Medicaid – adding up to two-thirds of people living with HIV relying on public insurance,” continued Packett. “This budget creates clear and obvious barriers to uninterrupted care, care that is needed to prevent new transmissions.”
In addition to stifling Medicaid access, the proposed budget cuts reduce funding to the National Institutes of Health (NIH) by $4.5 billion, and propose significant cuts to global AIDS programs, including President’s Emergency Plan for AIDS Relief (PEPFAR).
This all follows the President’s interest in diminishing and even repealing the Affordable Care Act (ACA), which has allowed almost 20 million people to gain new access to health coverage within the first 4 years of its passage.
Combined with cuts to housing and nutrition programs, the President’s budget also cuts $500 million from mental health treatment and $100 million from substance abuse treatment at SAMHSA. These support services for people living with HIV who experience mental health concerns and/or substance use disorders, and are among the hardest to retain in HIV care, are vital to ending the epidemic.
“It’s a good news/bad news scenario,” stated Dr. Margaret Hoffman-Terry, an HIV Specialist and Chair of the AAHIVM Board of Directors. “The good news is that federal funding for HIV testing, prevention and care has somewhat increased. But the bad news is if my patients no longer qualify for Medicaid or Medicare due to access restrictions, or possibly even to private payers through ACA mechanisms, it’s a non-starter. We’re effectively widening the gap between available treatment and access to care.”
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