August 10, 2022

Senate Appropriations Releases Funding Levels & Chamber Moves into Reconciliation

The Senate Appropriations Committee released the Chairman’s mark of the chamber’s 12 appropriations bills – making significant investments in non-defense spending. Of interest to readers, the Senate has proposed increased funding for ending the HIV epidemic in the U.S. In particular, the bills call for an increase of:

• $240 million for HIV testing, prevention, treatment, and research as part of the Ending the HIV Epidemic initiative,
• $55 million for the CDC’s HIV prevention programming and $50 million for Community Health Centers to focus on PrEP,
• $13.5 million for the CDC’s hepatitis division,
• $135 million for the Ryan White HIV/AIDS Program,
• $18 million for the Housing Opportunities for Persons with AIDS program,
• $3 million for the Minority AIDS Initiative, and
• $25 million for the CDC’s opioid related infectious diseases programming.

Unfortunately, the Senate did not appropriate any money toward a national PrEP program but did remove both the rider banning federal funding for syringe purchases in SSPs as well as the new House-led ban on the procurement of pipes and similar objects in such programs. Highlights from each bill can be viewed here, and the Chairman is calling on the Senate to quickly pass these spending bills.

Over the weekend, the Senate took up the Inflation Reduction Act through its reconciliation process. Readers will recall that this is a significantly pared down version of Build Back Better – and utilized reconciliation – a procedural tactic to get around the 60-vote threshold needed under current filibuster rules. The Academy called upon the Senate to support a provision that would close the Medicaid Coverage gap – allowing those in non-Medicaid expansion states to be eligible for health care coverage and subsidies that they would have access to if they lived in a state that expanded Medicaid coverage under the Affordable Care Act. Closing the Medicaid coverage gap is a crucial step toward ending the HIV epidemic and addressing racial disparities. The gap in prevention and care for those living in Medicaid expansion states versus those living in the remaining non-Medicaid expansion states continues to grow. Absent Medicaid expansion, southern states (where 95 percent of uninsured individuals now live) have become the epicenter of the HIV epidemic: in 2019, more than half of all new HIV diagnoses were in the south. People of color, who disproportionately live in the south, are bearing the greatest burden of the HIV epidemic: in 2019, 75% of people diagnosed with HIV were people of color. Unfortunately, the amendment offered by Sen. Warnock (D-GA) did not prevail, as both Democrats and Republicans fought to keep the cost of the bill low.