October 24, 2019

Who Will Pay for EtE?

Many people working in HIV have spent the last ten weeks immersed in writing Requests for Applications (RFAs) to submit to the Department of Health and Human Services (DHHS). With great hope, they are applying for funding that will enable them to be part of the “End the Epidemic” initiative. DHHS released the RFPs on August 8 and providers in Ending the Epidemic (EtE) target locations around the country had to submit their proposals by October 15 to be considered. The accepted proposals will announced on March 1, 2020.

What will likely still be up in the air at that time, however, is how the EtE, a major national initiative, will be paid for.

In his State of the Union address last February 8, President Trump said, “My budget will ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in the United States within 10 years.” On March 11, he followed up by allocating $291 million in his FY 2021 budget to the Department of Human Services for EtE – a first-year down payment on this decade-long project. With a strong launch and ongoing effort, HHS predicts that they can “reduce new HIV infections in the United States to less than 3,000 per year by 2030” – less than 10% of the 38,700 people who acquired HIV in 2016 (according to the last available federal data).

In March, the House of Representatives passed a FY 2020 budget that included the $291 million for President’s “End the Epidemic” initiative, along with a $116 million increase in funding for the existing Ryan White HIV/AIDS program and a $50 million increase for Health Centers, among other HIV-related budget lines.

The Senate, however, was unable to pass a complete budget proposal. Stuck at a fiscal impasse for 2020, the Senate narrowly passed budget agreement in August that enables them to avoid debt default and “raises the federal borrowing limit until July 2021.” It is at least enough to “avoid a potential fiscal disaster later this year.”

What will this impasse in the Senate mean to the people who have submitted their EtE RFPs and are preparing to launch an expanded array of HIV services in areas where they are most urgently needed? Stay tuned.