Congress Agrees to Increased HIV Funding

After months of delay, Congress delivered a massive $2.3 trillion bill that consists of two major parts — a full year’s regular spending bill and a relief package to address the COVID-19 pandemic emergency.

The Academy has carefully analyzed the COVID-19 package of approximately $900 billion dollars. The bill provided additional funding for small business relief (including nearly $300 million for forgivable Paycheck Protection Program loans), funding for schools, $300 in additional unemployment insurance extended through March 14, 2021 and direct payments of $600 for adults with incomes up to $75,000 and $600 per child. A deal to limit a last-minute effort by Senator Pat Toomey (R-PA) to end emergency federal reserve lending programs was accepted, allowing the package to move forward. Exemptions for corporate liability regarding COVID-19 which had been requested by Republicans and additional relief for state and local governments that had been sought by Democrats were both excluded from the deal.

While there is little direct funding for ending the HIV epidemic in the COVID-19 package, the Academy notes that there is additional funding for programs that may benefit some people with HIV, including $13 billion for the Supplemental Nutrition Assistance Program (SNAP), $25 billion for rental assistance and $4.25 billion directed to mental health and substance use disorder at the Substance Abuse and Mental Health Services Administration.

The COVID-19 package has been attached to Congress’s underlying $1.4 Trillion appropriations bill which funds the government for Fiscal Year (FY) 2021. The bill is overdue by nearly 3 months since FY 2021 actually began on October 1^st. This bill is referred to as an “omnibus” bill, since it actually joins up all 13 of the smaller appropriations bills. The massive bill was passed in both the House and the Senate on Monday.  In a speech released Tuesday, President Trump implied that he might not sign the bill without changes, including increasing the $600 payments (to individuals) to $2000.  Speaker of the House Nancy Pelosi (D-CA) and Senate Minority Leader Chuck Schumer (D-NY) both reacted by stating that they supported the larger checks.  Failure to sign the existing bill has the potential to delay relief by weeks for people who are facing economic uncertainty.  As of this writing, it is unclear both whether the President was serious and, if so, how the issue will be resolved.

In general, the appropriations bill was good for HIV programs. Funding for Ending the HIV Epidemic increased significantly, and many HIV programs will see a bump, including the Centers for Disease Control and Prevention with the Division of HIV/AIDS Prevention increasing by $36 million (to $964.7 million) and the Opioid Related Infectious Diseases Program increasing by $3 million to $13 million. Community Health Centers received a $57.3 million plus-up and the Health Resources Services Administration received an additional $52.3 million increase for the Ending the HIV Epidemic plan. The National Institutes of Health received a $14 million increase for AIDS research, and the Minority HIV/AIDS Fund received a $1.5 million increase. Housing Opportunities for People with AIDS (HOPWA) received a $20 million increase to a total of $430 million and the Ryan White Program increased Ending the HIV Epidemic funding by $35 million with the specific Ryan White Program Parts remaining at level funding. The Academy thanks the Federal AIDS Policy Partnership for assistance in tracking all the numbers.

The Academy notes that since funding is not specifically going to the individual parts of Ryan White, that some needs may be going unmet, especially in places that are not directly covered by the Ending the HIV Epidemic plan. We call on Health Resources Services Administration (HRSA), which administers the Ryan White Program, to ensure that funding remains adequate for all areas of the country. Likewise, the Academy is appreciative that Members of Congress were able to reach a COVID-19 deal. However the lack of funding for state and local programs threatens to undercut the COVID-19 response and may affect progress towards ending the HIV epidemic in many places. The Academy urges Congress to pass and the President to sign this entire bill, and then further urges the new Congress in January to come together to resolve funding shortfalls in the states and local jurisdictions that are hurting our effort to end the HIV epidemic.

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