Six Reasons the Republican Budget is a Potential Disaster for People Living with HIV

By Rob Banaszak on April 21, 2011 in Policy/Advocacy

Bill McCollby William McColl, Director, Political Affairs

On Friday, April 15th the House passed Rep. Paul Ryan’s (R-WI) Fiscal Year 2012 (FY12) budget on a near party line vote of 235 to 193.  The Democrats voted unanimously against the bill while four Republicans switched sides to vote against it.  They were right to vote against it.  This budget has the potential to leave many people living with HIV/AIDS without any sure way of accessing treatment.

6 Major Issues for People Affected by HIV
What would the Ryan Budget mean for people living with HIV/AIDS or at risk of being infected?  After careful review here are six things AIDS United is most concerned about.  The Republican plan would:

1. Create block grants to the States for Medicaid reducing federal support by about 33% (or $1.4 trillion).

  • Few federal standards could survive and services would become available on a state by state basis more than ever before.  States that have expressed stigma towards people living with HIV could easily roll back funding for services for PLWHs.
  • Even states with waivers that currently provide services to people who are HIV-positive but not diagnosed with AIDS would have to find ways to cut back – many states could choose to limit this care.
  • Medicaid services would have to be cut to a barebones minimum – it would be hard to find a doctor or get an appointment, drug formularies would have to be limited.

2. “Privatize Medicare” is privatized as a voucher program to buy services from private health insurers for all people beginning in 2022.  This means anyone under 55 years old now would be impacted by this change.

The vouchers will not increase in value as fast as medical costs, so they are unlikely to cover the rates of purchasing insurance for people living with HIV.  A lot of people living with HIV would likely move from Medicare to Medicaid if services were available at all.

3. Repeal and defund the Affordable Care Act resulting in:

  • An end to prohibition of lifetime and annual insurance caps.
  • An end to pre-existing condition clauses.
  • Loss of Medicaid eligibility for many PLWH’s with incomes below 133% of the federal poverty level.
  • High out of pocket costs for drugs for people with access to Medicare to pay.
  • Potential loss of the Prevention and Public Health Awareness Fund.
  • Loss of coverage for young adults.

4. Result in potential loss of funding for the Ryan White CARE Act – non-defense funding for health care would be cut to below FY 2008 levels and would be capped for five years. Even though the CARE Act has enjoyed strong bipartisan support, such a funding reduction would mean that none of the parts would be able to keep up with the need – in fact the need would grow as people who had been accessing Medicaid and Medicare turn to the CARE Act for help. This might cause:

  • Likely increases in HIV ADAP waiting lists.
  • Increases and wait lists for access to doctor visits.
  • Cutbacks on supportive services such as case management, transportation, help with translation needs, food and nutrition services and more.

5. A potential loss of funding for the HIV prevention – likely to be cut to FY 2003 or even lower levels and then capped.

  • The overall Centers for Disease Control and Prevention budget was cut to 2003 level for the remainder of FY ‘11.  It is likely they would remain a target for even further cutbacks in resources and virtually certain that they would not be raised.
  • 6. A potential loss of funding for the Housing Opportunities for People with AIDS (HOPWA) program and other housing programs.

    • Although HOPWA only received a 0.2% rescission for FY’11, the rest of the housing budget was cut by billions of dollars.

    All of this plus cuts to education and other programs would amount to about $4.3 trillion in cuts.  In the meantime the budget would give tax cuts of $4.2 million to the wealthiest people in America.

    Sorry, AIDS United can’t buy this.  We’re opposing the changes of the Republican plan that would hurt people living with HIV plan including the drastic cuts to Medicare and Medicaid that would threaten the main sources of treatment and care for people living with HIV.  So what can you do?

    What to do?
    The bright side of this issue is that this budget is not binding.  The President laid out a budget plan that accepts the need to find ways to cut overall spending levels, but which clearly maintains Medicare and similar priorities.  New Members of Congress do not understand the importance of these programs to people in their districts and State.  It’s not too late to stop the erosion of health care in this country.  We urge advocates to plan meetings when your Representative and Senators are in town during their recesses (or to attend local town hall meetings which are generally held during the recesses).  Tell them:

    • That you oppose the Ryan budget and any other budget that will make it harder for people living with HIV to get access to Medicare and Medicaid for treatment
    • That cutting health care programs like HIV/AIDS treatment programs while giving huge tax breaks to people earning more than $250,000 is wrong and that you oppose it.

    AIDS United can help you plan your meeting with your Members of Congress when they are in town. Click here for a tip sheet for planning and implementing your meeting, or email with questions.  The current recess is now-May 1. The House of Representatives is also out May 16-22 and June 6-12 while the Senate recess is July 4-10.  Keep an eye out for an AIDS United webinar in May that addresses the Ryan budget, cuts to HIV and how to talk with your Representatives.

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