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House Adopts Ryan FY 2013 Budget

by Ronald Johnson, Vice President of Policy & Advocacy
AIDS United

On Thursday, the full House of Representatives voted 228-191 to adopt the harsh Fiscal Year 2013 (FY 13) budget resolution (H Con. Res. 112) presented by Rep. Paul Ryan (R-WI), Chair of the House Budget Committee. No Democrats voted for the Ryan-authored budget and 10 Republicans voted against the resolution. Prior to passing the Ryan budget, the House voted down six alternative budget proposals, including plans introduced by the Congressional Progressive Caucus, the Congressional Black Caucus, House Democrats, the Republican Study Committee. Also among the six alternatives was a bipartisan proposal that the co-sponsors said was modeled on the recommendations of the 2010 Simpson-Bowles deficit reduction commission (National Commission on Fiscal Responsibility and Reform).

AIDS United was part of the nearly unanimous condemnation from, and strong opposition by,  the HIV/AIDS community, other disease-related and health care groups, and advocates for low-income individuals and families to Ryan’s FY 13 budget blueprint. The draconian cuts in spending for health care, programs that provide a safety net for low-income and other vulnerable populations, repeal of the Affordable Care Act, and the virtual dismantling of Medicaid and Medicare called for in the FY 13 Ryan budget, coupled with larger tax cuts for corporations and the most wealthy individuals, were considered, rightly, to be unconscionable.

The Senate is not expected to adopt the Ryan budget. Indeed, the full Senate likely will not vote on a budget resolution for FY 13. The Senate leadership considers a budget resolution unnecessary in light of the Budget Control Act (BCA), to which both Democrats and Republicans agreed last summer. The Senate is proceeding with FY 2013 appropriations under the discretionary spending cap for FY 13 called for in the BCA, which is $1.047 trillion. In contrast, the House-passed resolution puts FY 13 spending at $1.028 trillion, $19 billion below what the Senate will be using. The different spending levels for FY 13 will make reaching a House-Senate agreement on appropriation bills difficult and likely impossible before the start of the new fiscal year on October 1 and probably before the November elections. Conventional wisdom in the Washington arena is that final spending levels for FY 13 will be set in a lame duck session after the elections.

Bottom-line, this means that the HIV/AIDS community will go through another year of uncertainty about funding levels for the Ryan White HIV/AIDS Program, including ADAP; domestic HIV prevention; the HOPWA program; and support for HIV research. This is not a way to accomplish the ambitious goals the first-ever National HIV/AIDS Strategy. This is not a way to end an epidemic.

It’s also not a pretty picture for the first International AIDS Conference held in the United States in over 20 years.

AIDS United will continue to be engaged with its partner national organizations in demanding the highest funding possible for HIV/AIDS programs. As always we will keep you informed and provide opportunities for your direct engagement in advocacy.

To read the letter AIDS United sent to all Members of the House, click here
http://www.aidsunited.org/uploads/AIDS_United_Budget_Letter_to_House_Members_-_March_29.pdf

To read more about the alternative budgets offered by the Congressional Progressive Caucus, the Congressional Black Caucus, and the Republican Study Group, follow the below links:

http://grijalva.house.gov/uploads/Executive%20Summary%20FINAL.pdf

http://cdn.thecongressionalblackcaucus.com/wp-content/uploads/CBC-FY13-Budget-Factsheet.pdf

http://rsc.jordan.house.gov/UploadedFiles/RSC_FY_2013_Budget_Cut_Cap_and_Balance_Summary–FINAL.pdf

AIDS United Partners Participate in Syringe Exchange Day of Action

by Bill McColl, Director of Political Affairs
AIDS United

On March 21, many of AIDS United’s Partners including Public Policy Committee Members and Southern REACH grantees took time to contact their Members of Congress with the message that syringe exchange funding must be restored. Highlights from Day of Action activities included the Lower East Side Harm Reduction Coalition in New York City connecting their followers to Senators Schumer (D-NY) and Gillibrand (D-NY) by posting AU’s website and alert on Facebook and Tweeting it in English and Spanish.

In Denver, Colorado, the Harm Reduction Action Center participated in phoning and emailing U.S. Senators Bennet and Udall. The Center sent information to 500 supporters, and to their Facebook friends. A local progressive blog also documented their efforts here: http://www.theprecarious.com/content/clean-needle-access-must-activists-say

The AIDS Foundation of Chicago (AFC), organized meetings with staffers for Senators Durbin (D-IL) and Kirk (R-IL) in Springfield and in Chicago. AFC representatives brought information packets including sign on letters from service providers and state representatives. They also sent out an e-blast to 6,000 people linking to AU’s alert. Also, the national HIV Prevention Justice Alliance sent out an e-blast to 11,700 people

The North Carolina Harm Reduction Coalition (NCHRC) organized a meeting with Senator Hagan’s (D-NC) office in Raleigh, NC, a call-in to her office in DC, a letter writing campaign to her office in DC and a social media education campaign on the issue. Fourteen people attended the meeting in Raleigh (including members of law enforcement, lawyers, diabetics, people of transgender experience, drug users and religious leaders).

AIDS Action Committee of Massachusetts sent out alerts to the Massaschusetts Viral Hepatitis Coalition, the Massachusetts AIDS Policy Task Force, and its own “cyber action alert list.” The agency also issued a statement and put a blog post up on our website (see attached). AIDS Action is working on getting a meeting with Senator Kerry (D-MA).

Of course this is the perfect time to remind readers that although the Day of Action is over, the effort to end the federal ban on syringe exchange funding has just begun. You can still contact your own members of Congress here: If readers would like to work with grassroots organizers in your region on this effort, send our Political Director, William McColl a note at wmccoll@aidsunited.org and he
will help to connect you.

Supreme Court Hears Oral Arguments on the Affordable Care Act

Bill McCollby William McColl, Director of Political Affairs, AIDS United

On Monday, the court heard arguments around the question of whether the penalty prescribed by the ACA to individuals who have not obtained health insurance is actually a tax. If it is a tax, then the Anti-Injunction Act would bar a review of the law’s constitutionality until the provision actually goes into effect in 2014. Most observers of the court appeared to agree that both conservative and liberal justices do seem to judge the ACA as a whole and would likely issue a ruling that the penalty is not actually a tax.

On Tuesday the court studied the constitutionality of the individual mandate provision in the ACA. From the transcript it is clear that Solicitor General Donald Verilli faced extremely skeptical questions and the justices spent considerable time trying to find what they called a “limiting principle” (e.g. a reason that the federal government’s power to intervene in the market was both necessary and that it would be constrained).

The final arguments both took place on Wednesday, with time devoted to the question of “severability” – what part, if any, of the ACA could survive if the court ruled that the individual mandate was indeed unconstitutional. The choices ranged from striking just the individual mandate all the way to the idea that the entire law should be struck. In the afternoon the court heard arguments about the constitutionality of the Medicaid expansion scheduled to take effect on January 1st, 2014. Essentially the states argued that the federal government’s expansion of Medicaid, even the offer to pay for most of it, is so large that it is coercive, leading to the compromise of the state’s own sovereignty. Again, the aggressive questioning seemed to confirm that the conservative justices might be tempted to strike down that part of the law. Lyle Denniston, a long time court reporter, observed that such a ruling would sacrifice the Medicaid expansion that serves the needy “to a historic expression of judicial sympathy for states’ rights.” Click here to read more.

It is nearly impossible to predict the final outcome of these arguments. Although the justice’s questions during oral arguments occasionally telegraph an outcome, it is also true that cases are not dependent on the oral arguments themselves, particularly in a well briefed case such as this one. Perhaps what is now clear is that it is indeed possible that the justices might decide the law is unconstitutional. Perhaps given the tone of politics and the strong opposition to the law, thisshould not be too surprising. Yet many legal observers, including me, argued that the law was likely to be upheld. (See this video for more details.)

Justice Anthony Kennedy is likely to be the 5th vote either to uphold the law or to strike it down. Certainly it was clear from the questioning that he has the potential to rule against it. Yet at the end of the arguments regarding the individual mandate, Kennedy also seemed to come up with his own definition of a limiting principle, one that would allow him to uphold the law. For now, the only thing to do is wait – the ruling will likely be out by the end of June.

The transcripts and audio recordings of the oral arguments are below.

Oral Arguments:

Day 1 – Anti-Injunction Act

Day 2 – Individual Mandate

Day 3 – Severability

Day 4 – Medicaid Expansion

Transcripts:

Day 1 Anti-Injunction Act

Day 2 Individual Mandate

Day 3 – Severability

Day 4 – Medicaid Expansion

The Female Condom: Safe, Sexy, and Cost-Effective

by Jessica Terlikowski, Director of Regional Organizing
AIDS United

This week the journal AIDS and Behavior published study findings stating that the Washington, D.C. female condom education and distribution program is a cost effective strategy for reducing new HIV infections. The data overwhelmingly demonstrated that dollars invested in the program resulted in a cost savings of more than $8 million due to the prevention of nearly 23 HIV infections. The program is administered by the Washington AIDS Partnership (an AIDS United Community Partnership) and the D.C. Department of Health.

The female condom is an essential safer sex option for all genders seeking to protect the health of themselves and their partners. It is the only receptive partner initiated HIV, STI, and pregnancy prevention tool available. The female condom can be used for vaginal or anal sex.

The study’s findings shatter the notion that female condoms and not a worthwhile expenditure for HIV prevention programs. The reality is female condoms work.

Lead author and chairman of the Department of Health Behavior and Society at Johns Hopkins Bloomberg School of Public Health, David Holtgrave, stated in the Washington Post that “When we think about what it means for a city or state to have a comprehensive HIV program, this study really says you ought to include female condoms as one element of a comprehensive program because it’s acceptable, effective and cost-saving.”

Atlanta, Chicago, Houston, New York City, and San Francisco have launched similar programs focused on increasing awareness, acceptance, and use of female condoms through equipping community educators, health care professionals, case managers, and other services providers with skills necessary to effectively promote female condoms within their communities. Each of these jurisdictions reports greater acceptance of female condoms among end-users and increased willingness among providers to promote them as a result of their work. Other jurisdictions are currently laying the groundwork to launch their own programs.

The energy and enthusiasm around female condoms has increased tremendously since the new and improved female condom, the FC2, hit the market in 2010. Last year each of the female condom programs in the U.S. came together to launch the National Female Condom Coalition to increase awareness, access, and use of female condoms through education, advocacy, and collaboration. The Coalition now counts approximately 40 health departments and organizations dedicated to sexual health and reproductive justice, gay men’s health, HIV prevention, family planning, and HIV-positive women from across the country. This study will further strengthen advocacy efforts to ensure women and men in the U.S. and around the world are aware and can access this highly effective, pleasurable, and cost-effective prevention tool.

For more information about the National Female Condom Coalition, email jterlikowski@aidsunited.org.

North Carolina Harm Reduction Coalition (NCHRC) Organizes North Carolina Advocates to Participate in the National Day of Action on Syringe Exchange

By Robert Childs, Executive Director
North Carolina Harm Reduction Coalition

On Wednesday, March 21st, 2012, North Carolina Harm Reduction Coalition (NCHRC) organized local clergy, law enforcement, diabetics, people of transgender experience, lawyers and drug users from around North Carolina to particpate in the National Day of Action on Syringe Exchange. Congress recently reinstated the ban on federal funding for syringe exchange programs (SEPs).  SEPs provide sterile syringes and collect used syringes to reduce transmission of viral hepatitis, HIV, and other bloodborne infections associated with reuse of contaminated injection equipment by drug users and diabetics.  Most SEPs are part of a comprehensive health promotion effort that includes HIV & hepatitis testing, education on reducing sexual and drug use-related health risks, and referrals to drug treatment & other medical and social services. Republicans in the House were successful in reversing policy on syringe exchange through FY 2012 Appropriations in December 2011. They re-imposed a complete ban on the use of federal funding for SEPs despite overwhelming scientific evidence showing decreased HIV, viral hepatitis and drug abuse among SEP participants, not only improving public health but also saving tax payers millions of dollars.

On March 21st NCHRC organized three actions: a mass letter writing campaign, a phone bank and a meeting with Senator Hagan’s office in Raleigh, NC.  We asked Senator Hagan to be our champion on this public health issue and to commit to the following actions:

  1. Ensure negotiations restore Congress’ FY 2010 syringe exchange language for both the federal and Washington, DC jurisdictions in FY 2012 appropriations legislation.
  2. Include language from FY 2010 on syringe exchange in the programmatic appropriations request letters due March 29th.
  3. Release a statement in support of restoring federal funding for syringe access programs.
  4. Encourage the North Carolina legislature and governor to decriminalize syringes and/or legalize syringe exchange.

Sen. Hagan’s office personnel gave us an indication of support, but promised to run the issue by Senator Hagan for a definitive answer on her position. At our meeting in Raleigh with Hagan’s office, we brought together advocates from various backgrounds to discuss the issue during our 30 minute meeting. As Executive Director, I covered an overview of SEPs and the history of federal funding while Ronald Martin (one of NCHRC’s law enforcement consultants with over 20 years of law enforcement experience) explained why law enforcement benefit from SEPs.  He stated, “Why would we not want syringe exchange? Research has shown a 66% reduction in law enforcement needlesticks in communities where SEPs exist. One out of three law enforcement can expect a needlestick in their career and I support any measure to reduce harm against our officers.” Reverends Jenna and Andy outline the moral imperative for life-saving SEPs, and our diabetic and transgender allies discussed the need for syringe access among these populations. To round out the meeting, Lucas Vrbsky from the NC Chapter of the National Association of Social Workers discussed the social justice benefits of federal funding for SEPs, Lisa Hazirjian from the NC AIDS Action Network demonstrated the financial benefits of SEPs as well as HIV prevalence among injection drug users, Faina Shalts (from Harvard’s SHARP crew) explained SEPs’ public health benefits and Tessie Castillo (NCHRC’s Harm Reduction Coordinator) completed the ask.

We would like to thank our allies and NC coalition members from Wilmington to Franklin who made this day a success and allowed us to put a southern stamp of support on this national issue.  Even though NC does not have legal syringe exchange, we support federal funding for syringe exchange because if the federal government shows support by allocating federal dollars for SEPs, it assists us in making the case for southern states to adopt these measures as well.   NCHRC hopes to see the US Senate, especially our representative Kay Hagan, champion this issue and send the message that our state supports an initiative that would improve NC and the nation’s public health and safety.

North Carolina Harm Reduction Coalition is a grantee of AIDS United’s Southern REACH initiative

Ryan Budget Released: AIDS United Opposes

by Donna Crews, Director of Government Affairs

On Tuesday, March 20 Rep. Paul Ryan (R-WI) chairman of the House Budget Committee introduced his Fiscal Year 2013 (FY13) budget entitled “The Path to Prosperity – A Blueprint to American Renewal.”  The total spending called for in the proposed budget is $1.028 trillion.  That amount is $19 billion below the bipartisan agreement for FY13 reached last August in the Budget and Control Act (BCA) and $15 billion below the current Fiscal Year 2012 level.

The possible program cuts in the Ryan budget for FY 13 could be:

  • Severe cuts to Supplemental Nutritional Assistance Program (SNAP), formerly known as food stamps.
  • Elimination of the Affordable Care Act.
  • Cuts to housing programs to assist those in foreclosure.
  • Changes in the structure of the Medicare and Medicaid programs.

The resolution would also decrease the tax burden for wealthy individuals by lowering the top tax bracket by 10 points from 35% to 25%.  Everyone else’s tax rate would be 10 % thus increasing the tax rate on many low income individuals.  Rep. Ryan’s resolution calls for permanently extending the “Bush era tax cuts” and eliminates the alternative minimum tax rate.

The budget resolution was debated in the Budget Committee on Wednesday, March 21 and adopted on a 19-18 vote.  All 16 Democrats on the committee voted against the proposed budget; they were joined by 2 Republican committee members who thought the total spending amount was too high.  Rep. Jason Chaffetz (R-UT) was the only committee member not present for the vote.  The budget debate will now move to the full House for an expected vote next week.  There are indications that the views of the 2 Republicans who voted against the budget in the committee are reflected in the total Republican caucus in the House.  If this dissension holds up, the fate of the Ryan budget in the full House may be a cliff hanger.

AIDS United is firmly opposed to Rep. Paul Ryan’s (R-WI) budget FY 13resolution.  We believe it would l have a devastating impact on people living with or affected by HIV and AIDS.  We must ensure that the Affordable Care Act is implemented so that HIV positive low income individuals with incomes up to 133% of the federal poverty level (FPL) will be able to have access to care and medications through Medicaid prior to an AIDS defining diagnosis.  The only way to tackle the fiscal crisis is to have a balance of revenue growth and cuts in spending.  All of deficit reduction  cannot be borne by the non-defense discretionary portion of the budget.  We believe the debate between the Ryan  budget and President Obama’s FY 13 budget request show the stark differences between  the philosophies of the House Republicans and the Administration.  Rep. Ryan’s budget increases the coffers of the wealthy and President Obama’s budget continues to work to provide affordable healthcare programs for all.

AIDS United will continue to monitor the Ryan Budget as it moves through the legislative process and will keep you updated.  We encourage you to take action with calls to your Representative to urge a “No” vote when the resolution comes to the House floor.