What’s Missing from the Budget Discussions?

By Rob Banaszak on October 11, 2013 in Budget and Appropriations, Policy/Advocacy

Donna_Crews_2013_webby Donna Crews, Director of Government Affairs

There sure is a lot of conversation going on in Washington these days.  Government shutdown.  Economic shutdown. Repeal of delay of the Affordable Care Act.  A major topic of discussion seems to be getting lost in this mix, though: avoiding additional sequestration cuts come January 2014 if the Budget Control Act law is not revised.  We at AIDS United encourage our colleagues to continue to contact Congress to eliminate sequestration with a balanced approach to federal deficit reduction (federal cuts and revenue increases), to reopen the government, and avoid a federal default. The total spending amount ($986 Billion) being used in the proposed short-term Continuing Resolution (CR) for the discretionary portion of the bill assumes that sequestration continues. Continuing to use that total number, without repealing the sequester will trigger another round of automatic cuts in January. Sequestration must be repealed to ensure non-defense discretionary programs have the necessary funding to meet the growing needs in public health, education, and nutrition programs.

Last week, Minority Leader Nancy Pelosi said at a press conference after a meeting of the four leaders at the White House, “We’ll take your number to keep government open. Give us a chance to vote for it.”  However, AIDS United believes that the spending total should only be used for the short term CR.  The cuts have already cost way too much for the community-based member organizations of AIDS United’s Public Policy Committee (PPC). Congress must restore funding by utilizing the higher Senate number of $1.058 trillion for the long-term solution to Fiscal Year 2014 and replacing sequestration.  Some of our PPC member agencies have seen anywhere from five to 15 layoffs — including both medical doctors and lawyers.  Some have not filled as many as eight positions lost in attrition; are experiencing anywhere from 30 to 100 increased caseloads for case managers; and having to make drastic cuts to hot meal availability.  Waiting lists have been implemented for AIDS Drug Assistance Program (ADAP) medication and for medical treatment slots after an HIV positive initial diagnosis.  As one of our PPC members, Carole Treston of the Association of Nurses in AIDS Care (ANAC) stated, “A waiting list for care is not just an inconvenience; it is a critical time to engage a person in treatment.”  If that patient have to wait six weeks for an appointment it could diminish  motivation to engage in care and further deteriorate their health and the HIV status of his or her partner –  and possibly their community.

The impact of the sequester on HIV prevention programs are just as severe.  One of our PPC members closed their HIV prevention center serving men who have sex with men age 13 to 35, one of the populations most impacted by HIV.  While in one of our jurisdictions the cuts from the Centers for Disease Control and Prevention (CDC) were absorbed by the state, enabling their prevention programs to continue unscathed, the  majority of our PPC member organizations have been faced with dire prevention cuts, forcing reduction in HIV testing and prevention messages to the high-risk HIV-negative population.

HIV-focused trainings and workforce development have also been cut by more than ten percent due to rescissions and sequestration, just when the healthcare workforce — which needs HIV training — will increase with the expansion of the Affordable Care Act.  It is more important than ever to increase our training capacity as more healthcare professionals will interact with HIV-positive individuals across the healthcare spectrum.

At a time when we have the scientific prevention and treatment tools to begin to end the AIDS epidemic in the United States, it would be immoral to allow funding cuts due to sequestration to divert us from this worthy mission.  Congress must find a balanced solution to end the stalemate and – permanently eliminate the sequester; reopen the government; avoid an economic shutdown.  It is too important to the health and well-being of our nation.

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