June 1, 2012
As if the HIV/AIDS community did not have enough to deal with, now the impending "fiscal cliff" has been added to our collective worry list. The fiscal cliff has become the buzz term in the media and around the Washington, D.C. government community since Federal Reserve Chair Ben Bernanke used the term in testimony earlier this year before the House Financial Services Committee. The fiscal cliff is used to describe a worst case scenario resulting from the year end expiration of the Bush era tax cuts, the 2% payroll tax "holiday," the extended unemployment benefits package and the automatic spending cuts (sequestration) mandated by the Budget Control Act that will go into effect right after New Year's Day. The expiration of the current Medicare "doc fix" on Dec. 31 can be thrown in for good measure. The Congressional Budget Office (CBO) joined the fray last week by issuing an analysis of the potential impact on the economy of the elements that make up the fiscal cliff. The CBO's analysis was not a cheery one.
There seem to be four views for every three pundits as to what all this means and what can or should be done to avoid falling off the cliff. It is clear, however, that Congressional action will be needed and there is near universal agreement that Congress will not act until after the November elections, in a lame duck session. The questions are open as to whether Congress will make clear, albeit hard, decisions in the lame duck session, or punt to the new Congress that convenes in early 2013.
Setting aside the drama over the fiscal cliff, there are real implications for the response to HIV/AIDS. Dr. David Holtgrave from Johns Hopkins Bloomberg School of Public Health and his colleagues issued a new paper on the costs, consequences, and feasibility of strategies to achieving the goals of the National HIV/AIDS Strategy (NHAS) (see above article for a link to the paper from Dr. Holtgrave et al.). This latest paper follows an earlier one on the economic importance of NHAS for the country in which the authors estimated that an investment of $15.175 billion will be needed through 2015 to achieve NHAS targets. The latest paper concludes that the NHAS targets can still be achieved but not unless diagnostic and prevention services are scaled up. It is not likely that we would achieve such program expansion if the scenarios envisioned in the fiscal cliff are realized. We will not be able to achieve NHAS targets if drastic spending cuts to domestic programs are enacted and if there is not real revenue growth to stave off such draconian spending cuts. That's why what Congress and the administration do to avoid falling off the fiscal cliff is very important for the HIV/AIDS community, and that's why AIDS United will remain focused on keeping you informed and engaged. Ending the HIV/AIDS epidemic cannot be a casualty of falling off a cliff.
Click here to learn more about the "fiscal cliff."