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Debt Ceiling Dealing: What Sequestration Could Mean to the HIV Community

November/December 2012

Even if you have absolutely no interest in politics, you couldn't avoid hearing, reading, or watching reports about the battle over the debt ceiling between Republicans and Democrats in Congress in the spring and summer of 2011. The problem was that Republicans were threatening to shut down the government by refusing to allow the debt ceiling (the amount the U.S. borrows from other countries) to be raised, even though it has been traditionally raised almost automatically under both Republican and Democratic administrations.

This time, Congress and President Obama needed to figure out how to reduce the deficit by $2.3 trillion over the next 10 years. With the Republicans digging in their heels on not raising taxes and the Democrats refusing to eliminate or reform Social Security and Medicare, the threat of the United States' credit rating being downgraded was as real as that of her citizens seeing their own credit tank due to sky-high mortgage, medical, and credit card debt.

The Super Committee

After weeks of negotiation wherein President Obama proposed a plan to cut more spending ($4 trillion) if Republicans would allow the Bush tax cuts for the wealthy to expire and almost reaching an agreement before House Speaker John Boehner walked away, all parties admitted failure to reach an agreement and President Obama appointed six members of each party (three from each chamber) to the Joint Select Committee on Deficit Reduction, known thereafter as "the Super Committee." They started on August 11 and had until November 23 to reach an agreement. If they failed to agree on a plan or if Congress failed to approve it, automatic cuts, termed "sequestration," of $1.2 trillion would kick in. This was laid out in the Budget Control Act of 2011, which was signed into law on August 2, 2011. Both parties in both chambers passed it, so the deal was known and understood by everyone.


Unfortunately, the Super Committee worked fiercely, but unsuccessfully, battling the two factors of spending cuts and revenue raising until the deadline arrived. But in accepting their failure to compromise and come up with a plan, they walked away under the political cover of, "We tried our best, but now the cuts will be automatic and there's nothing we can do about it."

Most of us know the word "sequestration" in regard to juries being kept in hotel rooms, out of contact with, or separated from, family, friends, and the press. In this sense, it follows more precisely the dictionary's definition -- "removal or separation," as in removing the money from the budget or separating funding from the programs it funds.

So, just like in third grade when you agreed to help Timmy with his math homework (and ended up doing the whole thing) in exchange for the Twinkies his mother packed in his lunch every Friday and then Friday rolled around after he'd gotten an A on his math and he refused to honor the deal by giving you those Twinkies, now that we're looking at the reality of the cuts that come with sequestration, the Republicans are screaming about how the defense cuts (admittedly the largest at $54.7 billion, half of the $109 billion to be cut in 2013) are unreasonable -- in other words, welshing on the deal -- and threatening to do whatever they have to in order to protect the defense department budget.


On September 10, Florida Tea Party Republican Allen West introduced H.R. 6365, the National Security and Jobs Protection Act, which would restore much of the military cut by adding it to what's already being taken away from discretionary spending programs. It passed the House by a vote of 223 -- 196 on September 13 and was then sent to the Senate, where it will sit gathering dust until after the election. If Congress and the president can't agree on 6365 or an alternative plan, the automatic cuts totaling $109 billion will kick in. Since programs that actually keep people alive, HIV-positive and not, are considered fair game while the defense budget, in large part used to kill or disable our enemies, is evidently not, it is crucial that the HIV/AIDS community pays attention.

As delineated in a letter from The AIDS Institute to the leaders of Congress, a total of $538 million would be cut from the following programs in 2013:

  • CDC HIV Prevention -- $64 million
  • Ryan White CARE ACT -- $119 million
  • AIDS Drug Assistance Program (ADAP) -- $77 million
  • NIH AIDS Research -- $251 million
  • Housing Opportunities for People with AIDS (HOPWA) -- $27 million

The AIDS Institute estimates that just the ADAP cut alone would cause 9,400 HIV-positive people to lose access to their medications. Right now, thanks to the extra funding sent to troubled ADAPs in August, there are only 88 people on waiting lists in six states. The ADAP cut would almost guarantee the return of waiting lists in many of the states that have been able to eliminate them completely.

In addition to the issue of access to treatment, it is also a reality that 70% of the HIV-positive population in this country depends on Medicaid, Social Security Disability, and other safety net programs that, while originally exempt from sequestration, may now be in danger of being pawns in the negotiations that will no doubt go on after the election.


Even though legislative focus is not in Washington at the moment, that means that senators and representatives are likely to be home in their district offices. And that means that their constituents can actually call or make an appointment to speak to them about issues that matter to the voters. This would be a good time to remind them of something anyone living from paycheck to paycheck or struggling with being chronically overdrawn knows all too well -- when expenses are greater than income, you look for ways to increase the income in addition to giving up the daily Starbucks. You don't give up your home, your utilities, and your grocery budget before you get a second job, sell Grandma's silver, or get a roommate.

HIV/AIDS gives you the opportunity to learn how to communicate with your medical providers, social workers, and service providers. Now it can give you the opportunity to be an empowered communicator with your elected officials. Remember that you have the one thing they want the most -- your vote! Tell them what they need to do to get it and then hold them accountable.

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This article was provided by Positively Aware. It is a part of the publication Positively Aware. Visit Positively Aware's website to find out more about the publication.
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