AIDS Action Announces '97 Priorities as 105th Congress Set to Convene
January 7, 1996
Contact: Joe Zuñiga, AIDS Action
"Last year brought exciting news about the potential of new AIDS drug therapies to produce dramatic health improvements for people living with HIV and AIDS," said Deputy Executive Director Christine Lubinski. "Access to care will be the most salient issue we face in 1997. However, this issue is only one piece of the puzzle. It has always been AIDS Action's position that the most effective federal response to the epidemic must address all the needs of Americans living with HIV and AIDS, and our legislative priorities reflect that philosophy."
AIDS Program Funding
AIDS Action will advocate for increased fiscal year 1998 (FY98) funding for all AIDS care and social service programs. FY98 funding increases will be sought for the five titles of the Ryan White CARE Act program, including a separate appropriation for the AIDS Drug Assistance Program (ADAP) and the AIDS Education and Training Centers (AETC) program; the Housing Opportunities for People With AIDS (HOPWA) program and the McKinney Homeless Assistance grants; AIDS research at the National Institutes of Health (NIH); Centers for Disease Control and Prevention (CDC) prevention programs, especially community-based HIV prevention programs and STD prevention efforts; and substance abuse prevention and treatment efforts at the Substance Abuse & Mental Health Services Administration (SAMHSA).
Achieving funding increases may be made more difficult given President Clinton's stated commitment to achieving a balanced budget by 2002. AIDS Action fears that Clinton may recommend FY98 budget cuts in health and social programs, as well as fundamental changes to entitlement programs such as Medicaid and Medicare, in order to deliver a balanced budget. AIDS Action will work to ensure that the Clinton administration protects the integrity of essential HIV and AIDS programs in the face of budgetary pressures.
AIDS Action will also work with the 105th Congress to protect funding for critical AIDS programs. If the 105th Congress moves forward with major reductions in domestic discretionary or entitlement spending, entitlement reform, and/or tax cuts, AIDS Action will monitor and respond to the impact of these proposals on programs vital to people living with HIV and AIDS.
Medicaid serves as a health care safety-net for 53 percent of adults and 90 percent of children living with HIV and AIDS. Concurrently, Medicare has become an important health care payer, as people living with HIV and AIDS automatically qualify for Medicare parts A and B by maintaining SSDI or SSI disability income for at least 25 months. Alarmingly, both Medicaid and Medicare have been targeted for major budget cuts in the deficit reduction plans of both political parties.
Over half of all Americans receive their health care through some type of managed care arrangement. AIDS Action will work to increase consumer protections in the private managed care insurance market through the passage of viable managed care legislative proposals in the 105th Congress. AIDS Action will also work with coalition partners to develop a comprehensive managed care bill, and will work with the Clinton administration and federal agencies on managed care regulations to ensure consumer access to quality care.
AIDS Action's 1997 prevention agenda will include administrative and legislative advocacy to lift the federal funding ban on needle exchange programs; oversight of the management and administration of HIV prevention research and program funds at the CDC and the NIH and of federal prevention dollars managed by local and state health departments; and the coordination of opposition to Rep. Tom Coburn's (R-Okla.) HIV prevention legislation. AIDS Action will continue to oppose federally mandated mandatory testing, names reporting, and partner notification. Finally, AIDS Action will engage in a reexamination of counseling and testing programs, particularly in light of the great need to promote knowledge of serostatus and access to early intervention, and will continue to monitor and oppose congressional restrictions on the content of federally funded HIV prevention programs.
There is an inextricable link between stable and affordable housing for people living with HIV and AIDS and the ability to access care and the promise of new drug therapies. AIDS Action will work with the Clinton administration and the 105th Congress to reauthorize the Housing Opportunities for People With AIDS (HOPWA) program, which expired in 1994. AIDS Action will also work with the Department of Housing & Urban Development (HUD) to make existing housing programs more accessible and appropriate to people living with AIDS through the development of programs and policies that are responsive to their needs. Additionally, AIDS Action will work to see that an agenda is set for HUD's newly formed Office of HIV/AIDS Housing.
The 104th Congress passed the Ryan White CARE Act Amendments of 1996, which reauthorized the CARE Act for another five years. In 1997, AIDS Action will monitor the development of federal guidance for the implementation of the reauthorized law with the goal of ensuring a reasonable and consistent application of the legislation's requirements for CARE Act-funded programs.
At least 20 states have or are projecting serious ADAP budget shortfalls, leading to caps in enrollments, caps on triple combination drug therapy access, tightened eligibility standards, and restricted state drug formularies. Obviously, increasing both federal and state support for ADAP is an integral part of increasing access to comprehensive HIV and AIDS treatments. In addition, AIDS Action will work to improve federal- and state-level oversight of the ADAP program to assure that it works as fairly and efficiently as possible with the funds available. Finally, AIDS Action will assume a leadership role in developing and nurturing a national coalition whose mission will be to influence pharmaceutical industry decision-making on pricing, enhance discount programs for public payers such as Medicaid and ADAP, and improve the accountability of drug company patient assistance programs.
AIDS Action will continue to be at the forefront of the fight to preserve the integrity of the Food and Drug Administration (FDA) and its mission to enhance and protect the public health. AIDS Action will also monitor AIDS drug applications, and will work with the FDA to ensure that patients have access to complete and clear information about available HIV/AIDS drug therapies.
AIDS Action will work with the 105th Congress to reauthorize the National Institutes of Health (NIH). While there is potential for negative amendments - HIV prevention research, needle exchange, and other social agenda items - the likely top issues for AIDS Action will be the structure of the Office of AIDS Research (OAR) and the mechanism for funding all AIDS research at the NIH. AIDS Action will work to preserve the OAR's consolidated budget authority. In addition, AIDS Action's work on NIH oversight will be tightly focused on assuring the implementation of the recommendations of the Levine Committee, which in 1996 released its strategic plan for AIDS research. Special attention will be paid to the Levine Committee's call for better coordination of prevention research and the revitalization of the vaccine program.
AIDS Action will advocate for the reauthorization of The Rehabilitation Act, which prohibits discrimination on the basis of disability, including HIV disease, in programs that receive federal funding. AIDS Action will monitor legislative attempts to undermine key federal civil rights statutes such as the Americans with Disabilities Act (ADA) and work to protect the fundamental rights of legal immigrants and undocumented persons. And, AIDS Action will monitor the implementation of the Immigration Reform Act of 1996 and its effect on both documented and undocumented residents living with HIV and AIDS. AIDS Action will also monitor actions affecting access to public benefits and other civil rights matters, and will monitor Immigration and Naturalization Services (INS) actions in response to the first U.S. asylum case granted on the grounds that the applicant would be persecuted because of his serostatus.
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This article was provided by AIDS Action Council.