AIDS Action Weekly Update
July 26, 1996
Welcome to AIDS Action Council's Weekly Washington Update, an on-line newsletter that reviews what is happening in Washington on AIDS policy issues each week. If you have any comments or questions, please feel free to contact us at the e-mail address listed below.
Welfare Reform Provisions Impact on Health Care
The Senate passed a welfare reform plan Tuesday, July 23, 74-24. This bill will eliminate the entitlement status of a number of public assistance programs for the poorest Americans, the only "safety net" which keeps them from being destitute. Conference between the House and Senate versions began Thursday, 25 July. There are many disturbing provisions in these bills, including provisions which will have direct impact on the ability of very low-income people living with HIV/AIDS to access health care through Medicaid.
While the welfare reform bill is complex and the broader points of welfare reform enormous, AIDS advocates are hoping to influence this debate by focusing on the provisions that have the most direct impact on people living with HIV/AIDS. Those provisions are:
1) The Chafee-Breaux amendment, which maintains Medicaid eligibility for women and children currently eligible for Aid to Families with Dependent Children (AFDC), even if the states' eligibility standards for AFDC change. This would protect those currently eligible for Medicaid through AFDC and those eligible in the future, and prohibit states from lowering their income and resource eligibility standards for Medicaid in the future.
2) The Gramm amendment which denies any federal means-tested benefits to individuals who have been convicted for drug use, possession, or distribution. The effect of this amendment on people with AIDS (PWAs) is chilling as nearly half of new HIV cases are the result of injection drug use. These people would be denied welfare, food stamps, and Medicaid benefits.
3) In addition, the welfare reform plan derives much of its savings through denying government assistance to legal immigrants. Under this law current legal immigrants would be ineligible for SSI and food stamps and new legal immigrants would be denied eligibility for these programs and Medicaid for five years. This ban would also apply to those who become disabled after entering this country. AIDS advocates are encouraged to contact House and Senate conferees and ask them to preserve the Chafee-Breaux language, drop the Gramm amendment, and remove the provisions that deny access to benefits to legal immigrants. If these requests are not met, a presidential veto should be sought.
The three-month long standoff between Senate Democrats and the GOP leadership on the Health Insurance Reform Act (H.R. 3103) seems to have ended today, as an agreement has been reached on the issue of medical savings accounts (MSAs). Senate Democrats opposed to MSAs had blocked the naming of conferees up to this point, but a long meeting between House Ways and Means Chair Bill Archer (R-TX) and Senate Labor and Human Resources ranking member Ted Kennedy (D-MA) resulted in a breakthrough on this issue. The compromise involves a four-year MSA demonstration project that would affect no more than 750,000 policies. At the end of the four years, those wishing to remain on MSAs could do so, but Congress would have to vote to expand the program to anyone else. Senate conferees are Senators Trent Lott (R-MS), Ted Kennedy (D-MA), Nancy Kassebaum (R-KS), Daniel Moynihan (D-NY), and William Roth (R-DE). Conference could begin as early as today and negotiators are hoping to pass the legislation before the congressional August recess begins at the end of next week.
The FY 97 VA-HUD appropriations bill (HR 3666) is still pending Senate floor action and may be taken up early next week. AIDS advocates remain concerned that the Housing Opportunities for People With AIDS (HOPWA) remains flat-funded at the FY 95 post-rescission level of $171 million. An amendment strategy in the House to increase funding for HOPWA by $15 million failed, and the fact that the Senate bill contains less money for housing programs than the House bill makes the chances of increasing HOPWA funding remote. Although the president did request an additional $25 million for HOPWA which would increase funding for FY 97 to $196 million, the offset would come from an unfunded housing program, making it an unlikely possibility. Despite this dismal outlook, AIDS advocates will continue to contact their members of congress to urge them to increase funding for this vital housing program for people with AIDS as well as contact the president to make this a veto issue if HOPWA funding is not increased.
The FY 97 Labor-HHS-Education appropriations bill (H.R. 3755), originally scheduled this week for Senate subcommittee markup, is postponed until after the August recess. This gives AIDS activists additional time to press Senators for increases in funding for prevention, care and research. It is expected that the Senate will provide increases in biomedical research at the National Institutes of Health (NIH) in light of the Vancouver Conference several weeks ago and to restore the consolidated AIDS research appropriation to the Office of AIDS Research. However, the AIDS community is concerned that the Senate will not fund the President's supplemental request made earlier this week for an additional $65 million for the AIDS Drug Assistance Program (ADAP) which is funded under Title II of the Ryan White CARE Act. The AIDS community is also advocating for increases in the other titles of the CARE Act and for AIDS prevention programs at the Centers for Disease Control and Prevention (CDC).
The conference to resolve differences between the House and Senate versions of the FY 97 Department of Defense authorization bill (S. 1745) began this week. Of particular interest to AIDS advocates is the language regarding HIV-positive military personnel. The House version of the bill contains language inserted by Representative Robert Dornan (R-CA) which mandates the immediate discharge of HIV positive service members. The Senate version of the bill contains language by Senator John McCain (R-AZ) which calls on the Secretary of Defense to establish uniform policy regarding the retention of service members who are permanently nonworldwide deployable due to a chronic medical condition. The chances of the McCain language prevailing over the Dornan language are high, particularly since, Rep. Dornan was not selected as a conferee.
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This article was provided by AIDS Action Council. It is a part of the publication AIDS Action Weekly Update.