AIDS Action Weekly Update
June 20, 1997
Welcome to AIDS Action Council's Weekly Washington Update, an on-line newsletter for Handsnet subscribers 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.
VA/HUD Committee Appropriations Markup
The VA/HUD Appropriations Subcommittee will be meeting next week to consider and vote on fiscal year (FY) '98 funding for the Housing Opportunities for People with AIDS (HOPWA) program, as well as other housing programs. The VA/HUD appropriations Subcommittee is scheduled to mark up the bill on June 25th. HOPWA is currently funded at $196 million. The President has requested an additional $8 million in funding for a total of $204 million for FY '98. The President's request for HOPWA would be the minimal amount needed for HOPWA to begin to meet the housing needs in eligible jurisdictions. The true amount needed to fully meet housing needs for people with AIDS in FY '98 is $250 million. Advocates should contact their House members and urge them to contact the chair of the VA/HUD subcommittee, Representative Jerry Lewis (R-CA), in support of increased funding for HOPWA.
Release of Standard of Care Guidelines
The Department of Health and Human Services, Office of Public Health and Science released for comment, the standard of care guidelines for treatment of HIV with new combination therapies yesterday. The guidelines emphasize primary care and aggressive treatment at the earliest stages of infection, before irreversible immune system damage has occurred. However, in order for the guidelines to be meaningful, there needs to be an increased federal commitment to getting AIDS drug therapies into the hands of all Americans living with HIV and AIDS. Specifically, there needs to be support for the expansion of Medicaid eligibility to people in early stages of HIV infection, increased funding for the AIDS Drug Assistance Program (ADAP) and for the Ryan White CARE Act. HHS is seeking comments on "Guidelines for the Use of Antiretroviral Agents in HIV-Infected Adults and Adolescents." Comments should be postmarked by on or before July 21, 1997 and be mailed to Principals and Guidelines Comments, The H IV/AIDS Treatment Information Service, P.O. Box 6303, Rockville, MD, 20849-6303.
Senate Finance Committee Mark-Up
The Senate Finance Committee voted 20-0 to cut spending on Medicare by $115 billion and Medicaid by $13.6 billion over five years. The cuts will occur mostly through reduced payments to health care providers. The Committee also voted to reduce the Medicare medical savings accounts (MSAs) annual deductible, and to cap out-of-pocket expenses for beneficiaries. In addition, the MSA demonstration project would be reduced from 500,000 to 100,000 people. Increases in the Medicare deductible according to income guidelines was approved. The panel voted down a provision allowing states to hire private companies to administer health and welfare programs. However, Senator Gramm of Texas was successful in getting a provision passed allowing the state of Texas to use private companies in program administration. The Committee called for approximately $16 billion in block grants to the states to cover five million children who are currently without health insurance. Special needs children also exempted from mandatory enrollment in Medicaid managed care.
Disclosure of Confidential Information to Public Housing Agencies
The Senate Public Housing Reform and Responsibility Act of 1997 (S. 462) contains a provision that will require individuals who apply for public housing and Section 8 assistance to consent to the disclosure of confidential medical information about alcohol and drug use and treatment as a condition of receiving housing. The provision, 301 (d), sponsored by Senator Rod Grams (R-MN), would also require doctors, medical centers and clinics, hospitals, and drug treatment centers to disclose this information to the public housing agencies. The Grams provision overrides federal confidentiality regulations that protect this treatment information (confidentiality of Alcohol and Drug Abuse Patient Records) and violates the Fair Housing Act (FHA) which currently protects individuals in recovery from substance abuse from housing discrimination. The bill has passed the Senate Banking, Housing and Urban Affairs Committee and may be considered by the full Senate in the near future.
Repeal of FASA
Congress is considering repealing the Federal Acquisition Streamlining Act (FASA). Under FASA, AIDS Drug Assistance Programs (ADAPs), public hospitals, and state and local health departments could purchase life-saving drugs, including AIDS drug therapies, at discount rates. If implemented, this program could offer cost savings of between 31 percent and 62 percent on major HIV drugs. President Clinton signed the supplemental appropriations bill, which included language imposing a moratorium on implementation of FASA through the end of this session of Congress. The pharmaceutical industry and the business lobby remain undeterred in their campaign to repeal FASA. The appropriations process provides an opportunity to accomplish this goal. The FY '98 House Treasury/Postal appropriations bill may be a potential vehicle. Advocates continue to stress that FASA could be of great help to AIDS Drug Assistance Programs (ADAPs) who are experiencing budget shortfalls. These budget limitations have forced many states to limit their drug formularies or deny coverage for some people. Advocates should call their representatives and urge them to contact Representative Livingston, Obey, Kolbe, Hoyer, and Burton to express their opposition to repealing FASA and to urge hearings on the program.
The Senate Labor and Human Resources Committee approved by a vote of 14-4, S. 830, "The Food and Drug Administration Modernization and Accountability Act of 1997." The legislation makes changes the current drug and medical device approval process and would reauthorize the Prescription Drug User Fee Act of 1992. Advocates are concerned that these reform provisions threaten the public's health and safety by lowering regulatory standards. The full Senate is expected to take action on the legislation sometime in July. Democratic Senators Dodd (CT), Mikulski (MD), Murray (WA), Wellstone (MN) joined the 10 Republicans voting for the bill. Senators Kennedy (MA), Bingaman (NM), Reed (RI), and Harkin (IA) against the bill.
This article was provided by AIDS Action Council. It is a part of the publication AIDS Action Weekly Update.