AIDS Action Weekly Update
May 23, 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.
Clinton Names AIDS Vaccine As A Priority
During a commencement address at Morgan State University in Maryland last weekend President Bill Clinton announced his goal to find a vaccine to the AIDS virus, and challenged scientists to develop one within the next ten years. To underscore his commitment the president stated that he would add $17 million to the government's biomedical research budget to help attain that goal. Development of an AIDS vaccine will be quite a challenge in that determining its effectiveness will require the cooperation of thousands of HIV-negative individuals. This announcement reflects the recommendations of the Levine Report and its strategic plan for AIDS research.
Budget Resolution Passes In The House And Senate
The budget resolution, which sets the funding levels by which appropriators can determine spending for specific government programs, passed overwhelmingly in the House early Wednesday morning, 333-99. The House version of the budget resolution (H Con Res 84) includes $13.6 billion in cuts to Medicaid over a period of five years. The Health and Environment Subcommittee of the House Commerce Committee will begin to mark up the legislation to map out the details of these cuts to the Medicaid program June 4th with the full Commerce Committee to take up the proposal soon thereafter. The final legislation on Medicaid and Medicare will be included in a Budget Reconciliation bill, which may be completed before the July 4th recess. The Medicaid cuts will likely come largely from the Disproportionate Share Hospital (DSH) payment program, which assists hospitals that provide large volumes of care to uninsured and Medicaid populations. While the DSH program has been abused by some states who identify hospitals as DSH hospitals even though they do not serve these populations, DSH funding has provided crucial support to many hospitals that provide safety-net care for people living with HIV/AIDS. AIDS advocates support targeting DSH cuts in such a way that protects those hospitals that provide high levels of care, including uncompensated care, to low income and Medicaid populations rather than across-the-board cuts that will allow further abuses in the program and undermine the ability of public hospitals to provide care to needy individuals.
On the Senate side, passage of the budget resolution (S Con Res 27) was delayed due to consideration of a number of amendments that would have altered the spending and taxation levels in the budget. One of these was an amendment offered by Senators Arlen Specter (R-PA) and Tom Harkin (D-IA) which would have restored $100 million in cuts to health discretionary programs. These programs include AIDS programs such as the Ryan White CARE Act, HIV prevention at the Centers for Disease Control and Prevention (CDC), AIDS research at the National Institutes of Health (NIH), and AIDS programs within the Substance Abuse and Mental Health Services Administration (SAMHSA). Overall funding for the NIH would have been increased by $975 million, a 7.5 percent increase over FY 97. The Specter-Harkin amendment failed 37-67. The Senate passed their version of the budget resolution Friday afternoon, 78-22, before heading out for the Memorial Day recess.
FY 97 Supplemental Appropriations Bill Unfinished
Conference negotiations between the House and Senate versions of the FY 97 supplemental appropriations bill will resume following the Memorial Day recess as negotiators were unable to work out their differences before members started heading home for the recess. Although both versions of the bill contain an automatic continuing resolution (CR) to continue funding for programs in spending bills that have not been passed by the end of the fiscal year at FY 97 levels, there is a chance that this language could be removed or altered to increase the level above FY 97 levels. President Clinton is opposed to the automatic CR spending levels unless they are increased to the FY 98 levels outlined in the budget agreement and has threatened to veto the bill unless this occurs.
Also in the supplemental appropriations bill, the language to repeal the Federal Cooperative Purchasing Program was altered during conference negotiations. The original language contained in the Senate version would have repealed the program which would have allowed public hospitals, state and local health departments, and AIDS Drug Assistance Programs (ADAPs) to take advantage of even greater discounts than are now available to federally qualified health centers and some ADAPs under the Public Health Service 340-B pricing program. The program would have offered enormous savings on a range of items from prescription drugs to office furniture and computers. The compromise involved delaying consideration of this program until government officials could evaluate the merits of implementation. This moratorium increases the pressure for additional FY 97 funding for ADAP.
An amendment to provide an additional $68 million for ADAP was to have been offered last week by Representative Nancy Pelosi (D-CA), but due to the threat of a point of order, was not. The Administration has yet to weigh in with a request for the desperately needed ADAP funds. AIDS advocates should contact their public officials and encourage them to express their support of additional ADAP funds to the Administration.
SAMHSA Reauthorization Hearing
The Public Health and Safety Subcommittee of the Senate Labor and Human Resources Committee held a hearing on reauthorizing the Substance Abuse and Mental Health Services Agency (SAMHSA) Thursday, May 22. SAMHSA, which was created in 1992 through the Alcohol, Drug Abuse and Mental Health Administration (ADAMHA) Reorganization Act, has been operating without authorization since 1994. The $2 billion agency is divided into three centers, the Center for Substance Abuse Prevention (CSAP), the Center for Substance Abuse Treatment (CSAT), and the Center for Mental Health Services (CMHS), all of which include programs targeted toward individuals with or at risk for HIV/AIDS in addition to substance abuse and/or mental health disorders. The subcommittee chair, Senator Bill Frist (R-TN), and full committee chair Senator Jim Jeffords (R-VT) both expressed a commitment to having this agency reauthorized this year.
This article was provided by AIDS Action Council. It is a part of the publication AIDS Action Weekly Update.