Remember earlier this year when President Trump said he would ask Congress for $291 million in the U.S. budget to reduce new HIV infections by 90% by the year 2030? The administration even went so far as to release a list of 48 counties and seven states -- plus Washington, D.C. and San Juan, Puerto Rico -- with a disproportionately heavy HIV burden that were going to receive portions of that $291 million.
Trump's announcement was greeted with skepticism from HIV advocates -- understandably. This is an administration, after all, that fought tooth and nail (and in vain) to kill the Affordable Care Act (which dramatically expanded affordable health care coverage for millions of Americans, including those with, or at risk for, HIV), that has attacked LGBTQ (especially transgender) Americans in a variety of ways, and that has made immigrants fearful of seeking health care and other services.
Many HIV advocates noted the irony, if not the sheer schizophrenia, of Trump saying that he wanted to end HIV in the U.S. when his policies seemed to indicate anything but.
But despite all that, the truth is that the administration has begun to make good on its HIV funding promise, announcing last month that it had awarded $13.5 million (total) to those counties and states to start their ending-the-epidemic planning, with $1.5 million per year until 2023 to go to the group NASTAD (National Alliance of State and Territorial AIDS Directors) to aid state and county health departments in that process.
States and counties have until Dec. 31 of this year to submit their draft outlines, with more participation from community stakeholders (such as HIV/AIDS services agencies) to come after that, according to Emily McCloskey, NASTAD's director of policy and legislative affairs.
But what about the rest of that $291 million? The responsibility there, says McCloskey, lies with Congress, which has failed thus far to pass a budget for the new fiscal year, which began Oct. 1 and goes through the end of September 2020.
Of course, you could say that the fault for this lies with Trump, who has made funding for his controversial border wall a huge sticking point in the budget. And the budget process is also being slowed by impeachment proceedings.
But despite the usual matter of Trump making things complicated, "Congress still needs to do their job," says McCloskey. They've passed a short-term resolution to fund the government through Nov. 21 and, come that date, will likely pass another one to continue the funding through the end of the year -- but, of course, all this will collide with (and likely be overshadowed by) an impending impeachment vote in the House.
Then there's also the possibility that the stopgap resolution on the budget could continue well into next year -- a highly politicized election year -- in which case, the administration could pull money from other buckets to keep funding the HIV initiative.
According to McCloskey, it cannot, however, pull money from, say, HOPWA (Housing Opportunities for Persons With AIDS), which many HIV advocates had feared -- although it could pull a limited amount from the Department of Health and Human Services' Minority HIV/AIDS Fund. The administration already pulled $12 million from this fund for the above-mentioned first round of money for planning.
So that's where things stand at this point. Let's put it this way for now: It sure wouldn't hurt for you to call your representatives' office and tell them that, despite all the drama going on in D.C. right now, it's still important for the House and Senate to come together and pass a budget ASAP!