Here is more info on some of the most critical items for the HIV community that you will want to discuss with your members of Congress and/or their staff during this month’s recess.
I. Health Care: We #KilledRepeal!
We know you were right there with us every step of the way, making phone calls to your members of Congress, showing up at their offices, participating in rallies and marches, signing petitions, sharing on social media and, for some of us, even participating in direct actions that got us arrested.
We won! We should not underestimate our victory–it’s huge. It marked the culmination of 7 years in which Republicans dreamed of, and voted for, repealing the Affordable Care Act, which, for all its shortcomings, has allowed 20 million more Americans to have health coverage today than in 2009. Still, our work is far from done. Many Republican members of Congress still hope to undo the ACA, whether through a comprehensive bill or through undermining the law by changing regulations one by one. And they still have the power to do enormous damage to Medicaid and Medicare through the federal budget, which will be discussed in early September. Here is a good rundown for you of what could still happen, and what we need to watch for and take action on from Families USA.
- The final bill that would have repealed the ACA was voted down by only one vote. Yet 7 out of 10 Americans want both parties to work together to strengthen and improve the ACA rather than repealing it. All members of Congress should commit to working to make health care coverage more affordable to everyone who needs it and expanding coverage so that nobody in the U.S. dies or goes bankrupt from inadequate insurance. Insurance companies must continue to be held accountable for covering essential health benefits. Congress must continue making cost-sharing payments to offset high premiums for low-income Americans.
- Any attacks on Medicaid through the federal budget appropriations process will not be tolerated any more than the repeal efforts were.
- Members of Congress who voted for ACA repeal–whether by voting for the AHCA (House bill), the BCRA (Senate bill) or the Senate “skinny repeal” bill–chose to stand with Donald Trump, Mitch McConnell and the billionaires who would have gotten a massive tax cut out of the bill over you and your family. They turned their backs on the tens of millions of Americans who would have lost coverage altogether or seen protections for the quality and affordability of their coverage decline dramatically. We will remember their votes.
- We urge our members of Congress to support the Disability Integration Act (DIA). This important, bipartisan bill is sponsored by Senate Minority Leader Schumer (D-NY) in the Senate (S.910) and by Rep. Jim Sensenbrenner (R-WI) in the House (HR.2472). The DIA is civil rights legislation to address the fundamental issue that people who need Long Term Services and Supports (LTSS) are forced into institutions and losing their basic civil rights. 25 years after the signing of the Americans with Disabilities Act (ADA) of 1990, unwanted institutionalization remains a serious problem for people with disabilities and seniors. Although the DIA does NOT amend the ADA, the legislation, modeled on the ADA and the ADA Amendments Act, creates federal civil rights law which addresses the civil rights issue that people with disabilities who are stuck in institutions cannot benefit from many of the rights established under the ADA. (Learn more about the DIA here.)
- Indivisible has flyers that you can download that are specific to your state. Use them as handouts during town halls, canvassing homes, at meetings you attend or anywhere else they might be useful! You can also use them for talking points when speaking with your Senators or their staff.
- Here is a fact sheet on the Disability Integration Act you can leave with your member of Congress at a visit.
II. Federal Budget Justice
Labor & Health and Human Services Budget
In their FY 18 budget proposal, the House Appropriations Committee continued funding for many domestic HIV programs. The Committee is recommending that funding be maintained at fiscal year 2017 levels for the Ryan White HIV/AIDS Program, CDC HIV, hepatitis, and STD Prevention programs, and in a separate bill, HUD’s Housing Opportunities for People with AIDS (HOPWA) program.
However, the bill completely eliminates the Health and Human Services (HHS) Secretary’s Minority AIDS Initiative Program and cuts over $17 million from SAMHSA’s Minority AIDS Initiative programs. The budget also eliminated other programs that impact women, young people, and people of trans experience who are vulnerable to HIV, including the Teen Pregnancy and Prevention Program and Title X Family Planning, while calling for increased funding for abstinence-only programs. The budget also included a policy rider that prohibits any funding allocation to Planned Parenthood.
The House Republican budget plan, which has passed out of committee and could be voted on when Congress returns from recess in September, would also severely and disproportionately harm low and moderate-income families and individuals with deep cuts ($1.7 trillion 2018-2027) to health programs including the ACA and Medicaid and other low and moderate income programs ($1.2 trillion 2018-2027), like SNAP (formerly known as food stamps). Learn more about how Republicans could use the federal budget appropriations process to damage Medicare and social security here.
MAI & SMAIF Cuts (from AIDS United)
- The Minority AIDS Initiative (MAI) promotes novel programs that address critical emerging issues, and has established new collaborations across Federal agencies. These projects are significant in that they are designed to complement – and not duplicate – other HIV prevention and care activities and to create lasting changes in Federal programs that improve the quality, efficiency and impact of HIV programs that serve racial and ethnic minorities. Recent SMAIF funding supports efforts to improve the HIV care continuum for minority populations in the South, with a focus on disproportionately affected communities and people who inject drugs, as well as state and local health departments to collaborate with community-based organizations to develop comprehensive models of prevention, care, behavioral health, and social services for at risk populations, and a SAMHSA initiative that improves health outcomes for people of color at risk of HIV by connecting them with syringe service programs that provide HIV and viral hepatitis screenings, access to pre-exposure prophylaxis (PrEP), and drug treatment. The elimination of these funds would severely impede the response in tackling the epidemic for those who bear the highest burden. This would only further entrench the epidemic costing billions in medical costs.
- SAMHSA’s HIV/AIDS program enhances and expands effective, culturally-competent HIV/AIDS-related behavioral services in minority communities for people who need behavioral health services. These funds are not duplicative of other federal programs and target specific populations and provide prevention, treatment, and recovery support services, along with HIV testing for people at risk of mental illness. Additionally, they support integration of intimate partner violence (IPV) screening and referrals in behavioral health to reduce IPV and resultant HIV-related health disparities. We urge you to support efforts to restore funding to SMAIF and SAMHSA MAI, as called for in an amendment to the FY 2018 Labor-HHS appropriations bill offered by Rep. Barbara Lee (CA).
Family Planning/Title X
- The House appropriations bill would decimate access to family planning services by eliminating Title X, a bedrock public health program that provides high-quality preventive health care to millions of low income people and cutting off appropriated funds to Planned Parenthood.
- A 2016 study published in the American Journal of Public Health found that Title X would need $737 million annually to meet the need for publicly funded family planning in the United States. Rather than meet this need, Congress has steadily cut funding, from $317 million in FY 2010 to just $286.5 million in FY 2017. Funding cuts have already meant more than 1.2 million fewer patients were served in 2015 than were in 2010.
- The bill being advanced comes with enormous risk and sacrifice to the public’s health. In 2015, Title X-funded providers served more than 4 million patients at 3,951 service sites across the country. Two-thirds of those patients lived below the poverty line ($11,770 for a single person and $24,250 for a family of four that year), and almost half were uninsured. In 2014 alone, Title X-funded health centers helped prevent approximately 904,000 unintended pregnancies through contraceptive use.
- In 2010, Title X facilities helped to prevent over 99,000 chlamydia infections, over 13,000 cases of pelvic inflammatory disease, almost 3,700 cases of cervical cancer, over 2,100 deaths from cervical cancer, and over 400 HIV infections.
- Eliminating Title X is out-of-touch with the majority of Americans, including Republicans.
- In the February 2017 debate on the House floor on H.J.Res 43, Representative Martha Roby (R-AL) said, “I think we all agree that low-income women should have access to essential Title X services.”
- A clear majority (more than 80%) of Americans support broad access to contraception. Seventy-five percent favor continuing Title X, including 66% of Republicans.
Safety Net Cuts
- The budget resolution passed out of the House Budget Committee in July was terrible. It takes away trillions of dollars in Medicare, Medicaid, and SNAP in order to give new tax cuts to the wealthy and corporations. It makes massive cuts to basic services like education and transportation in order to give billions more in funding to the Pentagon. We demand a budget that protects programs that help the most vulnerable.
- The budgets we have seen from the President and the House cut billions from public education programs that support low-income children and their families. The FY18 funding bill for education cuts $2 billion from Title II funding, which supports our teachers. When my children’s school loses federal funding, it means classrooms get even more crowded and there are fewer after-school programs. My kid’s classroom is crowded enough.
- Proposed funding appropriations for HIV response (from AIDS Budget & Appropriations Committee)
- Coalition for Human Needs FY 2018 Budget Resource Page
- Center on Budget and Policy Priorities (CBPP) House Budget Report
- National Family Planning and Reproductive Health Association FY 18 House Bill Analysis and Talking Points (family planning and Title X)
- CBPP Report on Impact on Social Safety Net
- More information on Medicare changes that could happen through budget process
- VA Health Administration changes
Immigrant Rights – Support the Dream Act of 2017
10 Republican attorneys general (AGs) and one governor are suing the administration to end the Deferred Action for Childhood Arrivals (DACA) program. The AGs are from states that have passed anti-immigrant legislation in recent years, including Alabama, Arkansas, Louisiana, Idaho, Kansas, Nebraska, Tennessee, Texas, South Carolina, and West Virginia.
On July 20, 2017, Senators Lindsey Graham (R-SC), Dick Durbin (D-IL), Jeff Flake (R-AZ), and Chuck Schumer (D-NY) introduced the Dream Act of 2017. It is a bipartisan bill that would provide a direct road to U.S. citizenship for people who are either undocumented, have DACA or temporary protected status (TPS), and who graduate from U.S. high schools and attend college, enter the workforce, or enlist in a military program. In dealing with a presidential administration that has vowed to increase immigration enforcement and accept DACA’s rescission while expressing sympathy towards “Dreamers,” we must continue to pressure lawmakers to support inclusive, non–enforcement-based legislation that will protect as many people as possible.
- Through the Deferred Action for Childhood Arrivals (DACA) program, announced by President Obama on June 15, 2012, some of these young people have received temporary permission to stay in the U.S. for two years. However, DACA recipients are still without a road to lawful permanent resident (LPR) status or U.S. citizenship, and high-ranking officials in the Trump administration have warned about the program ending in the near future.
- The Dream Act of 2017, as introduced, is a strong bill that includes a path to citizenship. In its various iterations, the Dream Act has long enjoyed bipartisan support, and an overwhelming majority of Americans agree it’s the right thing to do.
- Those impacted by the Dream Act have grown up in the U.S. and are Americans, embedded in their communities. Deportation could land them in countries where they have no support system, no home, no job and in some cases, where they do not even speak the language. The Dream Act is a commonsense bill that deserves the support of all Senators.