HIV spending in U.S. House’s 2023 budget proposal.

With the possibility that either or both chambers of Congress will flip control following the upcoming midterm elections, it is increasingly unlikely that the 2023 budget will be passed before Oct. 1, 2022, the start of fiscal year 2023. 

Despite this, appropriators in the House did their part to keep the process moving in June by releasing draft legislation detailing the House’s proposal for FY 2023 spending. The process continues with the Senate, and while we anticipate Senate requests will differ significantly, there were a few policy priorities to highlight, including the Ryan White Program and the Housing Opportunities for Persons With AIDS Program. 

Here is an overview of some of the items in the House’s proposal that directly impact people living with HIV: 

Ryan White HIV/AIDS Program and The Ending the HIV Epidemic Initiative

The proposal would increase the Ryan White HIV/AIDS Program budget by $239 million, bringing its budget to $2.7 billion. More information is still forthcoming, but the lion’s share of the proposed increases would be directed to the Ending the HIV Epidemic Initiative. The initiative would see its funding double, while funding for core Ryan White programs would only increase by $75 million.  

Outside of Ryan White, the proposal would also give the Ending the HIV Epidemic Initiative a $50 million increase for community health centers and a further $50 million for the Division of HIV Prevention at the Centers for Disease Control and Prevention. These investments would allow for scaled up HIV prevention and treatment strategies, including preexposure prophylaxis, but only for the 57 priority jurisdictions included in the initiative. The priority jurisdictions cover about half the new HIV infections each year. 

Harm reduction

House appropriators also proposed solid support for harm reduction initiatives, including a $25 million increase in funding for the CDC’s Opioid Related Infectious Diseases Program. That would go directly to harm reduction organizations working to reduce the disparities experienced by people who use drugs. 

The legislation would also remove the ban on the use of federal funds on syringes and related injection drug use equipment. This is the third year in a row such a proposal has been made in the House. Hopefully, this will be the year Senate appropriators support evidence-based best practice by also removing the ban.

Minority HIV/AIDS Initiative

The House proposal would give the Minority HIV/AIDS Initiative a budget of $60 million. This is a $3 million increase and $2 million above the president’s budget request. But this number falls short of the community’s $105 million request, which is urgently needed to improve the health of communities of color living with or vulnerable to HIV.

Housing Opportunities for Persons With AIDS Program

The draft budget includes a $150 million increase for the Housing Opportunities for Persons With AIDS Program, the only source of federal funding dedicated to directly addressing the housing needs for people living with HIV. We cannot end the HIV epidemic without ensuring that all people living with HIV have access to stable, affordable housing. The proposal would give HOPWA a $600 million budget, which is significant because this is how much the community has been pushing. 

As more information is released and as the Senate makes its moves in the coming weeks, AIDS United will continue to provide more information. And we will continue to advocate for the funding that will keep us on track to end the HIV epidemic by 2030.