In the 118th Congress, HIV advocates face challenges and opportunities

For the first time in a century, House Republicans were unable to successfully elect a speaker of the House on their first attempt — or even the second. In the end it took 15 separate votes (and many more backroom concessions to members of the far right Freedom Caucus) for Republicans to unify behind a House speaker. The appearance of this much infighting and conflict before any of the 82 newly elected members of Congress had a chance to be sworn in is troubling. 

With that being said, we at AIDS United are still hopeful that this new Congress can meaningfully address many of the challenges faced by people living with and vulnerable to HIV. The work of HIV advocates and our congressional champions at the end of the last Congress led to some of the biggest single year increases in HIV funding ever. 

The recently passed fiscal year 2023 omnibus bill included a $76 million increase to the Ryan White HIV/AIDS Program, an investment of an additional $100 million for the fourth year of the Ending the HIV Epidemic initiative and a $49 million increase to the Housing Opportunities for People With AIDS program. The omnibus bill also included a $5 million increase for harm reduction spending in the Center for Disease Control and Prevention’s Opioid Related Infectious Diseases line and a $3.1 million increase for the Minority HIV/AIDS Initiative fund. Language was also included in the omnibus encouraging the distribution of MAI funding to minority-led organizations in keeping with the fund’s original intent, and eliminating the buprenorphine X waiver, which will remove barriers for medical providers seeking to prescribe life-saving buprenorphine for people with opioid use disorder.

With the House being led by a Republican party that has already stated their intent to reduce next year’s domestic discretionary spending to fiscal year 2022 level, maintaining and building on this increased investment in addressing the HIV epidemic will not be easy. But, it is important to remember that we still have a democratically controlled White House and Senate — and plenty of support from Republicans in both houses of Congress who recognize the importance of supporting people living with HIV. 

While many of our most dedicated HIV champions in Congress have retired or stepped down from positions of party leadership, this changing of the guard provides us with a unique opportunity to inform a new generation of senators and representatives about the issues and programs that matter most to the HIV community.

AIDS United and our partners are dedicating ourselves over the next two years to the education and development of potential congressional allies, centering racial justice and LGBTQ rights in our work. We will remain steadfast in our support for people who use drugs and people who engage in sex work, and we will focus significant time and effort to advocating for older adults living with HIV.

Federal HIV advocacy in the 118th Congress will not be easy, but it will be necessary. We have encountered harsher political climates in recent years and we have not only survived but flourished. We banded together to protect the Affordable Care Act from destruction in 2017 when Republicans controlled Congress and the White House, and we got the Trump administration to launch the Ending the HIV Epidemic Initiative in 2019. If we can do that, we should be able to make positive change over the next two years.