The impact of Senate appropriations on people living with HIV

Earlier this week, Democratic appropriators in the U.S. Senate released their Labor, Health and Human Services, Education and related agencies as well as the Transportation, Housing and Urban Development and related agencies Appropriation bills for the 2022 fiscal year. These bills contain critical funding for the Ryan White HIV/AIDS program, the Housing Opportunities for People With AIDS program, harm reduction initiatives and many other programs that impact people living with HIV. 

However, the amount of funding for these critical programs is considerably smaller than its partner bill that was released and voted on in the House earlier this year. This means that while some programs are seeing increases from the 2021 fiscal year bill, many of these increases are not at the levels the House set for 2022 — nor are they at the levels that HIV advocates requested. We need the Senate to match or exceed the commitment made to end the HIV epidemic that we saw in the House appropriations bills. 

The Senate appropriated $2.5 billion for the Ryan White HIV/AIDS program. This request is in lockstep with the President’s budget requests, and it includes a $131 million increase for the program over fiscal year 2021. This is a significant increase, but falls $100 million short from what House appropriators approved. Notably, the AIDS Education Training Centers would see their first significant increase in funding in two decades. The AIDS Education Training Centers would receive $38.6 million, which is an increase of $5 million from the last fiscal year but a $6 million decrease from what House appropriators requested. 

One of the biggest concerns with the Senate appropriations package is in regards to housing for people living with HIV. This program is set to undergo major changes in how its funding is divided in 2022, which will result in several major cities seeing hundreds of millions of dollars in funding cuts. Democratic Senate appropriators set funding for the HOPWA program at $450 million in the upcoming fiscal year, which would be a $20 million increase from last year’s funding levels. However, this would be $150 million less than the House bill, which is still not at the amount needed to ensure people living with HIV have access to safe and stable housing. 

The Senate bill increased funding for Ending the Epidemic programs to $643 million, which would be an increase of $245 million from 2021 enacted levels. Additionally, the Minority HIV/AIDS Fund is proposed to be funded at $58.4 million, an increase of $3 million from 2021 levels. This is one of the few areas where the increase from the House was reflected in the Senate’s version of the bill.

There were, however, some big wins for harm reduction and reproductive rights in the Senate bill. The Senate bill report language fully removes the ban on federal funding for syringes and related materials for syringe services providers. This would greatly improve access to clean injection supplies for people who use drugs and reduce HIV rates across the country. The Senate appropriations bill report also removes the Hyde Amendment, a harmful provision that limits the use of federal dollars for abortion-related care. This disproportionately impacts individuals of color, many of whom rely on programs such as Medicaid for their health care coverage. The removal of this language is at risk due to vocal opposition from Senator Joe Manchin, a critical vote for the passage of the budget.

The AIDS United Policy team will continue to monitor the Senate appropriations process and will continue advocacy for federal funding for programs that benefit people living with and vulnerable to HIV.