SAN FRANCISCO, May 24, 2017—San Francisco AIDS Foundation is opposed to the fiscal year 2018 budget released yesterday by President Donald Trump. If enacted, this budget would gut social service, health care, housing and food programs that millions of Americans—especially those over age 50 and the young—depend on for survival. It undermines disease prevention efforts, the most cost effective way to save lives and reduce public health costs, and cuts funding to state programs that support mental health. The Trump budget also ignores the success and progress of biomedical research that has extended lifespan and prevented new HIV transmissions.
"The best way to erase the progress we have made against the AIDS epidemic in the last 30 years is to reduce our investment in effective public health solutions," said CEO Joe Hollendoner. "Transmission rates are falling, and people are living decades longer with HIV than ever before. Now is not the time to roll back our commitment to and investment in the health of our communities."
The most devastating cuts include:
- $616 billion new cuts to Medicaid. The Medicaid program—also called Medi-Cal in California—provides health coverage to low income, elderly and disabled Americans. More than 40 percent of people living with HIV in the U.S. rely on Medicaid. This budget proposes to cut $616 billion from the program, which would come on top of the $880 billion in cuts to Medicaid in the American Health Care Act (AHCA) that was recently passed by the House of Representatives and is currently under consideration in the Senate. These cuts would be devastating and threaten the entitlement nature of Medicaid and strip the federal funding guarantee from long-term care for the elderly and health care for disabled and low-income individuals.
- $72.5 billion funding cut over 10 years and policy changes to the Social Security Disability Insurance (SSDI) program. The Trump budget would reduce eligibility and income to recipients, many of whom are aging out of their disability insurance coverage provided through employment. The HIV epidemic in the U.S. affects individuals of all ages but has a disproportionate impact on individuals over 50 who rely on SSDI.
- $26 million cut for the Housing Opportunities for People with AIDS (HOPWA). The Trump budget would cause thousands of people living with HIV across America to lose their homes. Not having a safe place to live destabilizes lives and health and drives up the costs of emergency care borne by the public.
- $186 million cut for critical Centers for Disease control and Prevention (CDC) prevention programs. The Trump budget proposes $147 million cuts to HIV prevention, $27 million cut for sexually transmitted disease (STD) prevention and $12 million cut for tuberculosis (TB) prevention programs at the CDC. The Trump budget undermines the ability of state health departments to provide HIV testing, STD and TB screenings, and education and access for pre-exposure prophylaxis (PrEP), the biomedical prevention protocol that prevents HIV transmission. The Trump budget assumes that state public health departments will have greater capacity to bill insurance companies for HIV and STD testing, however, cuts in Medicaid and health insurance subsidies for low-income individuals will undermine those capacities. Without access to care, these cuts will represent a substantial cut in HIV, STD and TB screening capacity nationwide.
- $1.1 billion cut to the National Institute of Allergy and Infectious Diseases (NIAID) which conducts the majority of HIV research at the National Institutes of Health (NIH). The Trump budget ignores the importance of biomedical research that saves lives and prevents new infections. Research conducted at NIAID includes vaccine, cure and anti-retroviral research that has extended the lives of millions of people living with HIV and has prevented millions of new HIV transmissions. NIAID research projects have led to the development and use of biomedical anti-retroviral drugs that are capable of suppressing the virus in those living with HIV and are now used in pre-exposure prophylaxis (PrEP) that prevents further HIV transmission.
- $252 million cut to the Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA reductions for mental health and treatment programs includes $116 million from the Community Mental Health Services Block Grant that is provided directly to the states. The Trump budget ends grants to states and shifts costs and responsibility to states with less funding.
- $59 million cut to the Ryan White HIV Treatment Program. The Trump budget eliminates funding for AIDS education and training centers (AETCs) that train health care professionals on HIV medical care to increase the HIV treatment workforce rapidly in decline. This budget also eliminates funding for the Special Projects of National Significance Program (SPNS), investments that fund innovative models of care for people living with HIV who are frequently out of care and lost to care including people of color who receive their care in isolated urban, migrant health, and border health care sites. Evidence demonstrates that these programs are effective at treating hard-to-reach populations.
- $193.3 billion cut to the Supplemental Nutrition Assistance Program (SNAP). The Trump budget calls for a 28.8% decrease in food support for the low income, elderly, and disabled. This budget threatens American lives by destabilizing the food security for low-income families and individuals, the elderly and the disabled, leaving the most vulnerable among us at risk for food insecurity and malnutrition.
"Every presidential budget is a messaging document that states the priorities of the administration," said Ernest Hopkins, director of legislative affairs at San Francisco AIDS Foundation. "With this budget, it is clear that President Trump's priorities are not focused on the health and wellness of the American people. This effort to destroy the safety net for the most vulnerable must not stand."
Community members can call on their members of Congress to say no to this budget proposal.
"It is important that we all urge our elected officials to prioritize health care access for the underserved, safe and affordable housing and food security for the low income," said Courtney Mulhern-Pearson, senior director of policy and strategy. "Tell Congress to reject this budget, reject the cuts and the elimination of important programs that support people living with HIV and promote health and wellness for all our communities."
About San Francisco AIDS Foundation
No city experienced epidemic levels of HIV faster than San Francisco. San Francisco AIDS Foundation works to extend the health and lifespan of those living with HIV and prevent new HIV transmissions. Established in 1982, the foundation provides HIV testing, access to pre-exposure prophylaxis (PrEP), syringe access and disposal services, harm reduction and substance use counseling, community engagement and supportive services, and policy advocacy and public education. The foundation has also reactivated the HIV Advocacy Network through which community members can directly contact their members of Congress. More information about the foundation is available at http://www.sfaf.org.