In a vote that followed party lines, the House Appropriations Committee passed the FY2018 Health and Human Services, Education, and Related Agencies Appropriations bill on July 20, 2017. The bill rejects most of the proposed cuts to health services recommended by the current Administration, but does little to boost funding for health services that desperately need additional financial support.
The bill “flat funds” – meaning there is no increase or decrease in funding – HIV programming, including the Ryan White Program, at the FY2017 level, with the Ryan White Program having already endured a $4 million cut in FY2016. While this flat funding does not allow the Program to keep pace with increasing need or rising health care costs, it is the preferred option to the $58.8 million cut to Ryan White funding that was requested by the President. The Committee also rejected an amendment brought by Rep. Barbara Lee (D – CA) to restore funding for the Minority AIDS Initiative Fund (MAI).
The bill also flat funds the CDC’s Viral Hepatitis programs at $34 million for the third consecutive year. Viral Hepatitis saw a modest $2.7 million budget boost in FY2016 to bring it to the $34 million mark, but funding has remained flat ever since. What is even more troubling is the comments made in the bill by the Committee concerning viral hepatitis prevalence. The Committee only makes a brief mention of its concern in the rise of cases of Hepatitis B in the U.S. despite the availability of a vaccine with an efficacy rate over 90%. There is no mention of concern about the skyrocketing rates of Hepatitis C in the U.S. among young adults tied to the opioid epidemic. While Hepatitis B and C rates are increasing in the U.S., rates of Hepatitis C are increasing at a far more rapid rate, and hundreds of thousands more Americans are affected by Hepatitis C than B. The Committee’s silence on this issue speaks loudly.
The Substance Abuse and Mental Health Services Administration (SAMHSA) was recommended to receive $2.2 billion for substance abuse treatment funding, including the continuation of a $500 million line item to fund state-level responses to the opioid epidemic. This SAMHSA funding recommendation is over $15 million more than what the President recommended for the Agency, despite the current President touting to constituents that he is committed to resolving the Nation’s opioid abuse crisis.
Legislators must start listening to the advice of health authorities and advocates who are imploring them to provide support to address the Hepatitis C epidemic in tandem with the opioid epidemic, as the two are fundamentally correlated. Actions such as this by the House Appropriations Committee indicate the government’s continued commitment to ignore data and insight from those working directly on health issues to provide the adequate resources needed to actually remediate the Nation’s most critical public health issues.
NASTAD has created a chart showing the breakdown of funding for HIV, Viral Hepatitis, and STD programs, which can be found here.