The President should continue his support of the Ryan White CARE Act and should endeavor to prevent the Congress from attaching unnecessary funding restrictions. He should also continue to vigorously support funding levels for the Ryan White CARE Act that are responsive to the rising caseloads and costs of delivering comprehensive services to people with HIV/AIDS and make the CARE Act a budget priority.
Administration's Response
The President's support for the CARE Act has been consistent and clearly articulated to the public and Congress. The President spoke out several times against the divisive tactics and amendments offered by Senator Jesse Helms. Administration officials at all levels made clear to Congress the Administration's position opposing all negative and extraneous amendments. It is unfortunate that the Republicans' distraction with the fight over Medicaid and the budget delayed completion of action on the CARE Act reauthorization, a measure for which there was such strong bipartisan support, but we are pleased to see it finally enacted into law.
The President continues to show strong leadership in support for increased funding for the CARE Act in the current fiscal year as well as FY 1997. Throughout the budget negotiations, funding increases for the CARE Act programs were a top priority. As a result of this persistence, CARE Act funding increased $105 million in FY 1996. This includes a budget amendment made by the President last month requesting an additional $52 million earmarked for the hard-pressed AIDS Drug Assistance Program (ADAP) under Title II.
Assessment of the Response
The Council commends the Administration's continued efforts to expand funding for the CARE Act. In particular, we are pleased with the Administration's leadership role in obtaining a $52 million emergency appropriation for ADAP and its strong advocacy for an additional $53 million in FY 1996. The President has also requested a $69 million increase for the CARE Act in his FY 1997 budget request. We also commend the President for his leadership in building bipartisan support for the Ryan White CARE Act renewal and funding increases.
Followup Action Recommended
While these funding increases are vital, the Council recognizes that they are modest relative to the critical need for CARE Act-funded services, especially in light of new drug developments. CARE Act programs will continue to play an essential role in ensuring access to these new therapies and must therefore receive substantial increases in funding in future years.
The President must maintain a strong commitment to the entitlement status of the Medicaid program, including a willingness to veto any legislation that inadequately funds or transforms Medicaid into a block grant.
Administration's Response
The President has fulfilled his commitment to protect Medicaid as an entitlement by vetoing legislation that would have gutted the Medicaid program. In his statement explaining his veto, the President mentioned the importance of Medicaid for people with AIDS as one of the reasons for opposing Republican efforts to make drastic cuts in and to block-grant the Medicaid program.
Assessment of the Response
The President's leadership was strong and effective, particularly his ability to create bipartisan support for Medicaid and Medicare.
Followup Action Recommended
We will continue to work with the Administration to turn back future challenges to Medicaid and Medicare.
The President must continue to demonstrate his strong support for the Housing Opportunities for Persons with AIDS (HOPWA) and other Federal housing programs that serve people living with AIDS. The President should make housing for people with AIDS (PWAs) a FY 1997 priority.
Administration's Response
The President has demonstrated his support for housing programs in the FY 1996 budget cycle. HOPWA has been protected from cuts, while many other housing programs have faced severe reductions. In the context of what is occurring with other housing programs, this is a tremendous victory. In the context of the rising need for housing services, it is recognized by the Administration that flat funding is insufficient. The Administration is examining ways to mitigate this in the context of the FY 1997 budget.
Assessment of the Response
Congress has imposed major cuts in many housing programs. AIDS housing programs have not been cut in this fiscal year, in large part due to the Administration's support of HOPWA. However, while flat funding is remarkable in the current fiscal climate, it is entirely inadequate in the overall context of the HIV/AIDS epidemic.
Followup Action Recommended
The Council strongly supports the proposals by Housing and Urban Development (HUD) Secretary Henry Cisneros to reprogram $15 million within the FY 1996 HUD budget to provide additional funding for HOPWA and to amend the President's FY 1997 budget to add an additional $50 million to funding for housing programs serving PWAs. The Council will work with the Administration on this effort. The Council recognizes the need to address the significance of housing for people with HIV/AIDS and the need to integrate housing services into a continuum of care.