| April
7, 2006
This Week in Washington
1. House Votes to Postpone Budget until After Spring Recess
2. Congress to Recess for 2 weeks.
CARE Act in Brief
1. Burr Agrees to Co-sponsor Coburn Reauthorization Bill
2. Analysis of the Annual ADAP Survey Forum
Announcements
1. NAPWA to Hold AIDSWatch 2006 from May 8 - 10
This Week in Washington
1. House Votes to Postpone Budget until After Spring Recess
On Friday, April 7th, the House failed to vote on its version
of the budget resolution for fiscal year (FY) 2007. House leadership
pulled the bill from the floor rather than risk a failing vote
after House Appropriators and House conservatives were unable
to reach a deal on spending outside of the Budget process.
In addition Republican moderates are continuing to negotiate for
an additional $7 billion in domestic spending on healthcare issues.
On March 16th, the Senate passed the “Specter-Harkin amendment”
which increases Labor, Health and Human Services, and Education
funding to FY 2005 level by an addition of $7 billion. This will
allow appropriators increased funds for necessary healthcare programs,
including HIV programs like the Ryan White CARE Act. If the amendment
is not included in the House version of the budget, the President’s
proposed new HIV funding (for HIV medications, grant programs
to community-based and faith-based organizations and for increased
HIV testing) is likely to be eliminated.
The dispute between appropriators and conservatives turns on the
use of “emergency funding” to bypass caps on the budget process.
House conservatives have added language that would restrict this
practice by allowing such spending to be challenged on the House
floor. House Appropriations Committee Chairman, Jerry Lewis (R-CA)
said that he would not “support a resolution that greatly diminishes
Congress' ability to respond to national disasters and makes it
more difficult for us to get our budget work done on time.”
Postponement of the House Budget Resolution will now allow advocates
to speak with their Members of Congress. AIDS Action urges all
of its members to meet with Representatives in their District
offices and urge them to support increasing Labor, Health and
Human Services, and Education funding to FY 2005 level by an addition
of $7 billion. If the House Budget resolution does not contain
the $7 billion Specter-Harkin increase for health and education
programs, passed overwhelmingly by the Senate, AIDS Action Members
are urged to ask their Representatives to vote “no” when the budget
returns to the floor after Spring Recess.
To find out who your Representative or Senator is and/or how to
contact their office, go to: http://capwiz.com/aac/dbq/officials/.
2. Congress to Recess for Two Weeks
Both the Senate and House of Representatives are expected to recess
for two weeks following final votes on Friday, April 7th. The
official Spring Recess is from Monday, April 10th until Friday,
April 21st, however Congress is effectively out from the 7th until
Tuesday the 26th because votes are not normally scheduled on Mondays.
Most Members of Congress are likely to return to their District
or State during this time due to campaign activities and local
work that needs to be accomplished. Therefore, this is an ideal
time to schedule meetings in the district and state with Members
of Congress and staff.
The House Clerk’s calendar is located here:
http://majoritywhip.house.gov/calendar.asp
(The Senate has not produced a similar easily readable calendar)
CARE Act in Brief
1. Burr Agrees to Co-sponsor Coburn Reauthorization
Bill
Senator Richard Burr (R-NC) was added as a co-sponsor of S. 2339,
the Ryan White CARE Act Amendments of 2006 on March 27th, 2006.
This bill was introduced in the Senate by Senator Tom Coburn (R-OK)
on February 28th. Senator Burr, who was a Member of the House
of Representatives, was an original co-sponsor of H.R. 4807, the
Ryan White CARE Act Amendments of 2000, which was sponsored by
Senator Coburn who was also in the House at that time. Senator
Burr is a member of the Senate Health, Education, Labor and Pensions
Committee. AIDS Action asked Senate staffers and others who are
close to Representative Burr if this meant that Senator Burr was
abandoning the bipartisan, bicameral process that has been put
in place by the Senate and House committees working on reauthorization.
Those sources have said that he has not abandoned the process,
but that he may be expressing support for Senator Coburn and frustration
with the slowness of the reauthorization process.
In related news, Representative Dave Weldon
(R-FL) introduced the companion bill to Senator Coburn’s bill
in the House on March 16th. The bill was given the number H.R.5009
and referred to both the Committee on Energy and Commerce and
the Committee on Financial Services. The bill currently has 18
co-sponsors. All of the co-sponsors are Republicans. Of the co-sponsors,
Representative John Shadegg (R-AZ) is on the Energy and Commerce
committee (which has 31 members) and Representatives Tom Feeney
(R-FL) and Jeb Hensarling (R-TX) are on the Financial Services
committee (which has 37 members). The legislation would need to
pass both committees before being considered on the House floor.
Additionally since it must go through the Energy and Commerce
committee it is subject to the bipartisan, bicameral negotiating
process between the Energy and Commerce and Senate Health, Education,
Labor and Pension (HELP) committees. AIDS Action will keep you
informed of any other changes to the Coburn/Weldon bill.
2. Analysis of the Annual ADAP Survey Forum
As reported last week, the Kaiser Family Foundation and the National
Alliance of State and Territorial AIDS Directors (NASTAD) hosted
a forum to release the 10th annual National ADAP Monitoring Project
Report. The report provides a survey of state AIDS Drug Assistance
Programs (ADAPs) in the 50 states, the District of Columbia, and
territories.
The speakers at the forum included:
Shana Christrup, Professional Staff Member, Senator Michael
Enzi, Chairman of Health, Education, Labor & Pensions Committee,
Connie Garner, Democratic Policy Director for Disabilities
and Special Needs Populations, Senator Edward Kennedy, Ranking
Member of Health, Education, Labor & Pensions Committee,
Jay Adams, West Virginia HIV Care Coordinator, West Virginia
Dept. of Health and Human Resources,
M. Beth Scalco, Director, HIV/AIDS Program, Louisiana
Office of Public Health,
Dwayne Haught, Manager, Texas HIV Medication Program,
Texas Department of State Health Services,
Murray Penner, Deputy Executive Director of Domestic
Programs, NASTAD; and
Arnold Doyle, Director, Public Policy, Roche Pharmaceuticals
Jen Kates, the Vice President and Director
for HIV Policy of the Kaiser Family Foundation moderated the discussion.
Ms. Kates developed three main topics of conversation including
how ADAPs reacted to the Hurricane Katrina disaster in August
of last year, how ADAPs are reacting to changes in Medicare Part
D and how ADAPs are faring in the ongoing reauthorization.
Ms. Scalco stated that Hurricane Katrina demonstrated that there
is not really a good backup plan for ADAP programs. There was
not a single place in the federal government or other states that
she could turn to as her agency tried to recover and to ensure
continuous services for her clients. In addition she noted that
the lack of ADAP portability was a very serious problem in the
long run. Mr. Haught noted that his agency is still enrolling
clients from New Orleans, more than six months after the hurricane
struck. He said a major issue that arose is that ADAP clients
often did not know what medications they were taking and that
they did not know where their medications were coming from. Many
of the clients stated that they received medications from “Charity”
when in fact they were receiving medications from Charity Hospital
through the ADAP program. Additionally he said that clients were
overwhelmed by their needs (including a need for transportation)
which created some barriers to receiving help.
Mr. Adams responded to the question regarding Medicare Part D.
He said that, as a low incidence state, West Virginia often experienced
changes to the ADAP program including the creation of Medicare
Part D as “a jolt.” The change to the way the system reacted was
complex and that clients really had only one issue in mind, which
was how to get their drugs. He said that West Virginia had decided
to help patients pay for the coverage gap between $2,250 and $5,100
which requires patients to pay 100% of costs (also known as the
doughnut hole). Unfortunately State ADAP funds are not counted
towards completion of these costs. Therefore he said it is “quite
discouraging” that many ADAP patients had already reached their
limit and that the state ADAP was now facing payment of costs
through the end of the year.
Ms. Christrup and Ms. Garner responded to questions about the
state of ADAP within the RWCA reauthorization process. Both said
that the Senate Health, Education, Labor and Pensions (HELP) committee
and Energy and Commerce Committee were continuing to work together
on reauthorization along bicameral and bipartisan lines. Ms. Christrup
said that ensuring access to services was a particular issue within
the committees’ negotiations and that there was a need to make
services equitable “for all Americans.” She said that the committee
recognized that there was a need to avoid undermining HIV services
infrastructure that was already in place, but that there was also
a need to build new infrastructure where the epidemic is developing.
“We are still in the throes of figuring out the basics,” she said.
Ms. Garner discussed the relationship between ADAP, Medicaid and
Medicare and said that there was a need to look at the system
of providing medications as a whole. “Do we really need to create
an entirely new structure?” she asked, “or should we reconfigure
what we have?” One particular issue is that every change contemplated
by the committee creates a “domino effect” and that consequently
it was important to ensure that whatever emerges from the committee
was well thought out. Ms. Garner closed by saying, “We don’t want
a bill to come out, that isn’t right.”
The discussion between Ms. Garner and Ms. Christrup is particularly
interesting. Ms. Garner’s strong statement about ensuring the
importance of getting a bill “right” caused some HIV advocates
to wonder if this meant that a bill would be delayed. After checking
in with Hill staffers, AIDS Action’s staff has heard that it is
still widely believed that a reauthorization bill continues to
be doable and that there are hopes for introduction of a bill
by June. Additionally, there continues to be strong support for
the bipartisan, bicameral process which would enable any legislation
produced to be voted on by both the House and Senate relatively
quickly after introduction.
During the question and answer session, Bill McColl, AIDS Action’s
Political Director noted that the release of the annual ADAP report
from 2004 had been the trigger for creating AIDS Action’s ADAP
proposal for the CARE Act, which focused on portability. “Didn’t
Katrina show that portability continues to be the major issue
for ADAP?” he asked. Ms. Scalco that she agreed that portability
was important, however, she was concerned that creating minimum
eligibility and a baseline formulary would create problems at
the state level including the possibility that states exceeding
the recommended eligibility and formulary requirements would lower
their standards. After the presentation, Mr. McColl spoke briefly
with another panelist who said that the idea of creating portability
would make sense because standardizing care would help states
to raising their eligibility and formulary levels.
The report can be found in these two places:
http://www.kff.org/hivaids/hiv033006pkg.cfm
http://www.nastad.org/ADAP/ADAP_2006_Annual_Report_v4.pdf
A webcast of the forum is available at:
http://www.kaisernetwork.org/health_cast/hcast_index.cfm?display=detail&hc=1686
Announcements
1. NAPWA To Hold AIDSWatch 2006 from May 8 - 10
The National Association of People With
AIDS (NAPWA) will hold AIDSWatch, its annual DC-based advocacy
event, from Monday, May 8 to Wednesday, May 10. Each year, NAPWA
invites people living with HIV to Washington, DC, where they first
participate in advocacy training sessions and then take their
stories, new skills, and updated materials to Capitol Hill. While
on Capitol Hill, participants meet with Members of Congress and
their staffs to urge them to strengthen essential health care
programs—like the Ryan White CARE Act, Housing Opportunities for
Persons with AIDS, and Medicaid/Medicare—through increases in
funding and improvements in legislation.
This year, AIDSWatch will also assist individuals
unable to travel to Washington, DC with the scheduling of meetings
closer to home, in the district offices of their Members of Congress.
Interested parties may learn more about this
year’s AIDSWatch by linking to http://www.napwa.org/aidswatch.html
and may register for AIDSWatch at http://www.napwa.org/register_online.html.
Individuals who have questions, cannot register
online, or wish to talk their plans over may contact High Noon
Communications, toll-free, at 1-866-243-7282 or by sending an
email to becky@highnooncommunications.com.
The AIDS Action Weekly Update
The Weekly Update is written with
a mind toward the interests of our members. If you are interested
in membership with AIDS Action, we invite you to contact members@aidsaction.org.
AIDS Action works
to end the HIV epidemic by advancing public policies that
prevent new infections, provide care for people living with
HIV, and support the search for a cure. AIDS Action serves
as the national voice for people living with HIV and represents
AIDS service organizations, health departments, and a diverse
network of community-based organizations across the country. |
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