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JANUARY 4, 2013
Happy New Year!

Happy New Year! All of us at AIDS United send best wishes for the New Year. 2013 started with a bang, and it doesn’t look like that we will be slowing anytime soon! Congress passed a fiscal cliff deal on January 1, 2013, but there is much work to be done over the next few months. The sequester has been delayed by two months, and the new Congress will face some difficult decisions between now and March. Furthermore, the President’s budget will be released in February, and we anticipate further Congressional debate on this issue. AIDSWatch will take place February 25-26, 2013 in Washington, D.C.  You can find out more and register today clicking here.  

New Year, New Congress

On January 3, 2013, the 113th Congress convened for the first time and welcomed 95 new members into its ranks. Although the November elections did not significantly alter the parties’ power, the makeup of the 113th Congress is much different from any of its predecessors.

There are now 20 female Senators, many of which are newly elected. In fact, New Hampshire is the first state to send only women to both chambers of Congress. For the first time in history, white men no longer constitute the majority of Democrats in the House. Although the overall majority of Members of Congress continues to be white men, the 113th Congress has among its ranks 41 African-Americans, 36 Hispanics, 10 Asian Americans, and two Native Americans. Senator Tammy Baldwin (D-WI) is the first openly gay Senator, and Representative Kyrsten Sinema (D-AZ) is the first openly bisexual Member of Congress.

The 113th Congress will make decisions on many issues relevant to the HIV/AIDS community, including striking a deal on the sequester, the budget, and possibly the Ryan White CARE Act. AIDS United will continue to work on behalf of those living with and affected by HIV/AIDS throughout the 113th Congress.

Click here to see some Committee Assignments relevant for the HIV/AIDS community.

The Fiscal Cliff Averted (For Now)

Early in the morning of New Year’s Day the Senate passed HR 8 "American Taxpayer Relief Act of 2012" by a vote of 89 – 8, with three Senators not voting. Later that night the House of Representatives passed the bill without amendments by a vote of 257 – 167. President Obama signed the legislation on January 2 . The passage of this legislation averted the January 1 and 2 deadlines that would have extended certain tax relief provisions enacted in 2001 and 2003, provided for expedited consideration of a bill providing comprehensive tax reform, two month delay of sequestration and for other purposes. We will outline below some of the provisions of the bill that may affect HIV/AIDS programs and healthcare funding.

The debate in the lame duck session of Congress was long and difficult between Election Day and New Year’s Day as President Obama, the House and Senate tried to address the fiscal crisis with a large grand bargain to solve the funding that is needed to avert the cuts that have been called with to avert the planned sequestration cuts, keep the Medicare doctors from receiving a 27% pay cut, ensure the long-term unemployed continue receiving benefits and many other issues. In the end the “grand bargain” did not come to fruition.

HR 8 permanently extended reduced tax rates and benefits enacted in 2001 and 2003 for most Americans. This bill increased taxes on individuals earning more than $400,000 and couples earning more than $450,000, the Congressional Budget Office has estimated this change will bring $600 billion of revenue over the next 10 years. HR 8 also postponed the cuts from sequestration by 2 months. According to Congressional Quarterly the cost for the 2 month delay was $24 billion, this was paid for with $12 billion in revenue from retirement accounts and $12 billion in cuts to the budget cap for FY 2013 and FY 2014. The amount for FY 2013 is $4 billion and $8 billion from FY 2014 evenly divided between security and non-security discretionary accounts. The cap for FY 2013 for non-security is actually higher than what has thus far been allocated by $3 billion. It is not clear if how that additional funding will be allocated. The Security side has a different problem, its allocation is $6 billion less than what has previously allocated.

HR 8 also again extended the scheduled 27% deduction in Medicare doctor payments for one year. As we look to implementation of the Affordable Care Act it was important to avert that cut and possible loss of doctors who would agree to see Medicare patients. This funding was offset by several funds related health care. The most prominent is the continued reduction in the rates paid to hospitals for uncompensated care called Disproportionate Share Hospital (DSH). The Affordable Care Act included reduction in this funding as states were encouraged to adopt Medicaid expansion, leaving fewer people without health insurance and in need of uncompensated care. CBO estimates that this fund will be reduced by $4.2 billion over the next ten years. Since the Supreme Court made expansion optional we must continue to remind state officials that the funding to treat those most in need will continue to shrink and Medicaid expansion will be important in caring for their citizens.

HR 8 extends for one year unemployment insurance for the chronically unemployed, makes permanent tax cuts for the middle class, continues exemptions to estate taxes (with an increase in the rate from 35% to 40%), and makes permanent the alternative minimum tax patch that would have prevented higher income earners from paying taxes using credits and deductions instead.

The Community Living Assistance Services and Supports (CLASS) Program was repealed in the legislation. CBO did not allocate a numerical value to this repeal since the bill had been suspended since October of 2011. The CLASS Act was meant to be a self sustaining fund to provide cash benefits for long term care services. It was determined to pay for itself for a 10 year window, but it was not sustainable over the 75 year window that needed to be proven.

The White House released the following fact sheet detailing “the Tax Agreement: A Victory for Middle-Class Families and the Economy can be found here .

A fact sheet in outline form on some of the issues from the fiscal cliff deal from the National Priorities Project can be found here. Their mission is to make our complex federal budget transparent and accessible so people can exercise their right and responsibility to oversee and influence how their tax dollars are spent.

Fiscal Cliff Agreement: Concerns Going Forward

The American Taxpayer Relief Act (H.R. 8), which Congress passed on New Year’s Day and the President signed into law on Thursday, is a stopgap, bare bones measure that leaves most of the larger issues of deficit reduction and responding to long-term budget reform unresolved. While the agreement’s provisions are a mix of “the good, the bad, and the ugly,” as one advocate noted, the agreement should not be judged as if it were the final word. There is much more to come, especially in the next three months. One way to look at the agreement is as the end of Act II of a continuing drama, with Act I being the Budget Control Act of 2011. There are one or more acts to be played out before a more decisive denouement. These next stages will focus on increasing the debt ceiling, the still pending automatic spending cuts (sequestration), and completing the appropriations process for the current 2013 fiscal year. That said, the agreement raises very important concerns going forward for those of us in the HIV/AIDS and broader health communities and others concerned about social and economic justice. The concerns will require us to remain very vigilant over the next 90 days.

The central theme of the concerns is that some provisions of the fiscal agreement and its stopgap approach will create tremendous pressure on spending for non-defense discretionary (NDD) programs and entitlement programs, including Medicaid and Medicare. The Republican leadership in both the Senate and the House of Representatives has made it very clear that they view the next stages as being all about deep spending cuts and drastic changes to Medicaid, Medicare, and other safety net entitlement programs for low-income people. In an op-ed article posted on Thursday, Senate Minority Leader Mitch McConnell wrote: …the only thing we can do to solve the nation’s fiscal problem is to tackle government spending head on—and particularly, spending on health care programs …” Congressional Republicans see the $620 billion revenue in the fiscal cliff agreement as achieving a “balanced approach.” They likely will use the debt ceiling debate, decision-making on sequestration, and the FY 2013 appropriations completion to force the President and Congressional Democrats to accept an all spending cuts approach to resolve the issues.

The President has made forceful statements that the next stages must be balanced with additional revenue as well as spending cuts, without harming entitlement programs. He has noted that the fiscal cliff agreement provision that delays sequestration to March 1 was paid for dollar for dollar with revenue and spending cuts. He sees that as a precedent for moving forward. He has indicated also that he will not negotiate spending cuts for an increase in the debt ceiling.

The upcoming battles will be very important for the HIV/AIDS and broader health care communities. Funding for the Ryan White Program, HIV prevention, AIDS housing, and implementation of the Affordable Care Act cannot be sacrificed. “Entitlement reform” cannot be a smokescreen for effectively dismantling the safety net for low-income and other vulnerable populations. Additional revenue of at least $1 trillion must be part of any final set of agreements (see this article by Robert Greenstein to learn more about a balanced approach moving forward).

We will all need to keep the pressure on the White House and on Congress in the weeks ahead. Working with our partners at the national, regional, and local levels, AIDS United will be fully engaged in protecting programs to end the HIV/AIDS epidemic, achieving meaningful health care reform, and preserving the social and economic safety net.

Announcements

AIDSWatch 2013

Join the National Association of People with AIDS, the Treatment Access Expansion Project, and AIDS United for AIDSWatch 2013! AIDSWatch 2013 will be held February 25-26, 2013 in Washington, D.C., and all are invited to register! For more information about AIDSWatch and how to register, please click here.


Presidential Inauguration Website Launched

The Joint Congressional Committee on Inaugural Ceremonies has launched the Presidential Inauguration website in advance of President Obama’s inauguration on January 21, 2013. To learn more about the events during Inauguration weekend and to learn how to get tickets, visit the website here.


National Black HIV/AIDS Awareness Day is February 7, 2013

National Black HIV/AIDS Awareness Day is just over a month away! To learn more about events and programs being held on February 7, 2013,  click here. To learn about other HIV/AIDS awareness days through the year, click here.

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