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Weekly Policy Update 01-07-2011
In This Issue...

AIDS United
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Welcome to Weekly Policy Update
112th Congress
Congressional and Major Events HIV Calendar for 2011
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Welcome to Weekly Policy Update

Happy New Year! This is the first, renamed Weekly Policy Update under our new organization, AIDS United, following the successful merger of the National AIDS Fund (NAF) and AIDS Action. Please visit the new AIDS United web site at: www.aidsunited.org.

The Weekly Policy Update will continue as an important vehicle for AIDS United’s public policy and advocacy efforts. With AIDS United, our public policy and advocacy work will broaden to include building local, state and regional advocacy capacity and enhancing federal capacity to ensure that public policy is guided by community needs. The focus of the Update will likewise broaden to include critical developments at the local, state and regional levels. As the beginning of the 30th year of the HIV/AIDS epidemic approaches, the HIV/AIDS community faces many challenges but also many opportunities finally to end the epidemic. Implementing health care reform and realizing the vision of the National HIV/AIDS Strategy will require mobilization at all levels with multiple partners and stakeholders. We hope that the fusion of NAF and AIDS Action can both model and reflect the exciting possibilities that lie ahead. Our continuing goal for the Update is to keep you informed of public policy developments so that our collective advocacy is well targeted and strengthened.
 

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112th Congress

Overview of 112th Congress
On January 5th, Members of the new 112th Congress met for the first time and were sworn in to their official duties. It was almost immediately evident that the Congress will reflect the more conservative nature of the new Members who were sworn in. This was particularly clear in the case of the House of Representatives which now has 242 Republicans to 193 Democrats, a swing of 63 seats. The Senate retained a weakened Democratic caucus majority of 53 Senators to 47 Republican Senators. The previous Congress had 59 Senators that caucused with the Democrats versus 51 Republican Senators.

An interesting factor to watch in this Congress is the sharpening of political differences. The Republican majority ran strongly conservative campaigns and figure to be perhaps the most conservative majority in decades. In the House, many of the remaining Democrats were in the safest seats and consequently represent a strongly liberal viewpoint which virtually ensures a clash on nearly every issue. However, given the strong rules which favor the majority in the House, Republicans are likely to be able to impose their will with relative ease. The new Speaker of the House, John Boehner (R-OH), has already pledged to repeal Health Care Reform and is in the process of instituting new rules in the House which will not require tax cuts to find an offset in spending cuts. However, any increases in spending will require offsetting cuts. Additional new Republican leadership in the House includes Majority Leader Eric Cantor (R-VA) and Majority Whip Kevin McCarthy (R-CA). The Democratic leadership includes Minority Leader Nancy Pelosi (D-CA) and Minority Whip Steny Hoyer (D-MD). The previous Majority Whip, Representative Jim Clyburn (D-SC) has been named “Assistant Leader,” a new post.

In terms of HIV/AIDS issues, the main concerns are potential rollbacks in funding, particularly as state treatment and prevention budgets are under extraordinary pressure, and a return to culture war issues over abstinence-only and federal funding for syringe exchange. The likely changes are strongly reflected in the choices for Committee and Subcommittee Chairs in the Energy and Commerce Committee and the Appropriations Committee with which AIDS United works most closely

Rep. Harold Rogers (R-KY) is the Chair of the Appropriations Committee. His statement on his appointment as chair can be found here. Rep. Rogers has had a long history on the Appropriations Committee and believes there is a substantial amount of spending that can be cut. As his first cutting action he recommended the Appropriation committee take a 9% cut while the rest of the House took a 5% cut in committee and Member office accounts.
Rep. Dennis (Denny) Rehberg (R-MT) is chair of the Labor Health and Human Services Subcommittee. His statement on his appointment can be found here. Rep. Rehberg is the only Republican on the subcommittee from the last Congress. He is committed to cutting the LHHS funding very close to the bone.
Rep. Fred Upton (R-MI) is the chair of the Energy and Commerce Committee. His statement upon his appointment can be found here. He has changed his moderate stance to much more conservative since his appointment as chair of the committee.
Rep. Joe Pitts (R-PA) is the Chair of the Health Subcommittee. His statement on his appointment to the chair can be found here. Rep. Pitts is a true “social conservative” and was appointed to this position to ensure the conservative voice remains strong in the committee. His statement mentions his work on HIV internationally, but not on domestic HIV. He is a strong abstinence-only and pro-life proponent.
Rep. Paul Ryan (R-WI) is the Chair of the Budget Committee. His statement on his appointment can be found here. He has been given increased powers in this Congress (see Rules section in this edition of The Update) and is working to cut over $100 billion from the federal budget this calendar year.

The Senate, as always the cooler head of the two houses, likely will shift along these partisan lines as well. However there remain a number of vulnerable and conservative Democrats who will likely continue to look for opportunities to work in bipartisan fashion with the stronger Republican Minority. The leadership of both the House and Senate remained relatively stable, including Senator Harry Reid (D-NV) as Majority Leader and Dick Durbin (D-IL) as Majority Whip. Senator Mitch McConnell (R-KY) remains the Minority Leader and Jon Kyl (R-AZ) remains the Minority Whip.

House Republicans Move to Repeal health Care Reform
This week, as the 112th Congress began, Republicans in the U.S. House of Representatives followed through with campaign pledges to repeal the Patient Protection and Affordable Care Act (PPACA). On Friday, January 7, the House voted 236 to 181 to approve a rule for next week’s debate on the repeal of President Obama’s signature piece of health care legislation. This sets the stage for an up-or-down vote on January 12, next Wednesday, on H.R. 2, the bill to repeal the PPACA. Although the repeal bill is expected to pass overwhelmingly in the House, it stands virtually no chance of passing in a Senate that is still controlled by Democrats and President Obama has already stated that he would veto any repeal bill that reaches his desk. Also this week, the Congressional Budget Office (CBO) estimated that a repeal of the health care bill would add $230 billion to the national deficit over the next 10 years. In his first press conference as House Speaker, John Boehner (R-OH) rejected the CBO analysis.

Congressional Democrats appear anxious for the chance to reframe the PPACA to the American people. "Republicans want another debate about health-care reform? Well, so should Democrats. They beat us in Round One with lies and scare tactics. We welcome a second shot," Rep. Anthony Weiner (D-N.Y.) said. The White House has called on advocates and organizations that helped with the passage of health care reform to begin the next phase of advocacy by protecting the legislation. Advocacy for the preservation of this reform can start by emphasizing the benefits such as affordable coverage for small businesses, more affordable drugs for seniors, increased coverage for children, and elimination of insurance policies that use pre-existing conditions as disqualifiers for coverage.

AIDS United is strongly opposed to the repeal of the PPACA and is committed to fighting against it. If repealed, the following consumer protections would be lost:
o 16 million people with incomes below 133% of the federal poverty level and disabilities would lose eligibility to be covered by Medicaid expansion. This means that individuals living with HIV would continue to wait for an AIDS diagnosis before becoming eligible for Medicaid.
o More than 183,000 individuals on Medicare Part D who participate in ADAP (AIDS Drug Assistance Program) will be required to pay $4,550 out of pocket costs once they hit the initial coverage limit of $2,510. Under the new law, ADAP benefits will be considered toward TrOOP so that ADAP, rather than individuals living with HIV, pays the out-of-pocket expenses.
o Loss of the Prevention and Public Health Awaeness Fund (The Fund). The Fund made $500 million available in FY2010, including $30.4 million for HIV prevention, and would make $15 billion over ten years in mandatory spending to expand and sustain the necessary infrastructure to prevent disease, detect it early, and manage conditions before they become severe.
o Over 1.2 million young adults would lose their insurance coverage through their parents’ health plans.
o Over 165 million residents of the United States with private insurance coverage would suddenly find themselves vulnerable again to having lifetime limits placed on how much insurance companies will spend on their health care.
o 15.9 million people in the United States would be at risk of losing their insurance as insurance companies would once again be allowed cut off someone's coverage unexpectedly when they are in an accident or become sick because of a simple mistake on an application.
o 44.1 million seniors in the United States who have Medicare coverage would be forced to pay a co-pay to receive important preventive services, like mammograms and colonoscopies.
o Over 2.7 million on Medicare Would See Significantly Higher Prescription Drug Costs.

Click here for the statement of the new Director of the White House Office of Management and Budget, Jack Lew, on the repeal effort.

New Rules for the House
On Wednesday, January 5th during the opening session of the 112th Congress, the House adopted a series of new rules to govern their work. One of the rules with a direct impact on federally funded HIV programs is the rule allowing Budget Chairman Paul Ryan (R-WI) “unprecedented power to force reductions in spending for the current fiscal year - reductions likely to be opposed by the White House”, according to a Washington Post article entitled House Republicans adopt new rules for tax and spending legislation on 1/5/11.

Rep. Ryan continued the pledge made by Republicans during the campaign to return government spending to Fiscal Year (FY) 2008 levels, prior to President Obama’s additional funding to avert financial crisis with the Economic Recovery/Stimulus bill. The Republican majority has had to backtrack on promises to cut $100 billion from the FY11 budget since we are now nearly halfway through the fiscal year. The rule gives Rep. Ryan the authority to insert in the Congressional Record discretionary funding limits for the FY11 budget. These figures would be binding, setting the caps for all discretionary spending for the reminder of the current fiscal year. There will not be an opportunity for debate or discussion of the levels that he sets, according to the new rules.

If the FY08 levels become reality, the Ryan White program in the HIV portfolio could lose approximately $150 million while the domestic HIV prevention program at the Centers for Disease Control and Prevention could lose approximately $36 million in funding. Cuts to other programs could be quite drastic depending on where the spending level is set.

The rules also empower the Budget Chairman to exempt from enforcement the fiscal effects of repealing the health care reform law. The Congressional Budget Office has estimated that the repeal of the law would increase the federal deficit by $230 billion over the next 10 years. This is a figure that the Republican leadership challenges; however, the rules have given Rep. Ryan the ability to ignore the fiscal constraints of a repeal.

The new rules also have impacted the funding of the House of Representatives itself. The House has cut their budget by 5% across the board with a 9% reduction in the Appropriations Committee. The reductions will be seen in staff cuts as well as Member reductions per committee. For example the Appropriations Committee will reduce the number of Members on the committee from 60 to 50. Both majority and minority staff will also be cut in an effort to save funding. Members’ personal office accounts will also be cut with expected savings of $35 million in the first year.

The Appropriations Committee Chairman Rep. Harold Rogers (R-KY) has stated that, “Our budget ax will swing wide and true, and no area of the federal government will be immune from our scrutiny and cuts.” Both Rep. Rogers and Rep. Ryan have stated that the proposed FY11 cuts are just the beginning; the FY12 budget and appropriations cycle will continue the cuts to domestic discretionary spending and the plan is to cut more than $100 billion in this calendar year.

Senate Contemplates Filibuster Reform
After a tumultuous 111th Congress which set a record with 230 filibusters and in which many more bills never received a vote due to the practice of using secret “holds,” the first order of business for the Senate is to reform the filibuster rules. Heretofore, the rules have been used to require 60 vote majorities (out of 100 votes total) to even begin debate and then typically require 60 vote majorities in at least two additional points before a final vote is held on passage of legislation. There is strong Democratic support for the rules reform effort. In December, every Democratic senator returning to the 112th Congress signed a letter to Senate Majority Leader Harry Reid (D-NV) to change the filibuster rules. Since the Democratic caucus remains a majority of the Senate with 53 votes there is a one time opportunity at the beginning of the Congress to enact changes to the rules with just 51 votes. In the past, once the filibuster rules have been set, they have been impossible to change since the change itself is subject to being filibustered.

Senator Reid has said that he is interested in negotiating changes with Senate Republicans including Minority Leader Mitch McConnell (R-KY) but has said that he would not hesitate to use the majority to amend the filibuster rule without Republican input if talks fail. Senator Reid bought more time to have negotiations with the Republicans by opening the Senate on January 5th and then “adjourning” prior to enacting any substantive legislation. By deciding to adjourn rather than to recess, the opening legislative day would be continued and those seeking to reform the rules would be able to comply with Senate rules requiring 24 hours of notice of the rules. Even as maneuvering began, Democrats themselves had not yet fully agreed what the rules changes should be. The most substantive proposal was introduced by Senators Tom Udall (D-NM), Jeff Merkley (D-OR) and Tom Harkin (D-IA) and 22 additional co-sponsors as S. Res. 10. The proposal would eliminate the filibuster on motions to proceed, eliminate secret holds, guarantees consideration of amendments for both the majority and minority, ensure real debate, and expedite nominations. It would still take 60 votes to end debate on a measure.

This is potentially significant to the HIV/AIDS community because it would make it more difficult to simply filibuster popular health care items and make it easier to ensure that nominations receive an up or down vote. At the same time, the strategy carries some risk since it would weaken the ability to use holds as a bargaining chip on potentially controversial items such as abstinence-only funding and syringe exchange.

Even as the debate around changing the filibuster rules played out in the Senate, substantive legislative issues began to play out as well. In particular Senator Reid and others in the Senate Democratic leadership released a letter to House Majority Leader John Boehner (R-OH) stating that, “If House Republicans move forward with a repeal of the healthcare law that threatens consumer benefits like the ‘donut hole’ fix, we will block it in the Senate. This proposal deserves a chance to work. It is too important to be treated as collateral damage in a partisan mission to repeal health care.”

More information about S. Res. 10 can be found here: http://merkley.senate.gov/newsroom/press/release/?id=9D8813DF-95C1-4721-8A54-F44A6180A4A9

The Reid letter to Boehner can be found here:
http://democrats.senate.gov/newsroom/record.cfm?id=330148&

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Congressional and Major Events HIV Calendar for 2011

Note: these are regular meetings and important dates that the AIDS United Policy and Advocacy Team has generally tracked and/or attended

Jan 25 State of the Union Address
Washington, D.C.

Jan 27-28 Presidential Advisory Council on HIV/AIDS (PACHA)*
Washington, D.C.

Jan 27-29 Families USA: Health Action 2011
Washington, D.C.

Feb 7 National Black HIV/AIDS Awareness Day

Feb 14 Administration Budget Release (important because it begins the Congressional budget/appropriations legislative season)

Feb 15 Federal AIDS Policy Partnership Meeting
Washington, D.C.

Feb 16 – 18 NAPWA AIDSWatch 2011 (in the past AIDS Action has played a partnering role)
Washington, D.C.

Mar At a recent FAPP meeting 3 HIV groups have said that they are planning briefings for March – more details as we receive them.

Mar 1 Deadline to Raise U.S. Debt Ceiling (important as possible must pass legislation to which anti-health care reform legislation and spending cuts could be added)

Mar 5 Continuing Resolution runs out (important because Congress must pass a CR to fund the remainder of FY 2011 by this date to keep the government operating)

Mar 10 National Women and Girls HIV/AIDS Awareness Day

May 18 HIV Vaccine Awareness Day (important to work under our HIV Vaccine Project grant)

Mar 20 National Native HIV/AIDS Awareness Day

May ?? CDC/HRSA Advisory Committee for HIV and STD Prevention and Treatment (CHAC)
(dates not yet known, but likely in May)
Atlanta, GA

May 19 National Asian & Pacific Islander HIV/AIDS Awareness Day

June 8 Caribbean American HIV/AIDS Awareness Day

June 27 National HIV Testing Day

Aug 14-17 2011 National HIV Prevention Conference (AIDS United is a Partner Organization)
Atlanta, GA

Sept 11 - 13 Congressional Hispanic Caucus Institute Public Policy Conference
Washington, D.C.

Sept 18 National HIV/AIDS and Aging Awareness Day

Sept 21-24 Congressional Black Caucus Foundation Annual Legislative Conference
Washington, D.C.

Sept 27 National Gay Men's HIV/AIDS Awareness Day

Sept 30 End of Fiscal Year 2011 (Appropriations bills are supposed to be passed by this date although in recent years Congress has tended to pass a CR)

Oct 15 National Gay Men's HIV/AIDS Awareness Day

Oct 29 – Nov 2 American Public Health Association 139th Annual Meeting & Exposition
Washington, D.C.

Nov ?? CDC/HRSA Advisory Committee for HIV and STD Prevention and Treatment (CHAC) (dates not yet known, but likely in November)
Washington, DC

Nov 10-13 United States Conference on AIDS (AIDS United is a Partner Organization)
Chicago, IL

Dec 1 World AIDS Day

*There are likely to be as many as 3 more PACHA meetings – dates not yet set during the year

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