AIDSWatch 2011 citizen advocates climbed Capitol Hill with three Asks:

• Invest in Full Implementation of the National HIV/AIDS Strategy

• Defend Healthcare Reform and Support Implementation

• Support Increased Funding of HIV/AIDS Programs - Preservation of Funding Is Critical

     Congressional Ask #1
     Invest in Full Implementation of the National HIV/AIDS Strategy

Greater progress against HIV in the United States is achievable and fiscally responsible. With targeted investments and greater leadership, the United States can lessen human suffering, boost productivity, and create lasting savings.

Released in 2010, the National HIV/AIDS Strategy (NHAS) charts a course of action to achieve greater progress in fighting HIV/AIDS by 2015 in three critical areas:

• Reduce annual HIV infections by 25 percent (from 56,000 to 42,000)

• Increase the number of HIV-positive Americans who know their HIV status (79 percent to 90 percent) and increase the number of newly diagnosed who are linked to clinical care within three months of diagnosis (65 percent to 85 percent)

• Achieve maximum viral suppression among at least 20 percent of HIV-diagnosed African Americans, Latinos, and men who have sex with men.

     Why invest in full implementation of the National HIV/AIDS Strategy

√ With its detailed scientific analysis and targeted recommendations, the NHAS makes an authoritative case that curbing the spread of HIV in the United States is imminently achievable.

√ Public health experts estimate that achieving a 25 percent reduction in annual HIV infections as called for in the Strategy will save $18 billion in averted public sector service costs. With fewer HIV infections, the savings compound over time.

√ The NHAS provides Congress with a credible roadmap to maximize anti-HIV efforts. The administration pledges to update Congress annually on progress implementing the NHAS.

√ Better governance through increased transparency, accountability, coordination, and greater efficiency are cornerstone principles of the NHAS to maximize scarce resources.

√ The NHAS enlists state and local governments, the private sector, civil society, community actors, and others to help achieve the nation's HIV mitigation goals.

√ To have the greatest impact, the NHAS calls for targeted HIV prevention, care, housing, and research investments and streamlined governmental administration where the HIV epidemic is most acute.

Investments in the Affordable Care Act and HIV-related prevention, care, housing, and research activities will set the United States on course to avert hundreds of thousands of HIV infections and associated costs.

     Congressional Ask #2
     Defend Healthcare Reform and Support Implementation

The Patient Protection and Affordable Care Act of 2010 (ACA) is the most comprehensive reform to the United States' healthcare system since the passage of Medicare and Medicaid in 1965. Healthcare reform presents an unprecedented opportunity to increase access to affordable care and truly address our nation's ongoing HIV/AIDS crisis; it is greatly reducing preventable, high-cost medical interventions and helping to reduce new HIV infections by providing access to the HIV testing, care, and support services necessary to slow this epidemic. We cannot let the promise that reform holds for the 1.2 million people living with HIV and AIDS in this country many of whom are among the 50 million people who are currently uninsured in the United States fall victim to fear and misconceptions.

     What are the most significant accomplishments of healthcare reform?

• Starting in 2014, eliminates the Medicaid disability requirement and provides immediate access to comprehensive healthcare through Medicaid for most low-income Americans, including uninsured people living with HIV and AIDS in the United States

• Eliminates the Medicare Part D "donut hole" by 2020, immediately allows ADAP to count toward an individual's true out-of-pocket copayment obligations (TrOOP), and reduces copayments by more than 50%, from $4500 to $2150 for most people living with HIV and AIDS on Medicare

• Greatly reduces private health insurance discrimination by mandating access to private insurance coverage regardless of pre-existing health conditions

• Makes private health insurance more affordable to low and middle-income Americans through various discounts and cost-sharing

• Focuses on prevention and wellness and reducing health disparities by investing in community-based prevention initiatives and guaranteeing access to free preventive healthcare services

• Invests in expansion of community health centers and the healthcare workforce and encourages coordinated and cost-effective models of care

     The Ask: How Congress Can Defend and Support Healthcare Reform

1. We urge you to consider the promise that healthcare reform holds, not only for people living with HIV and AIDS, but for the entire nation, and vote against repeal of all or parts of the Patient Protection and Affordable Care Act. Advances in treatment have transformed HIV to a chronic, manageable medical condition for those who have access to early and comprehensive healthcare services. We cannot return to a time when high-cost hospitalizations and emergency room care were the only options for many people living with this disease.

2. Healthcare reform is an essential vehicle for enactment of the goals and principles of our National HIV/AIDS Strategy, which includes reducing new HIV infections, increasing access to care, improving health outcomes, and reducing HIV-related health disparities. Ensure that those healthcare reform provisions that help to meet these goals, such as the Prevention and Public Health Fund, are fully implemented and funded.

     Congressional Ask #3
     Support Increased Funding of HIV/AIDS Programs
     Preservation of Funding Is Critical

Federal funding to combat the HIV epidemic has been lacking and is not keeping pace with the care, treatment, and service needs of the growing number of people living with HIV and AIDS in the United States. Our nation's National HIV/AIDS Strategy calls for a significant reduction in new HIV infections and improved access to HIV care and treatment for individuals living with HIV, but these goals cannot be met without adequate federal funding.

In order to make these critical goals a reality, we need Congress to increase funding of HIV/AIDS programs. Most essential, funding for domestic HIV/AIDS programs must be preserved; persons living with HIV and AIDS cannot afford to turn the clock back on funding.

Increase accessibility to care, treatment, and essential services for people living with HIV and AIDS by increasing Ryan White program funding to keep pace with growing need.

• Ryan White programs are a critical part of this nation's response to HIV/AIDS, providing care, treatment, and essential services to those with the greatest need. Ryan White programs serve approximately 577,000 low-income, uninsured, and underinsured individuals each year and will play a key role in helping the nation meet the President's National HIV/AIDS Strategy goal of ensuring access to HIV care and improving health outcomes for everyone living with HIV.

Federal funding for the AIDS Drug Assistance Program (ADAP) must be increased

• The current access to care and public health crisis brought on by ADAP shortfalls has left thousands of people on waiting lists in states across the country waiting to get access to lifesaving HIV medications. In addition, many states have greatly restricted the drugs covered by ADAP and restricted eligibility for the program. As part of our funding request for the Ryan White program, Congress must increase funding for this critical component.

Support new investments in HIV prevention education by increasing funding at the Centers for Disease Control and Prevention (CDC)

• A significant increase in funding of HIV prevention initiatives is needed to reduce the number of new HIV infections, which have remained unchanged at about 56,000 per year since 2001. Reducing new infections is a major pillar of the National HIV/AIDS Strategy, and to meet this goal, state and local health departments and community-based organizations need adequate resources to strengthen and expand HIV testing, outreach, and prevention education programs.

Expand access to housing by increasing Housing Opportunities for People With AIDS (HOPWA) funding

• Access to safe and affordable housing is essential to improving individual health outcomes and promoting public health. However, demand for housing far exceeds availability, and increased HOPWA funding is needed to support efforts to address this critical component of the HIV-care continuum. In addition, the HIV community will be seeking reauthorization of the HOPWA program in the near future; we hope members of Congress will support efforts to reauthorize this important program.
Increase efforts to respond to the disproportionate impact of HIV on communities of color by increasing funding for the Minority AIDS Initiative (MAI)

• Targeted funding is urgently needed to address the huge disparities in HIV infection among communities of color and to meet the National HIV/AIDS Strategy goals with regard to health disparities. MAI funding improves access to culturally and linguistically appropriate outreach, education, prevention, care, and treatment programs and services.

Further efforts to effectively address AIDS at home by increasing funding for AIDS research at the National Institutes of Health (NIH)

• Inadequate funding of the NIH has slowed important research efforts aimed at ending the HIV/AIDS epidemic in the United States. To reverse this trend, funding increases are needed for the Office of AIDS Research at NIH.

Significant scientific advances have been made in research to find a cure for HIV; at this time, it is critical that funding targeted to a cure for HIV, as well other HIV research, continue to be funded and receive needed increases.