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Impact of Funding Cuts on ADAP

Impact of Funding Cuts on ADAP. Emily McCloskey, NASTAD July 8, 2013. NASTAD.

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Impact of Funding Cuts on ADAP

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  1. Impact of Funding Cuts on ADAP Emily McCloskey, NASTAD July 8, 2013

  2. NASTAD • NASTAD is a non-profit national association of state health department HIV/AIDS program directors who administer HIV/AIDS and viral hepatitis prevention, care and treatment programs funded by state and federal governments. • Domestic Programs • Health Care Access, Health Equity, Prevention, Viral Hepatitis • Policy and Legislative Affairs • Global Program

  3. Agenda • AIDS Drug Assistance Program (ADAP) Funding History • FY2013 Funding • FY2014 Funding

  4. How ADAP is Funded • ADAPs are a partnership between federal and state governments and the pharmaceutical industry.

  5. Historical Growth of Funding

  6. Budget Outlook • The Budget Control Act established discretionary spending caps for fiscal years 2012-2021. • It also established the Joint Select Committee on Deficit Reduction to create deficit reduction legislation. The Committee’s failure would trigger sequestration on January 1, 2013. • The American Tax Payer Relief Act of 2012 postponed sequestration until March 1, 2013.

  7. Budget Outlook • Discretionary spending caps for fiscal years 2012-2021 for $984 billion in savings over 10 years or $109 billion annually • Under law, cuts will occur annually – spread evenly – over 9 more years and include sequestration if Congress and White House don’t agree • $350 billion less over 10 years than in 2013 for non-defense discretionary programs (NDD)

  8. FY2013 • In FY2013, ADAPs were funded at $886 million, a cut of $47 million due to sequestration. • NASTAD estimates this sequester cut could affect over 8,200 clients currently enrolled on ADAP.

  9. FY2013(continued) • $35 million was transferred to ADAP for emergency relief funding (ERF) from other HHS programs, including other parts of Ryan White. • Congress did not continue emergency funding from FY2012 so Administration had to retransfer the funds. • Total ERF is $75 million in FY2013 - $65 for continuation and $10 million for new competing grants. In FY2012, 25 states received funding. • This does not effect the sequester cut and it does not represent an increase in funding for FY2013.

  10. FY2013(continued) • FY2013 also brings changes to the ADAP award formula calculations: • Normal shifts of proportion of the country’s living HIV/AIDS cases • Only name-based HIV cases reported to CDC will be used • The hold harmless provision will decrease to 92.5% of states’ FY2012 award • FY2013 is the final year of the transitional grant area (TGA) transfer

  11. FY2013(continued) • With the implementation of health reform and continued fiscal challenges, ADAPs may continue to experience shifts in state funding allocations, including potential reductions. • States still have not received their full FY2013 awards, creating uncertainty for ADAPs.

  12. FY2014 • If sequestration is not fixed, cuts will continue each fiscal year until FY2021 • Congress could choose to target the cuts through the appropriations process or could continue to realize the cuts through across-the-board reductions

  13. FY2014(continued) • President Obama’s budget was released on April 10, 2013 and includes: • $20 million increase for Ryan White Program, including $10 million increase for ADAP • $35 million Emergency Relief Funding continued • Eliminates the sequester

  14. FY2014(continued) • The House and Senate have very different FY2014 budgets • The House allocation for Labor, Health and Human Services, Education, and Related Agencies is $121.8 billion, which represents an 18.6% cut from FY2013. • If applied universally, ADAP could be funded at $721 million, a $164 million cut. • The Senate’s budget funds at much higher levels than the House budget and eliminates the sequester

  15. FY2014(continued) • The Senate Appropriations Committee Labor, Health and Human Services, Education, and Related Agencies Subcommittee will mark up their bill on Tuesday. • It is unlikely that the House will vote on a bill. • Currently the most likely scenario is a continuing resolution and the continuation of sequestration.

  16. Contact Information Emily McCloskey Manager, Policy and Legislative Affairs emccloskey@NASTAD.org 202.434.8067

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