Congress Moving Forward Without Budget Resolutions and Advanced Opioid Bills
Beginning the week on tax day, Congress grappled with a diverse set of issues. The House considered IRS oversight bills, celebrated 100 years of women in Congress, and advanced several opioid bills. The Senate advanced Federal Aviation Administration (FAA) reauthorization, considered energy policy reform, and began movement on the Transportation Housing and Urban Development funding bill.
Budget & Appropriations
In terms of the federal budget and appropriations, Congress moved forward without House and Senate budget resolutions. The Senate was able to produce the topline numbers for appropriators to do their work because of a provision inserted into last year’s Bipartisan Budget Act (BBA). Senate Budget Committee Chairman Michael Enzi (R-WY) filed discretionary spending topline numbers, known as 302(b)s, for fiscal year (FY) 2017. Enzi set the budget limits at $551 billion for defense spending and $518.5 billion for nondefense spending, in line with the caps enacted under the BBA.
Since the House does not have a similar provision under the BBA, and has not passed an FY 2017 budget resolution, its leaders are unable to bring spending bills to the floor until after May 15. That has not stopped House Appropriations Committee members from moving forward. They held a closed hearing on the budget with the intelligence community, made progress marking up bills in the subcommittees, and the full committee approved the Energy and Water, Agriculture, and Military Construction/VA spending bills. We have been keeping a close eye on two particular appropriations measure of importance to people living with HIV, the Labor Health and Human Services (LHHS) bill and the Transportation Housing and Urban Development appropriations bill.
Senator Roy Blunt (R-MO), chairman of the Labor-HHS-Education Appropriations Subcommittee, scoffed at questions of whether his panel’s bill–which contains the most divisive policy riders on labor and abortion, could make it through the Senate. AIDS United has conducted several meetings with various senior Senate LHHS subcommittee staff and they have confirmed our suspicions:
- Senate LHHS staff expect to move its LHHS bill through committee,
- They do not anticipate a bill to be finalized at committee in the House, and finally
- There is no expectation that a vote will occur to pass either bill.
We anticipate that the Senate will produce a bill without poison pill policy riders on abortion or labor issues. Then the House and Senate must negotiate a balance between a more conservative measure out of the House, that is finally rolled into an omnibus appropriations bill for 2017. Given that the fiscal year ends on September 30th and Congress is set to take a seven-week recess beginning on July 15th, it is increasingly likely that Congress will pass a continuing resolution to avoid a government shutdown in September.
The Senate Transportation, Housing and Urban Development, and Related Agencies Appropriations Subcommittee passed a $56.5 billion bill to fund the U.S. Department of Transportation, U.S. Department of Housing and Urban Development, and related agencies in fiscal year 2017. Important to AIDS United and our readers, the Department of Housing and Urban Development has jurisdiction over the Housing Opportunities for People with AIDS Act (HOPWA) program.
- The bill calls for level funding for HOPWA at $335 million. It also requests that the program be modified so that funds are better targeted to communities with the highest burden of HIV.
AIDS United joins National AIDS Housing Coalition (NAHC) and other community partners in the belief that the formula to distribute HOPWA funds must be updated to reflect current trends in the HIV epidemic. This means switching from counting cumulative AIDS cases (including AIDS deaths since the inception of the epidemic) to living HIV cases. In addition, the administration and the community want both a housing cost factor and a poverty factor included in a formula. However the community calls for changes to be phased in over a five-year period, fully taking effect in year six. During the phase in period, there would be—for each grantee—a 5% cap on losses and a 10% cap on gains from any prior year allocation, whereas the administration includes a stop-loss provision that would be phased in over a period of three years with a 10% cap on losses and a 20% cap on gains from any prior year allocation.
On Wednesday, the House Energy and Commerce Health Subcommittee advanced several bills and amendments aimed at combatting the opioid epidemic. Ranging from bills expanding naloxone access, to bills improving access to medication assisted therapy (MAT) for opioid use disorders, they passed with broad bipartisan support. However, concerns around the “enabling” impact of MAT or naloxone–a concern which is not supported by research–were raised, and several components of these bills may face further scrutiny when presented before the full committee.
Also concern was raised around the lack of additional funding to pay for the various provisions of the proposed bills–a point of contention between Congressional Democrats and Republicans over the last several months–and could further jeopardize the bills as they’re brought before the broader Energy and Commerce Committee.
Of particular note, are:
- H.R. 3691 (“Improving Treatment for Pregnant Women Act of 2015”), which would reauthorize residential treatment programs for pregnant and postpartum women within the Public Health Services Act and provide for pilot programs to provide grants to State substance use service agencies to expand this service delivery.
- H.R. 4586 (“Lali’s Law”), which would require the Department of Health and Human Services to provide grants to states looking to establish standing orders for broad prescription of naloxone, as well as allowing for layperson distribution of naloxone which would allow local outreach agencies and community-based organizations to distribute naloxone directly to those who need it most.
- H.R. 4981 (“Opioid Use Disorder Treatment Expansion and Modernization Act”), which would increase the number of patients a provider could treat with buprenorphine to 250, expand the scope of providers who can prescribe buprenorphine to include physician assistants and nurse practitioners, as well require providers who prescribe buprenorphine to provide directly or have referral information available for counseling and other ancillary services.
If passed into law, these bills would provide desperately needed access to overdose prevention and treatment services to people who inject drugs where they most need them. AIDS United supports the passage of these bills–particularly provisions allowing for layperson naloxone distribution and additional prescribers of buprenorphine–and will continue to monitor their progress closely.
AIDS United is encouraged by the flurry of activity around programs that affect people living with HIV as well as people who inject drugs. We will continue to advocate for robust funding and common sense policies. For questions, please reach out to Director of Government Affairs, Carl Baloney at email@example.com.