Last week, a $1.1 trillion spending package was passed by both the House and Senate and signed by President Trump, ensuring the federal government will stay open until the conclusion of the fiscal year at the end of September. And, while this FY17 budget will provide most HIV programs with level funding for the next few months, there is little cause for celebration as a much bigger and potentially devastating budgetary showdown is on the horizon.

What does the future of HIV funding look like in the next fiscal year? The short answer is that it’s difficult to tell at this early stage, but it doesn’t look good. With the budget proposal deadline approaching on May 23, advocates are interested in how the administration prioritizes people living with HIV. In March, the “skinny budget” was released with financially large cuts for the National Institutes of Health, the Department of Health and Human Services, the Environmental Protection Agency, small independent agencies, and more.

Although the budget request is not final, sources indicate that Trump plans  $800 billion in cuts over the course of 10 years from entitlement programs such as Medicaid and Social Security Disability Services. There is no indication which programs could be cut beyond Medicaid, but means-tested mandatory spending programs that are at-risk include food stamps, Temporary Assistance for Needy Families, Supplemental Security Income, child nutrition programs, and the Pell Grant program. As of right now, the Trump Administration has continued to insist that the President is intent on keeping promises made on the campaign trail and on his social media platforms not to cut Medicare and Social Security, but these promises ring especially hollow as he has also repeatedly promised not to cut Medicaid.

These concerns are compounded by the recently passed House version of the American Health Care Act  which effectively ends Medicaid as we know it by ending the expansion and turning it into a per capita cap program. According to the Congressional Budget Office (CBO) score released for the bill’s first version released in March, the AHCA would cut Medicaid spending by $880 billion over the next decade. There is no reason to believe that the revised AHCA, which is due in less than two weeks, will fare any better. There is also concern with the future of funding towards the Department of Labor and Department of Housing and Urban Development that would impede the holistic progress of ending the HIV epidemic.

At AIDS United, we are very skeptical of the FY18 budget and appropriations cycle. We will continue to work alongside our national and grassroots partners to reverse the cuts to Part C programs in the Ryan White Care Act and to STD prevention. Our advocacy will continue to hold the administration and Congress accountable for increased funding in the interest of ending the HIV epidemic.