As the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies considers this week what programs to fund in the 2023 budget, many public health concerns will demand their attention. One funding decision that would aim to end HIV — and that goal can be achieved — would also provide long-term benefits for the entire health care system. HIV continues to infect thousands of Americans each year, many of them gay men, even though an effective prevention tool known as pre-exposure prophylaxis (PrEP) is available. PrEP, which lowers the risk of contracting HIV by 99%, was first approved by the FDA in 2012 as a daily pill and is now available in a superior form as an every-other-month injection.
The leadership of the US Senate Appropriations Committee delivered welcome news recently to HIV and public health advocates with the release of their fiscal year 2022 spending bills. Like their colleagues in the House, the Senate has proposed significant funding increases to the Ending the HIV Epidemic in the U.S. initiative with at least $245 million more to focus on increased testing, prevention, treatment, and research programs. This matches the amount proposed in President Biden’s budget and approved by the House.
Even before the Affordable Care Act reduced uninsured rates in our country, it required private insurers to cover essential preventive care at no cost to patients. But just as other pieces of the law require enforcement, so does this one. Today, many individuals face obstacles to accessing affordable treatments that prevent HIV despite insurers’ legal obligation to provide them and federal guidance requiring they be made freely available. In the fight to end the HIV epidemic, federal and state regulators must hold noncompliant health plans accountable to ensure that people can receive the medication and services they need to prevent HIV.
This year, roughly 14,000 Americans will die from hepatitis C, an infectious disease that can be cured by a simple pill in a matter of weeks. It’s infuriating that our government hasn’t done more to end this highly infectious disease that disproportionately impacts minorities and people struggling with substance use disorder. Curative drugs first hit the market in 2013. But hepatitis C cases actually rose 63 percent between 2015 and 2019, according to a new report from the Centers for Disease Control and Prevention.
There’s no question that our healthcare system is broken. Where there is disagreement is in how to fix it. Current proposals being considered by the Congress do little to address the out-of-pocket spending requirements and insurance company access restrictions that impose the biggest burdens on patients. Failing to address these issues would be a huge missed opportunity.