An Economy Built to Last and Security for the LGBT Community

We now face a make-or-break moment for the middle class and those trying to reach it. After decades of eroding middle-class security as those at the very top saw their incomes rise as never before and after a historic recession that plunged our economy into a crisis from which we are still fighting to recover, it is time to construct an economy that is built to last. The President’s 2013 Budget is built around the idea that our country does best when everyone gets a fair shot, does their fair share, and plays by the same rules. We must transform our economy from one focused on speculating, spending, and borrowing to one constructed on the solid foundation of educating, innovating, and building. That begins with putting the Nation on a path to living within our means – by cutting wasteful spending, asking all Americans to shoulder their fair share, and making tough choices on some things we cannot afford, while keeping the investments we need to grow the economy and create jobs. The Budget targets scarce federal resources to the areas critical to growing the economy and restoring middle-class security: education and skills for American workers, innovation and manufacturing, clean energy, and infrastructure. The Budget is a blueprint for how we can rebuild an economy where hard work pays off and responsibility is rewarded.

To construct an economy that is built to last and provide security for the LGBT community, while continuing to defend their rights, the 2013 Budget will:

Strengthen Anti-Discrimination Enforcement. Even in tough budget times, the substantial investments that have been made by the Administration to strengthen civil rights enforcement against racial, ethnic, sexual orientation, religious, gender, and gender identity discrimination continue in the 2013 Budget. The Budget also proposes an increase for the Community Relations Service in the Department of Justice to fight hate crimes.

Support Federal Employee Domestic Partner Benefits. The Administration supports the Domestic Partnership Benefits and Obligations Act of 2009, which provides the same benefits to same-sex domestic partners of Federal employees as those provided to married heterosexual partners of Federal employees. These benefits include health insurance, survivor annuities, compensation for work-related injuries, travel and relocation benefits, life insurance, and vision and dental benefits. The Administration has also, to the extent permissible by current law, expanded benefits for same-sex partners of federal employees.

Combat Hate Crimes. The substantial investments that have been made in Civil Rights enforcement during this Administration also continue in the 2013 Budget. In addition to the protections on the basis of sexual orientation or gender identity under the Matthew Shepard and James Byrd, Jr. Hate Crimes Prevention Act, the Budget also proposes an increase for the Community Relations Service to fight hate crime.

Support Equal Rights for Hospital Visitation. On April 15, 2010, the President issued a Presidential Memorandum directing the Department of Health and Human Services to ensure that those hospitals that receive Medicare and Medicaid funds give lesbian, gay, bisexual and transgender patients and their families the compassion, dignity and respect they deserve in difficult times, as well as widows and widowers with no children, members of religious orders, and others who otherwise may not have been able to receive visits from good friends and loved ones who are not immediate relatives, or select them to make decisions on their behalf in case of incapacitation. And in November of 2010, the Centers for Medicare & Medicaid Services issued a final rule which updates hospital Conditions of Participation (CoP) requiring all Medicare and Medicaid-participating hospitals to explain to their patients their right to choose who may visit them during their inpatient stay, regardless of whether the visitor is a family member, a spouse, a domestic partner, or other visitor.

Support the National HIV/AIDS Strategy (NHAS) and Expand Investments in Prevention, Care, and Research. The Budget expands access to HIV/AIDS prevention and care activities and supports the goals of the National HIV/AIDS Strategy: reducing HIV incidence, increasing access to care and optimizing health outcomes, and reducing HIV-related health disparities. The Budget prioritizes HIV/AIDS resources within high-burden communities and among high-risk groups, including gay and bisexual men, Black Americans, Latino Americans and substance users. Compared to 2012, the Budget increases domestic discretionary HIV/AIDS funding at HHS by $119 million and Veterans Affairs (VA) HIV/AIDS funding by $74 million. Overall, total U.S. Government-wide spending on HIV/AIDS increases by $800 million in 2013.

Expand the Ryan White HIV/AIDS Program. The Budget includes an increase of $75 million for care and treatment through the Ryan White HIV/AIDS Program. The Budget includes $1 billion for AIDS drug assistance programs, an increase of $67 million above 2012 levels to expand access to life saving HIV-related medications for uninsured and underinsured people living with HIV/AIDS. Based on current projections, this increase in funding for ADAP, combined with sufficient state contributions, will eliminate ADAP waiting lists in 2013. The Budget also increases funding for the Ryan White Part C program by $15 million to expand access to critical early intervention and primary care services for the most vulnerable populations living with HIV/AIDS. To address the disproportionate impact of HIV/AIDS on communities of color, there is an $8 million increase in funding above 2012 for Ryan White Minority AIDS Initiative activities, totaling $169 million in 2013.

Support Housing Assistance for People Living with HIV/AIDS. The President’s Budget requests $330 million for HUD’s Housing Opportunities for Persons with AIDS (HOPWA) program, to address housing needs among people living with HIV/AIDS and their families. The program provides States and localities with the resources to create comprehensive strategies for providing housing assistance that gives patients the stability needed for effective treatment. However, the current formula for distributing HOPWA funds does not reflect the current nature of the epidemic. To modernize the HOPWA program, the Administration is proposing an updated formula based on the number of people living with HIV and adjusted for an area’s fair market rent and poverty rates, focusing HOPWA on the areas with the most need. The proposal will also include several changes that will allow better targeting of HOPWA resources and more flexibility for grantees to provide the most cost-effective, timely interventions. These changes, which will be proposed in separate legislation, will improve the Nation’s response to the specialized housing needs of HIV/AIDS patients.

Combat Violence and the Bullying of Children. The Budget provides $86 million for grants to States and local educational agencies under the Department of Education’s Successful, Safe, and Healthy Students program. State and local grants support the development and implementation of comprehensive strategies, which are designed to continuously measure and improve conditions for learning and student outcomes. That includes activities aimed at preventing and reducing substance use, violence, harassment or bullying, and promoting student mental, physical, and emotional health.

Support the President’s Ambitious Goals to Address Global AIDS. On World AIDS Day 2011, the President announced ambitious new targets for the prevention and treatment of HIV/AIDS that will bring us closer to the goal of an AIDS-free generation. Through the President’s Emergency Plan for AIDS Relief (PEPFAR), the Budget supports focused investments on proven methods to prevent new HIV infections, including supporting voluntary medical male circumcision, preventing mother-to-child transmission, expanding access to condoms, and providing antiretroviral treatment (ART) for 6 million patients. These expanded targets are possible in a constrained budget environment due to the strong programmatic foundation that the U.S. has built under Presidents Bush and Obama, and relentless work to bring down costs and find efficiencies. The per-patient cost to the U.S. of providing anti-retroviral treatment has fallen by over 50 percent since 2008 because PEPFAR has invested carefully, tailoring prevention to countries’ urgent needs, using generic drugs, shipping more efficiently, and linking PEPFAR to other needed health services. The Budget fully funds the balance of the Administration’s historic three-year, $4 billion pledge to the Global Fund to Fight AIDS, Tuberculosis, and Malaria, in recognition of this multilateral partner’s key role in global health and its progress in instituting reform.