As President Trump stood before a joint session of Congress for his State of the Union address in February, he urged Republicans and Democrats alike to support the audacious goal of stopping the spread of HIV within a decade. “Together, we will defeat AIDS in America and beyond,” he declared.
The White House’s 2020 budget request, issued this week, does propose an additional $291 million as a down payment for a new HIV initiative. Yet the $4.7 trillion budget also calls for sharp spending reductions to Medicaid, the public insurance program for the poor on which more than 2 in 5 Americans with the virus depend.
Such a contradiction — giving while also taking away — runs through the budget arithmetic for many of the Trump administration’s health-care priorities. In addition to combating HIV, the president has taken aim at childhood cancer and the opioid crisis, but his budget would undermine all those efforts by shrinking the health infrastructure that people struggling with those issues rely on while throttling back national cancer research spending — even as it offers discrete pots of money for those causes, policymakers say.