Budget Negotiations Threaten D.C. Needle-Exchange Programs

After Republicans took back the House in November, I predicted three ways in which the new majority would try to interfere with the District, based largely on what Republican majorities did in the 1990s: prohibiting local funding for abortion services and needle-exchange programs, and bringing back a school-voucher system. This weekend, Republicans were able to secure two of these goals as rider amendments to the budget deal that avoided a shutdown late Friday night. The third is still on the table.

The GOP won reinstatement of the Hyde Amendment in D.C. -- previously in effect from 1995 to 2009 -- which prevents local D.C. funds from paying for abortions for poor women on Medicaid. Second, Republicans got their prized school-voucher program; the GOP under Newt Gingrich introduced the program in 1996, and it remained until Obama and Democrats ended it in 2009.

The remaining battle involves cutting funding to D.C. for needle-exchange programs that prevent the spread of HIV/AIDS. D.C. leads the nation in HIV infection rate with an estimated 1 in 20 residents living with HIV or AIDS -- an official epidemic. In 1998, Republicans in Congress banned D.C. from putting local funds toward needle exchanges, even thought dirty needles accounted for 37 percent of infections. Congress lifted that ban in 2007. According to the CDC, needle exchanges prevent HIV infection at a cost of $4000 to $12,000 per person/family while a lifetime of medical costs for someone who is HIV positive totals a whopping $619,000. Moreover, with the city's leading provider of clean syringes having closed its doors due to financial hardship in February, ending public funding would immediately put intravenous drug users at a higher risk of infection. The budget passed by House Republicans in February included a rider prohibiting local funding for needle exchanges, and initial reports this weekend said the fate of these programs was undetermined.

It’s a matter of autonomy, of being able to care for your citizens, and of keeping medical costs under control. If Republicans get these three policy riders in the budget deal this week, they’ll be free to move on to medical marijuana, marriage equality, and safe gun laws during the impending debt-ceiling negotiations.

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