Federal Updates
Budget
Congress Strikes Two-Year Bipartisan Budget Deal with Disproportionate Increase in Military Spending
On Feb. 9, Congress passed a two-year budget deal, after failed negotiations led to two government shutdowns in the past month. The deal includes lifting previous limits on military defense and non-defense discretionary spending (NDD), an extension of expired Community Health Centers funding, and a four-year extension of the Children’s Health Insurance Plan (CHIP) funding. While NDD typically includes spending on education, training, science, technology, housing, transportation, and foreign aid, the administration’s policy priorities have raised concerns that a disproportionate share of the NDD spending in this deal will be used to support military construction, state and foreign operations, and the Department of Homeland Security (DHS), which oversees immigration enforcement. The deal will increase spending by $300 billion over the next two years, and passed despite opposition from Democrats who sought a commitment from Republicans to protect immigrants covered under the Deferred Action for Childhood Arrivals Program (DACA). However, no deal on immigration came out of budget negotiations, with the program set to expire on March 5.
President’s Fiscal Year 2019 Budget Attacks Housing, Food Stamps, Healthcare
On Feb. 12, the President released his budget for fiscal year 2019. The budget largely contradicts the two-year the budget deal reached in Congress just prior to its release, assumed the repeal of the Affordable Care Act and proposed deep cuts to NDD spending by 42% over the next 10 years. Other proposed cuts include:
- Ryan White Program by $43 million
- Medicaid and Affordable Care Act marketplace subsidies by $763 billion over ten years
- Housing Opportunities for People with AIDS (HOPWA) by $26 million
- Supplemental Nutrition Assistance Program (SNAP, formerly food stamps) by more than $213 billion over the next ten years, along with a proposal to substitute more than 40 percent of participant grocery funds with a mailed box of non-perishable foods.
The Secretary’s Minority AIDS Initiative Fund (SMAIF) and the Substance Use and Mental Health Service Administration’s (SAMSHA) Minority AIDS Fund were not included in this budget, but could also lose funding. Though widely considered “dead on arrival” (not likely to be passed by Congress) the draconian cuts proposed in the budget further highlight the administration’s policy priorities reflecting a complete disregard for the health and quality of life for low-income people.
Administration Updates
Brett Giroir Confirmed New HHS Assistant Secretary Despite Strong Opposition from Democrats
On Feb. 9, the Senate confirmed Dr. Brett Giroir as HHS Assistant Secretary for Health. Giroir will be responsible for overseeing the Office of Population Affairs, which administers Title X grants to family planning clinics, and the Office of Adolescent Health, which oversees the Teen Pregnancy Prevention Program. The confirmation comes despite Democrats’ concerns that Giroir will further the Trump Administration’s agenda of obstructing access to reproductive health services.
LGBT Rights
Second Court Rules Title VII Anti Sex Discrimination Laws Cover Also Cover Sexual Orientation
On Feb. 26, the U.S. 2nd Circuit Court of Appeals became the second court to rule that a federal law banning bias based on sex in the workplace also prohibits discrimination against gay employees. The Trump administration has argued federal employment discrimination protections did not extend to discrimination based on sexual orientation. Yet in his ruling, Judge Robert Katzmann wrote that even though Congress had not sought to address bias based on sexual orientation in Title VII, laws “often go beyond the principal evil to cover reasonably comparable evils.” Title VII of the Civil Rights Act of 1964 is a federal law that prohibits employers from discriminating against employees on the basis of sex, race, color, national origin, and religion. The U.S. Supreme Court has declined to rule on the issue.
Sexual/Reproductive Health, Rights, Safety
Department of Health and Human Services Worked with Hate Group to Defund State Planned Parenthoods
In January, HHS gave states permission to ignore Obama-era rules that required they include Planned Parenthood in their Medicaid programs. The House of Representatives Oversight Committee, found that HHS received a draft legal analysis from the conservative Alliance Defending Freedom (ADF), a known Christian Right hate group, a week before the announcement. The Trump Administration’s close connection to ADF and their agenda is a cause of great concern as legal battles continue over the continued funding of Planned Parenthoods across the country.
HHS Shifts Title X Family Planning Program Funding Priorities to Favor Religious Organizations and Abstinence Only Education
On Feb. 23, HHS Office of Population Affairs released a Funding Opportunity Announcement (FOA), for the Title X federal family planning program. Though the $260 million grant application did not explicitly exclude Planned Parenthood clinics, it radically shifts the program’s funding priorities by emphasizing abstinence and “natural family planning.” Advocates view the announcement as another attempt by the administration to further undermine access to quality reproductive health care and information for the 4 million people who access services through Title X. The call for applications removed references to Quality Family Planning recommendations, the national standard of clinical care for family planning services produced by the Centers for Disease Control and Prevention (CDC) and the U.S. Office of Population Affairs, as well as references to ensuring access to the 18 FDA-approved contraceptive methods. The funding shift is also expected to open the program’s doors to participation of religious and anti-abortion counseling centers while making participation by comprehensive sexual and reproductive healthcare providers and experts more difficult.
House Passes Bill Criminalizing Sex Worker Safety
On Feb. 27, the House passed H.R. 1865, the Allow States and Victims to Fight Online Sex Trafficking Act of 2017 (FOSTA), which would make it a federal crime to facilitate sexual exchanges online, punishable by up to ten years. This would criminalize hosting safety information online, harm reduction techniques like asking for referrals via email, community spaces for sex workers and advertising platforms which allow people to engage in indoor sex work (as opposed to on the streets). The bill would also open advertising platforms to civil liability for facilitating sex trafficking without giving any clear guidelines for what that would mean. Both provisions would have a negative impact on the health, rights and safety of sex workers, making them more vulnerable to violence and exploitation.
Social Safety Net/Economic Justice
Indiana, Arkansas Approve Medicaid Work Requirements
On Feb 2, Indiana became the second state approved for a waiver to apply work requirements to Medicaid beneficiaries. In addition, the waiver included a requirement that participants promptly submit paperwork proving eligibility for Medicaid or be locked out of enrollment for three months after initially pushing for a six-month lockout period. Before the waiver was approved, beneficiaries could reapply at any time by submitting updated documents. These “lockout” policies have been criticized for being unnecessarily harsh in denying individuals coverage for months at a time for failing to send in a document or missing a premium payment. Indiana’s work requirements mandate adult enrollees to work an average of 20 hours a month, starting in 2019. Studies have shown that most adult Medicaid enrollees that do not already work are going to school or are too sick to work. March 5, Arkansas also approved work requirements for Medicaid.
Administration Moves to Expand Work Requirements to Housing and Food Assistance
At the beginning of February, reports surfaced that draft legislation from the Department of Housing and Urban Development (HUD) was also considering increasing rent and implementing work requirements for the federal subsidized housing voucher program, also known as Section 8. Under existing rules, most households that receive federal housing subsidies pay 30% of their adjusted income as rent – income left over after eligible participants receive mandatory deductions for having dependents, being elderly and disabled, and having childcare, medical and disability expenses. The proposed legislation would eliminate these deductions, negatively and disproportionately impacting low-income households with children, the elderly, or people with medical conditions. Additionally, the draft legislation would stipulate work requirements of up to 32 hours a week “per adult in the household who is not elderly or a person with disabilities.”
On Feb. 23, the U.S. Department of Agriculture (USDA) also announced it was opening a public comment period, seeking ideas on how to “promote work and self-sufficiency among able-bodied adults” participating in the SNAP (food stamp) program. Under federal law, able-bodied adults without dependents are restricted to three months of benefits within a 36-month period unless they work at least 80 hours per month or participate in certain educational or job-training activities. States however, can request federal waivers of this time if there are few jobs open in the area. Unfortunately, the Trump administration wants to make it more difficult for states to obtain those waivers by limiting access to individual counties with a 10% unemployment rate over a 12-month period.
Trump Works to Weaken Anti-Discrimination Protections in Lending
Feb. 1, the administration removed the enforcement powers of the Office of Fair Lending and Equal Opportunity, a unit of the Consumer Financial Protection Bureau (CFPB). The CFPB is responsible for investigating discriminatory lending practices and obtaining settlements from banks that charged people of color higher interest rates than for white borrowers. The office will now focus on “advocacy, coordination and education,” rather than enforcement and oversight of companies according to budget director Mick Mulvaney. While serving in Congress, Mulvaney sponsored legislation to abolish the Bureau, and has worked to gut other consumer protections from payday lenders since joining the administration.
Immigrant Justice
Supreme Court Declines to Rule on DACA, Leaving Program Safe for the Extended Future
After Trump ended the DACA program in September 2017, Congress has tried and failed repeatedly to renew protections for 1.8 million Dreamers (undocumented immigrant youth who had been brought into the country as children). In the meantime, hundreds of Dreamers have been losing their protected status every day, putting them at risk for deportation. Two federal courts have ruled against the Trump administration’s abrupt decision to end DACA by March 5 and on Feb. 26, the Supreme Court declined to hear the case, leaving the lower federal court ruling maintaining DACA in place.
Administration Attacks Family Immigration, Penalizes Use of Social Safety Net Programs
The Department of Homeland Security’s (DHS) has drafted a “public charge” rule that would allow immigration officers to scrutinize aspiring immigrants’ use of public benefits. The rule frames immigrants as a burden on U.S. taxpayers and would significantly restrict family-based immigration from Latin America and Southeast Asia—regions whose immigrants tend to have relatively low socioeconomic status–as well as elderly immigrants. Permanent residents could be denied citizenship and be at risk of deportation if they use federal means-tested public benefits (like food stamps and health insurance subsidies), and sponsors would also have to repay benefits received. Additionally, the rule singles out people with disabilities for exclusion, citing that the presence of a “costly medical condition” without “unsubsidized health insurance” as a factor that must be weighed heavily against the applicant. Instead, the draft rules would alter current policies to favor immigrants with higher education and incomes.
Supreme Court Rules Immigrant Detainees can be Denied Bond Hearings
On Feb. 27, in a significant loss for immigrants appealing what are sometimes indefinite detentions by the government, the Supreme Court in a 5-3 decision struck down a lower court ruling that said immigrants who have been detained must be allowed a bond hearing every six months. Bond hearings determine whether detainees can post bail and have the possibility of release. The ruling applies to all immigrants, including those who are documented or who are seeking asylum. The case was initially brought by Alejandro Rodriguez, an immigrant from Mexico who was detained for three years without a bond hearing while the government considered deportation. The Court sent the case back down to the lower court to resolve whether indefinite detentions without a chance for bail is unconstitutional.
Disability Justice
Houses Passes H.R. 620, Stripping People with Disabilities of Civil Rights
Under Title III of the Americans with Disabilities Act (ADA), businesses open to the public are prohibited from discriminating against people with disabilities. Under current law, if a person with a disability encounters a barrier that prevents them from entering the business, the ADA gives them the option to speak with the business owners, file a complaint with the Department of Justice, or file a lawsuit. On Feb. 15, the House passed a law that would limit those options. The so-called “ADA Education and Reform Act” prevents people with disabilities from immediately going to court and instead requires that they exhaust numerous procedural remedies. Under the new law, many businesses would no longer be required to be ADA compliant ahead of time and would likely wait until a complaint is filed before taking action. Passage of the bill has been widely condemned by disability and civil rights advocates, who fear the legislation would turn back decades of progress for people with disabilities including accessibility to public spaces necessary to live their daily lives.
State Updates
California
SB 1021 – Pricing Protections for Medications
Feb. 8, California state Sen. Scott Weiner introduced SB 1021, which would set limits on monthly co-pays and drug pricing standards that are currently set to expire at the end of 2019. Pricing protections included in the bill apply to drugs used in both HIV treatment and prevention drugs and will cover PrEP.
San Francisco to become first U.S. City to Open Safe Injection Sites
San Francisco will be opening two safe injection sites this July, becoming the first city in the country to do so. Safe injection sites are places where people who inject drugs can legally go to inject under medical supervision. These sites are designed to reduce health risks associated with injectable drug use including overdoses and communicable disease transmission. The sites will start off being privately funded and local non-profits that currently operate needle exchanges and or offer drug addiction services will be chosen to operate the sites. Seattle, Baltimore and Philadelphia are amongst other cities planning to open safe injection sites.
Florida
Florida Strikes Down Proposal to Weaken Privacy Protections
Feb. 1, Florida’s Constitution Revision Commission (CRC) voted down Proposal 22, which would have revised the language of the state’s existing constitutional privacy clause (prevents government intrusion into marriage, sexual relationships, activities within the home or medical decisions) by narrowing it down to cover disclosure of personal information only. Previously, the clause had been used by state courts to uphold the right to have an abortion. The proposed revision would have prevented courts from continuing to use the privacy clause towards that end, opening the path for legislators to limit abortion access in the state.
Court Rules Felony Voting Restoration Process Biased and Unconstitutional
Also on Feb. 1, a district court in Florida found that the state’s process for returning voting rights to people convicted of felonies was unconstitutional. While the previous governor, then-Republican Gov. Charlie Crist, had loosened restrictions on restoration of civil rights, Republican Governor Rick Scott crafted a policy that made people convicted of felonies wait at least five years after completing their sentences, serve probation and pay all restitution in order to apply for the right to vote and other civil rights. Gov. Scott and a partisan Cabinet meeting as a clemency board would consider these cases—for which the petitioners had to appear in person–with largely unfettered discretion cases four times a year. Decisions could take a decade to be issued and the Cabinet had a backlog of more than 10,000 cases. U.S. District Judge Mark Walker strongly condemned this process for giving the politicians too much discretion and allowing too much potential for bias.
Mississippi
15-Week Abortion Ban Headed to Full Senate Vote
Feb. 27, Mississippi’s Senate committee approved House Bill 1510, which would ban abortions after 15 weeks. If passed, the ban would be the most restrictive abortion law in the country. Currently, state abortion bans across the U.S. are set at 20 weeks. A full Senate vote is expected by March 7.