Governor's Tough Choices

By Courtney Mulhern-Pearson, Director of State & Local Affairs

Even Governor Jerry Brown admits he’s not happy with his state budget proposal. With California facing a $9.2 billion deficit in the next fiscal year, the governor says he has no choice but to make painful cuts. But in the midst of these economically challenging times it is essential the governor not turn his back on our state’s most vulnerable citizens, including those living with or at risk for HIV.

A Heavy Burden

The AIDS Drug Assistance Program, or ADAP, is a critical lifeline for many people living with HIV/AIDS. It provides medications to more than 40,000 low-income, uninsured, and underinsured people in California. 

The governor’s plan calls for people on ADAP to share costs, and in some cases monthly co-payments could be as high as nearly $400 for life-saving medications. Forcing co-payments for AIDS drugs will ultimately result in people dropping out of the program altogether, putting their health and the greater community at risk.

Now is not the time to place a heavier financial burden on people who are already living on the margins and who rely on this program to stay healthy. ADAP is essential to people across our state that would not otherwise be able to access HIV medications. Cuts to ADAP services will have costly implications for our state and will result in advanced HIV disease, increased co-morbidities, and even premature death for Californians. 

Medications provided by ADAP also help to prevent the spread of HIV. People on effective treatment can reduce the amount of HIV in their blood to undetectable levels. Mounting evidence shows an undetectable viral load makes HIV-positive people less likely to spread the virus to others. In fact, a study published by the National Institutes of Health shows HIV-positive people who are on effective therapy are 96% less likely to transmit the virus to their uninfected partners. For every new HIV infection we prevent, California saves an estimated $600,000 in lifetime treatment costs. 

Cuts to Health & Human Services

The governor’s budget proposal includes other deep cuts to health and human services programs that would have devastating impacts on people living with HIV/AIDS in California.

The governor proposes cutting nearly $950 million from CalWORKs, the state’s welfare-to-work program. The cost savings would be achieved by limiting the amount of time most adults could be on the program from four years to two years. The governor also wants to cut nearly $164 million from In-Home Supportive Services, which provides services for the elderly and people who have disabilities.

Yet again, Californians who are unemployed, uninsured, or disabled, including many people living with HIV/AIDS who rely on these benefits, would be forced to make sacrifices that will ultimately jeopardize their health and well-being. At a time when we should be expanding services for people living with HIV because a stable network of care and services is essential to improving health and stopping the spread of the disease the governor proposes we take a step backward, and that is not acceptable public health policy.

What’s Next?

Governor Brown will now try to convince voters to raise taxes in a ballot measure in November. His budget proposal relies heavily on the temporary tax increases, which he hopes will generate nearly $7 billion. San Francisco AIDS Foundation supports this initiative to increase state revenues. Without the tax hikes, Brown says the state would be forced to immediately enact at $5.4 billion spending cut. It’s unacceptable to balance the state budget on the backs of people who are disadvantaged.

We will work collaboratively with community partners and our grassroots supporters to advocate for alternative solutions to ensure that the burden of these cuts do not fall on people without the political power to fight them. For example, last year the foundation and its allies worked closely with the State Office of AIDS to expand a program to keep people insured by paying their premiums, which resulted in a cost savings to ADAP. 

We will continue to seek innovative solutions such as this as the legislature holds budget hearings in the coming weeks and months. San Francisco AIDS Foundation will play a leadership role in voicing the concerns of our clients and HIV-positive people throughout California to ensure everyone has access to proper care and treatment. We’re looking forward to an ongoing dialogue and active collaboration with the Brown administration and legislators.

Get Involved

We can always use the help of community supporters like to you to make calls or write letters. We invite you to join our HIV Advocacy Network (HAN) to follow our efforts at the local, state, and federal levels. We’ll send you updates on our important policy initiatives, and from time to time we’ll ask you to reach out to the governor’s office or your legislators to support our efforts. When lawmakers hear from people like you, change happens. Become a part of HAN today.


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