Order Code RL30731
CRS Report for Congress
Received through the CRS Web
AIDS Funding for Federal Government Programs:
FY1981-FY2007
Updated April 18, 2006
Judith A. Johnson
Specialist in Life Sciences
Domestic Social Policy Division
Congressional Research Service ˜ The Library of Congress

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AIDS Funding for Federal Government Programs:
FY1981-FY2007
Summary
Federal government AIDS spending is estimated at $21.1 billion in FY2006:
65% is for treatment programs; research receives 14%; income support programs
receive 10%; and prevention programs receive 11%. The government-wide request
level for FY2007 is $22.8 billion. AIDS programs within the Department of Health
and Human Services (HHS) account for 75% of the total amount spent on HIV/AIDS
by the federal government. Funding for HIV/AIDS research, prevention, and
treatment programs within the HHS discretionary budget has increased from
$200,000 in FY1981 to an estimated $6.24 billion in FY2006; the Administration’s
request for FY2007 is $6.41 billion. The FY2007 budget includes $188 million for
a new Domestic HIV/AIDS Initiative, of which $95 million will provide expanded
treatment and outreach through the Ryan White program within the Health Resources
and Services Administration (HRSA) and $93 million will fund increased testing
among high-risk populations through the Centers for Disease Control and Prevention
(CDC). Funding for HIV/AIDS treatment within HHS entitlement programs has
increased from $10 million in FY1983 to an estimated $9.5 billion in FY2006.
Entitlement spending depends on the number of HIV/AIDS cases that qualify. The
estimate for FY2007 is $10.3 billion for HIV/AIDS treatment within HHS
entitlement programs.

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Contents
HHS Discretionary Funding: NIH, CDC, and HRSA . . . . . . . . . . . . . . . . . . 3
NIH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
CDC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
HRSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
HHS Entitlement Funding: Medicaid and Medicare at CMS . . . . . . . . . . . . 4
Medicaid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Medicare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Funding for Other AIDS Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
HIV/AIDS Minority Initiative . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Ricky Ray Hemophilia Relief Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
International HIV/AIDS Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
List of Figures
Figure 1. Estimated Total Federal Spending
on HIV/AIDS by Function, FY2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Figure 2. Estimated Total Federal Spending
on HIV/AIDS by Agency, FY2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Figure 3. Estimated Federal Government Spending
on HIV/AIDS Treatment, FY2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Figure 4. HHS Spending on HIV/AIDS Programs . . . . . . . . . . . . . . . . . . . . . . . 14
Figure 5. HHS HIV/AIDS Spending by Program/Function
as a Percentage of Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
List of Tables
Table 1. HIV/AIDS Minority Initiative . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Table 2. HHS Discretionary Funding for HIV/AIDS . . . . . . . . . . . . . . . . . . . . . . . 9
Table 3. HHS Discretionary Funding for HIV/AIDS,
by Agency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Table 4. Total Federal Government Spending on HIV/AIDS
by Function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Table 5. Federal Government Spending on HIV/AIDS:
FY1982-FY2007 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Table 6. Federal Government Spending
on International HIV/AIDS Programs by Function . . . . . . . . . . . . . . . . . . . 16

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AIDS Funding for Federal Government
Programs: FY1981-FY2007
AIDS (acquired immune deficiency syndrome) impairs the immune system and
leaves affected individuals susceptible to certain opportunistic infections and cancer.
Since 1981, a cumulative total of 944,306 AIDS cases in the United States have been
reported to the Centers for Disease Control and Prevention (CDC).1 Of this total,
415,193 persons were reported to be living with AIDS as of the end of December
2004. In addition to the total number of people living with AIDS, another 462,792
persons were known to be infected with the human immunodeficiency virus (HIV)
(in the 33 states, Guam, and the Virgin Islands that have been reporting confidential
name-based HIV infection case numbers to CDC since 2000).
Federal government AIDS spending is estimated at $21.1 billion in FY2006 (see
Table 5). The Bush Administration request for FY2007 is $22.8 billion. Of the total
amount spent by the federal government on HIV/AIDS in FY2006, the majority
(65%) of funding is for treatment programs; funding for research receives 14% of the
total (see Figure 1 and Table 4). The remaining amounts are for prevention
programs (11%) and income support for persons with AIDS (10%).
Figure 1. Estimated Total Federal Spending on
HIV/AIDS by Function, FY2006
Total $21.1 billion
Research
14%
Prevention
11%
Income
Support
Treatment
10%
65%
Source: HHS Budget Office, April 3, 2006.
1 CDC, HIV/AIDS Surveillance Report, 2004, vol. 16, p. 12.

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AIDS programs within HHS (Health and Human Services) account for 75% of
the total amount spent on AIDS by the federal government (see Figure 2). HHS
entitlement funding supports the treatment of HIV/AIDS patients through Medicaid
and Medicare, which are administered by the Centers for Medicare and Medicaid
Services (CMS). HHS discretionary funding supports AIDS research and prevention
programs, as well as treatment programs. Table 2 provides a history of HHS
discretionary funding for HIV/AIDS from the beginning of the epidemic in FY1981
to the present.
Funding for HIV/AIDS programs within HHS has increased markedly over the
past 15 years as measured in constant 2000 dollars, shown in Figure 4 near the end
of this report. However, most of the rise can be attributed to increased spending on
Medicaid, Medicare, and treatment programs in the discretionary budget, largely
through the Ryan White CARE Act program administered by the Health Resources
and Services Administration (HRSA). The increase in HIV/AIDS research and
prevention programs has been much less pronounced, and their portion of the total
amount spent by HHS on HIV/AIDS has declined over the past 15 years (see Figure
5). For example, in FY1992 HIV/AIDS research and prevention programs at HHS
accounted for 51% of the total amount spent by HHS on HIV/AIDS; by FY2006,
such programs were about 25% of the total amount spent by HHS on HIV/AIDS,
reflecting the growing amounts spent on treatment services under Medicaid and
Medicare.
Figure 2. Estimated Total Federal Spending
on HIV/AIDS by Agency, FY2006
Total $21.1 billion
Other
State Dept.
Veterans
2%
9%
2%
HHS
Discretionary
USAID
30%
3%
Social
Security
8%
HHS
Entitlement
46%
Source: HHS Budget Office, April 3, 2006.
Note: USAID, U.S. Agency for International Development. See Table 4.
About 93% of FY2006 HHS discretionary funding for HIV/AIDS is allocated
to three HHS agencies: the National Institutes of Health (NIH), which supports

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HIV/AIDS research; CDC, which supports HIV/AIDS prevention programs; and,
HRSA, which administers the Ryan White CARE Act, an HIV/AIDS treatment
program (see Table 3 and Table 4). The budgets and activities of these three
agencies are briefly described below, followed by a discussion of entitlement
program spending on HIV/AIDS.
HHS Discretionary Funding: NIH, CDC, and HRSA
NIH. NIH is the principal agency of the federal government charged with the
conduct and support of biomedical and behavioral research. NIH conducts research
at its own 26 institutes and centers and supports more than 50,000 scientists at 2,000
U.S. institutions. NIH funding for FY2006 was provided in P.L. 109-149 (H.R.
3010), and NIH estimates FY2006 funding for AIDS research at $2.904 billion. The
Administration’s request for FY2007 is $2.888 billion. Funding for AIDS research
is distributed among the NIH institutes in accordance with the scientific priorities
identified in the annual comprehensive plan for AIDS research developed by the
institutes along with the Office of AIDS Research (OAR).
OAR was established in statute by the National Institutes of Health
Revitalization Act of 1993 (P.L. 103-43) and given substantially enhanced authority
and responsibility beyond the office NIH had established under the same name.
Congress appropriated funds to OAR in FY1995. However, since FY1996, Congress
has not provided a direct appropriation for the OAR (aside from amounts identified
for the operations of the office itself). For FY2006, both the House and Senate
reports (H.Rept. 109-143 and S. Rept 109-103) accompanying the Labor, HHS, and
Education and Related Agencies Appropriation bill (H.R. 3010) do not specify a
funding amount for AIDS research at NIH. Instead, funding for AIDS research is
included within the appropriation for each Institute/Center/Division of NIH, with
decisions as to specific projects to fund and levels of funding left to the Director of
NIH and the Director of OAR.
CDC. CDC works with community, state, national, and international public
health agencies to prevent HIV infection and reduce AIDS-associated morbidity and
mortality through its information and education programs. CDC also supports
research, surveillance, and epidemiology studies on HIV/AIDS. In prior fiscal years,
about 80% of CDC HIV funds were distributed to state and local agencies through
cooperative agreements, grants, and contracts. CDC funding for FY2006 was
provided in P.L. 109-149 (H.R. 3010). According to the HHS Budget Office, CDC
will be spending $842 million on HIV/AIDS activities in FY2006; the
Administration’s request for FY2007 is $930 million. The increased funding in
FY2007 is for a new Domestic HIV/AIDS initiative focused on testing of high-risk
populations.
HRSA. The HIV/AIDS Bureau within HRSA administers the Ryan White
CARE Act, a four-part federal grant program designed to provide emergency relief
and essential health care services to patients infected with HIV. The program funds
hundreds of grantees that serve 571,000 people each year. HRSA funding for
FY2006 was provided in P.L. 109-149 (H.R. 3010). According to the HHS Budget
Office, HRSA will be spending $2.065 billion for Ryan White activities in FY2006.
The Administration’s request for FY2007 is $2.160 billion. The increase of $95

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million for FY2007 is for a new Domestic HIV/AIDS initiative: $70 million will be
used to assist states with waiting lists of patients who would like to participate in the
AIDS Drug Assistance Program (ADAP), and $25 million will be used to expand
outreach efforts. (For further information on Ryan White programs, see CRS Report
RL33279, AIDS: The Ryan White CARE Act, by Judith A. Johnson and Paulette C.
Morgan.)
HHS Entitlement Funding: Medicaid and Medicare at CMS
Medicaid. Medicaid is a federal-state matching entitlement program that
provides medical assistance for eligible low-income persons and families and certain
aged, disabled, and medically needy individuals. Within broad federal guidelines,
each state designs and administers its own Medicaid program, resulting in wide
variations among the states in coverage, benefits offered, and payment for services.
The portion of a state’s Medicaid budget provided by the federal government varies
from 50% in relatively affluent states to 80% in poorer states. Medicaid is the largest
source of federal funding for AIDS treatment and health care services (see Figure 3).
Figure 3. Estimated Federal Government Spending
on HIV/AIDS Treatment, FY2006
Total $13.8 billion
VA
AID
Other
3%
1%
3%
State Dept.
9%
Medicaid
Ryan White
46%
15%
Medicare
23%
Source: HHS Budget Office, April 3, 2006.
Note: Other includes the following: Substance Abuse and Mental Health; Public Health
Emergency Fund; Department of Defense; Bureau of Prisons; Federal Employee Health Benefits
Program; Global AIDS Trust Fund. See Table 3.
For FY2006, the federal share of Medicaid spending on AIDS treatment is
estimated at $6.3 billion, and for FY2007, the federal share estimate is $6.8 billion.
Total FY2006 federal and state Medicaid spending for AIDS treatment will be an
estimated $11.1 billion ($6.3 billion federal and $4.8 billion state).2 According to
CMS, approximately 55% of adults with AIDS and up to 90% of children with AIDS
2 Estimate based on average federal Medicaid assistance percentage (FMAP) for the Nation
as a whole.

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depend on Medicaid to pay for their care. In order to obtain Medicaid coverage,
persons must belong to one of the categories of persons who can qualify for coverage
(such as families with children and disabled persons) and have low income or deplete
their income on the cost of their care. Medicaid plays an important role in needed
health care for persons with HIV and AIDS because of its coverage of prescription
drugs.
Medicare. Medicare is a federal health care insurance program for the elderly
and certain disabled persons. In general, in order to qualify for coverage under
Medicare, a person must be age 65 or older, disabled, or suffering from kidney failure
(end-stage renal disease or ESRD). According to one estimate, by the end of 1996,
about 12% of people living with AIDS were covered by Medicare; 83% of these
beneficiaries qualified because of a disability,3 the remainder were eligible because
they were 65 or older or had ESRD.4 The elderly qualify the month they turn 65, and
those with ESRD qualify within three months of being diagnosed with irreversible
kidney disease requiring dialysis or a kidney transplant. However, disabled people,
including those with AIDS, must wait for a total of 29 months after a determination
that they are disabled before they become eligible for Medicare coverage.5
Early in the epidemic, few individuals with AIDS survived the long waiting
period. With improved drug therapies, the life expectancy of individuals with HIV
has increased, and it is expected that the number able to qualify for Medicare
coverage will continue to rise.6 The Medicare Prescription Drug, Improvement and
Modernization Act of 2003 (P.L. 108-173) provided for the implementation of a
prescription drug program effective January 1, 2006. For FY2006, funding for the
care of persons with HIV/AIDS under Medicare is estimated to be $3.2 billion, and
the estimate for FY2007 is $3.5 billion. However, the new outpatient prescription
drug benefit may significantly increase Medicare spending for persons with
HIV/AIDS beyond current estimates.
Funding for Other AIDS Programs
HIV/AIDS Minority Initiative. In 1998 the White House announced a series
of initiatives targeting appropriated funds for HIV/AIDS prevention and treatment
programs in minority communities. The Congressional Black Caucus worked with
the Clinton Administration to formulate the approach. For FY2006, a total of $399
3 An HIV-positive individual must have a recognized AIDS-defining illness in order to meet
the disability classification.
4 Nancy Fasciano et al., Profile of Medicare Beneficiaries with AIDS: Application of an
AIDS Case Finding Algorithm, Executive Summary, Oct. 14, 1999. Submitted by
Mathematica Policy Research, Inc.
5 Disabled people begin collecting Social Security disability cash benefits five months after
a determination that they are disabled and then must wait an additional 24 months for a total
of 29 months before becoming eligible for Medicare.
6 Combination drug therapies do not work for everyone with HIV. However, for individuals
who are successfully treated, the drug therapies will keep them healthy longer, thereby
preventing some from qualifying for disability.

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million is provided to continue these activities. For FY2007, the Administration has
requested $399.3 million. See Table 1 below for further details.
Table 1. HIV/AIDS Minority Initiative
($ in millions)
Program
FY2004
FY2005
FY2006
FY2007
HRSA
$129.6
$128.5
$128.5
$128.5
CDC
97.3
94.2
96.1
96.1
NIH
—
—
—
—
SAMHSA
110.2
112.4
111.8
111.8
Minority Communities Fund
49.5
52.4
51.9
51.9
Office of Minority Health
10.2
7.9
9.7
9.7
Office of Women’s Health
1.0
1.1
1.0
1.3
Total, Minority HIV/AIDS Initiative
397.9
396.6
399.0
399.3
Source: Table prepared by the Congressional Research (CRS) based on analysis from the HHS
Budget Office, Mar. 28, 2006.
Ricky Ray Hemophilia Relief Fund. The Ricky Ray Hemophilia Act of
1998 established within the Treasury Department a trust fund to provide
compassionate payments of $100,000 to individuals who have blood clotting
disorders, such as hemophilia, and who contracted HIV due to contaminated blood
products administered between July 1, 1982 and December 31, 1987.7 For FY2000,
P.L. 106-113 provided (within the Office of the Secretary in the Public Health and
Social Services Emergency Fund) $75 million for the trust fund; $10 million of the
total was for program management. The trust fund, known as the Ricky Ray
Hemophilia Relief Fund, was administered by HRSA. Payments were made to
eligible individuals who filed petitions (with the required documentation) postmarked
between July 31, 2000 and November 13, 2001. Payments were made in the order
in which the petitions were received. HRSA received more than 5,700 petitions. For
FY2001 the trust fund was appropriated $580 million. According to the HRSA
website, more than $555 million in compassionate payments have been made to more
than 7,100 eligible individuals. All eligible petitions have been processed for
payment. The Administration did not request appropriations for the trust fund for
subsequent years because prior funding was sufficient to make compassionate
payments on all eligible petitions. The trust fund was terminated in November 2003.8
International HIV/AIDS Programs. As indicated in Table 6, federal
government spending on international HIV/AIDS programs in FY2006 is $3.2
7 Further information can be found at:[http://bhpr.hrsa.gov/rickyray/].
8 HRSA Newsbrief, Sept. 24, 2002. See the HRSA website at [http://newsroom.hrsa.gov/
NewsBriefs/2002/rickyray.htm].

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billion; the Administration’s request for FY2007 is $3.9 billion.9 On January 28,
2003, President Bush announced in the State of the Union speech a new five-year $15
billion program, the President’s Emergency Plan for AIDS Relief (PEPFAR).10 The
program targets countries with a very high prevalence of HIV infection: Botswana,
Côte d’Ivoire, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria,
Rwanda, South Africa, Tanzania, Uganda, Vietnam, and Zambia. In the targeted
countries, the goals of the five-year plan are to prevent 7 million new infections,
provide treatment to 2 million HIV-infected people, and provide care for 10 million
HIV-infected individuals and AIDS orphans. In February 2006, the State Department
released the second annual report to Congress on PEPFAR. According to the report,
through FY2005 the United States provided treatment to 471,000 people, prevented
an estimated 47,100 infant HIV infections, and supported HIV counseling and testing
services for over 9.4 million people.11
On June 19, 2002, President Bush announced the Mother-to-Child HIV
Prevention Initiative, a $500 million program that targets the countries mentioned
above that have been hard hit by the HIV/AIDS epidemic. The goal of the Mother-
to-Child HIV Prevention Initiative is to improve health care delivery and reduce
mother-to-infant transmission of HIV by 40% within five years.12 The
Administration requested $200 million in FY2003 and $300 million in FY2004.
Funding for the Initiative was provided by the Foreign Operations appropriation
through the U.S. Agency for International Development (USAID) and the Labor,
HHS appropriation through international HIV/AIDS programs at CDC. Congress
provided $140 million for the Mother-to-Child HIV Prevention Initiative in FY2003
($100 million through USAID and $40 million through CDC) and full funding of
$300 million for FY2004 ($150 million via both USAID and CDC). In subsequent
years, the Mother-to-Child HIV Prevention Initiative has continued within PEPFAR.
A third program, the Global Fund to Fight AIDS, Tuberculous and Malaria, was
first proposed at the July 2000 G-8 Summit in Okinawa.13 The purpose of the Global
Fund is to attract, manage and disburse funding through a public-private partnership
9 For additional information, see CRS Report RS21181, HIV/AIDS International Programs:
Appropriations, FY2003-FY2006, by Tiaji Salaam-Blyther, and CRS Issue Brief IB10050,
AIDS in Africa, by Nicolas Cook.
10 The U.S. Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003 (H.R.
1298, P.L. 108-25), signed into law on May 27, 2003, authorizes $15 billion for
international HIV/AIDS programs. In July 2003, President Bush nominated Randall Tobias
as the U.S. Global AIDS Coordinator, a position created by H.R. 1298. The appointment
has the rank of ambassador, reporting directly to the Secretary of State. Additional details
on the Administration plan are found in the February 2004 State Department report
[http://www.state.gov/documents/organization/29831.pdf].
11 U.S. State Department, Action Today, A Foundation for Tomorrow: The President’s Plan
for AIDS Relief, Feb. 8, 2006. 160 pp. [http://www.state.gov/s/gac/rl/c16742.htm]
12 President Bush’s International Mother and Child Prevention Initiative, June 19, 2002, at
[http://www.whitehouse.gov/news/releases/2002/06/20020619-1.html].
13 Fact Sheet, Office of the Spokesman, U.S. Department of State, Dec. 13, 2002, at
[http://www.state.gov/r/pa/prs/ps/2002/15583.htm].

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dedicated to the reduction of infections, illness and death caused by these three
diseases in countries in need. The concept of the Global Fund was unanimously
endorsed at a special session on HIV/AIDS held by the United Nations General
Assembly in June 2001. The Global Fund was established in January 2002 as a
charitable foundation in Geneva, Switzerland; the first round of grants was approved
in April 2002. U.S. support of the fund occurs through USAID and HHS.14 The
United States has contributed a total of $1.5 billion to the Global Fund, 31% of all
funds received by the Global Fund.15
14 For further information, see CRS Report RL31712, The Global Fund to Fight AIDS,
Tuberculosis and Malaria: Background and Current Issues, by Raymond W. Copson and
Tiaji Salaam.
15 Global Fund Donor Pledge information can be found at [http://www.theglobalfund.org/
en/files/pledges&contributions.xls]. Additional information on the Global Fund can be
found at [http://www.theglobalfund.org/en/].

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Table 2. HHS Discretionary Funding for HIV/AIDS
($ in thousands)
$ Increase over
% Increase over
Year
Funding
prior year
prior year
FY1981
$200
—
—
FY1982
5,555
$5,355
2,678%
FY1983
28,736
23,181
417%
FY1984
61,460
32,724
114%
FY1985
108,618
47,158
77%
FY1986
233,793
125,175
115%
FY1987
502,455
268,662
115%
FY1988
962,018
459,563
94%
FY1989
1,304,012
341,994
36%
FY1990
1,592,756
288,744
22%
FY1991
1,891,232
298,476
19%
FY1992
1,963,414
72,182
4%
FY1993
2,079,591
116,639
6%
FY1994
2,568,682
489,091
24%
FY1995
2,700,498
131,816
5%
FY1996
2,897,923
197,425
7%
FY1997
3,267,220
369,297
13%
FY1998 3,536,519
269,299
8%
FY1999
4,094,489
557,970
16%
FY2000
4,546,326
451,837
11%
FY2001
5,225,645
679,319
15%
FY2002
5,788,553
562,908
11%
FY2003
6,093,846
305,293
5%
FY2004
6,242,501
148,655
2%
FY2005
6,279,141
36,640
0.6%
FY2006 enacted
6,241,549
-37,592
-0.6%
FY2007 request
6,409,178
167,629
3%
Source: Table prepared by the Congressional Research Service (CRS) based on analysis from HHS
Budget Office, April 3, 2006.

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Table 3. HHS Discretionary Funding for HIV/AIDS, by Agency
($ in thousands)
Agency
FY1999
FY2000
FY2001 FY2002
FY2003 FY2004* FY2005* FY2006
FY2007
FDA
$70,400
$76,317
$75,818
$75,818
$72,830
$73,847
$87,661
$89,423
$89,423
HRSA
1,415,847
1,599,231
1,815,000
1,917,200
2,024,962
2,066,861
2,075,296
2,064,713
2,159,713
IHS
3,649
3,770
3,810
3,886
3,940
4,013
4,074
4,198
3,542
CDC
656,590
687,164
859,045
931,141
936,426
862,854
855,535
842,360
929,653
NIH
1,792,739
2,004,428
2,247,015
2,499,458
2,716,218
2,849,952
2,920,551
2,903,664
2,888,492
SAMHSA
91,894
110,347
156,677
169,034
170,614
171,205
173,024
172,326
172,351
AHRQ
1,839
1,787
3,381
2,913
1,825
2,017
1,088
2,000
2,100
OS
61,531
63,282
64,899
64,103
67,681
62,637
62,712
63,865
63,904
Global AIDS Trust Fund
—
—
—
125,000
99,350
149,115
99,200
99,000
100,000
Total
$4,094,489
$4,546,326
$5,225,645
$5,788,553
$6,093,846
$6,242,501
$6,279,141
$6,241,549
$6,409,178
Source: Table prepared by the Congressional Research Service (CRS) based on analysis from HHS Budget Office, April 3, 2006.
* CDC reported funding for HIV/AIDS expenditures have been comparably adjusted downward to reflect the new budget structure at CDC that excludes administrative and management
costs. The FY2004 adjustment was about $68 million, and the FY2005 adjustment was about $74 million.
FDA: Food and Drug Administration; HRSA: Health Resources and Services Administration; IHS: Indian Health Service; CDC: Centers for Disease Control and Prevention;
NIH: National Institutes of Health; SAMHSA: Substance Abuse and Mental Health Services Administration; AHRQ: Agency for Healthcare Research and Quality; OS: Office
of the Secretary (includes the Office of HIV/AIDS Policy, Office for Civil Rights, Office of Minority Health, Office of Women’s Health and the Public Health and Social Services
Emergency Fund/Minority Communities Fund); Global Aids Trust Fund: While budgeted in NIH, HHS contributions to the Global Fund to Fight HIV/AIDS, Malaria, and
Tuberculosis are not reflected in the NIH HIV/AIDS spending figures, but are accounted for separately.

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Table 4. Total Federal Government Spending on HIV/AIDS by Function
($ in millions)
FY2005 Actual
FY2006 Enacted
FY2007 President’s Budget
Income
Income
Income
Agency/Department
Research
Prevent
Treatmt
support
Total
Research
Prevent
Treatmt
support
Total
Research
Prevent
Treatmt
support
Total
FDA
$88
—
—
—
$88
$89
—
—
—
$89
$89
—
—
—
$89
HRSA
—
2
2,073
—
2,075
—
2
2,063
—
2,065
—
2
2,158
—
2,160
IHS
1
3
—
—
4
1
3
—
—
4
1
2
—
—
4
CDC
—
856
—
—
856
—
842
—
—
842
—
930
—
—
930
NIH
2,921
—
—
—
2,921
2,904
—
—
—
2,904
2,888
—
—
—
2,888
SAMHSA
—
41
132
—
173
—
40
132
—
172
—
40
132
—
172
AHRQ
1
—
—
—
1
2
—
—
—
2
2
—
—
—
2
OS
—
10
—
—
10
—
12
—
—
12
—
12
—
—
12
PH emergency fund
—
37
15
—
52
—
37
15
—
52
—
37
15
—
52
Global AIDS trust fund
50
50
99
50
50
99
—
50
50
—
100
HHS discretionary
$3,011
$999
$2,270
—
$6,279
$2,996
$986
$2,259
—
$6,242
$2,981
$1,037
$2,354
—
$6,409
CMS/Medicaid
—
—
5,700
—
5,700
—
—
6,300
—
6,300
—
—
6,800
—
6,800
CMS/Medicare
—
—
2,900
—
2,900
—
—
3,200
—
3,200
—
—
3,500
—
3,500
Subtotal, HHS
$3,011
$999 $10,870
— $14,879
$2,996
$986 $11,759
— $15,742
$2,981
$1,073 $12,654
— $16,709
Social Security — DI
—
—
—
$1,250
$1,250
—
—
—
$1,293
$1,293
—
—
—
$1,334
$1,334
Social Security — SSI
—
—
—
450
450
—
—
—
450
450
—
—
—
435
435
Veterans Affairs
8
35
402
—
445
8
35
415
—
457
$8
$35
$431
—
473
Defense Department.
36
17
57
—
110
22
23
58
—
102
22
18
58
—
97
Agency for Int. Dev.
—
509
124
—
633
—
498
124
—
621
—
405
50
—
455
Justice/Bureau of Prisons
—
2
18
—
20
—
2
19
—
21
—
2
19
—
21
State Department
—
460
916
—
1,376
—
693
1,284
—
1,977
—
983
1,913
—
2,896
Labor Department
—
2
—
—
2
—
0
—
—
0
—
—
—
—
—
Education Dept.
—
—
—
—
—
—
—
—
—
—
—
—
—
—
—
HUD
—
—
—
282
282
—
—
—
286
286
—
—
—
300
300
OPM-FEHB
—
—
370
—
370
—
—
100
—
100
—
—
100
—
100
Subtotal, Non-HHS
$44
$1,025
$1,887
$1,982
$4,938
$30
$1,251
$1,999
$2,029
$5,308
$30
$1,443
$2,570
$2,069
$6,111
Total, federal
government
$3,055
$2,024 $12,757
$1,982 $19,817
$3,026
$2,237 $13,758
$2,029 $21,050
$3,011
$2,516 $15,224
$2,069 $22,820
Source: Table prepared by the Congressional Research Service (CRS) based on analysis from HHS Budget Office, April 3, 2006. HHS: Department of Health and Human Services;
CMS: Centers for Medicare and Medicaid Services; DI: Disability Insurance; HUD: Department of Housing and Urban Development; SSI: Supplemental Security Income; OPM-FEHB:
Office of Personnel Management-Federal Employees Health Benefits.

---

CRS-12
Table 5. Federal Government Spending on HIV/AIDS: FY1982-FY2007
($ in millions)
HHS
CMS
SS
DoJ-
OPM-
Year
Discretionary
Medicaid
Medicare
DI
SSI
VA
Defense
AID
Prisons
State
Labor
HUD
FEHB
Education
Total
1982
$6
—
—
—
—
2
—
—
—
—
—
—
—
—
$8
1983
$29
10
—
—
—
5
—
—
—
—
—
—
—
—
$44
1984
$60
30
—
5
1
7
—
—
—
—
—
—
—
—
$103
1985
$109
70
5
10
3
8
—
—
—
—
—
—
—
—
$205
1986
$234
130
5
30
5
20
79
—
—
—
—
—
5
—
$508
1987
$502
200
15
55
15
51
74
—
1
—
1
—
8
—
$922
1988
$962
330
30
95
20
78
53
30
1
—
1
1
13
1
$1,615
1989
$1,304
490
55
150
35
136
86
40
2
1
1
—
22
—
$2,322
1990
$1,592
670
110
184
55
220
124
71
5
1
1
—
37
—
$3,070
1991
$1,891
870
180
266
95
258
127
78
5
1
1
—
61
—
$3,833
1992
$1,967
800
400
372
150
279
125
94
5
1
1
48
103
—
$4,345
1993
$2,079
1,000
600
481
200
299
155
117
5
1
1
100
175
—
$5,213
1994
$2,569
1,300
800
568
250
312
127
115
6
1
1
156
193
—
$6,398
1995
$2,700
1,500
1,000
631
250
317
110
120
6
1
1
171
212
—
$7,019
1996
$2,898
1,800
1,100
684
250
331
98
115
6
—
1
171
226
—
$7,680

---

CRS-13
HHS
CMS
SS
DoJ-
OPM-
Year
Discretionary
Medicaid
Medicare
DI
SSI
VA
Defense
AID
Prisons
State
Labor
HUD
FEHB
Education
Total
1997
$3,267
2,200
1,300
738
275
350
84
117
7
—
2
196
241
—
$8,777
1998
$3,537
2,600
1,400
787
305
378
95
121
7
—
2
204
253
—
$9,689
1999
$4,094
2,900
1,500
828
330
401
86
139
7
—
2
225
266
1
$10,779
2000a
$4,546
3,300
1,700
870
370
345
97
200
8
—
2
232
279
1
$12,025
2001a
$5,226
3,700
1,900
919
340
405
108
430
15
—
11
257
292
1
$14,184
2002
$5,789
4,200
2,050
961
390
391
96
510
16
—
11
277
297
—
$14,988
2003
$6,094
4,800
2,400
1,019
395
396
82
774
17
141
11
290
321
—
$16,739
2004
$6,243
5,400
2,600
1,050
415
402
105
963
17
638
11
295
343
—
$18,481
2005
$6,279
5,700
2,900
1,250
450
445
110
633
20
1,376
2
282
370
—
$19,817
2006
$6,242
6,300
3,200
1,293
450
457
102
621
21
1,977
—
286
100
—
$21,050
2007b
$6,409
6,800
3,500
1,334
435
473
97
455
21
2,896
—
300
100
—
$22,820
Source: Table prepared by the Congressional Research Service (CRS) based on analysis from HHS Budget Office, April 3, 2006. May not add due to rounding.
a. FY2000 total includes $75 million for the HRSA Ricky Ray Hemophilia program, and FY2001 total includes $580 million for the HRSA Ricky Ray Hemophilia program.
b. FY2007 is the Administration’s request.
HHS: Department of Health and Human Services; Discretionary AIDS budget; CMS: Centers for Medicare and Medicaid Services; SS: Social Security; DI: Disability Insurance;
SSI: Supplemental Security Income; VA: Veterans Affairs; AID: U.S. Agency for International Development; DoJ-Prisons: Department of Justice, Bureau of Prisons; HUD:
Department of Housing and Urban Development; OPM-FEHB: Office of Personnel Management-Federal Employees Health Benefits

---

CRS-14
Figure 4. HHS Spending on HIV/AIDS Programs
(Constant 2000 $)
16000
14000
12000
10000
8000
6000
4000
2000
0
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
Discretionary: Research
Discretionary: Prevention
Discretionary: Treatment
Medicaid
Medicare
Source: HHS Budget Office, April 3, 2006. FY2006 is enacted; FY2007 is based on the Administration’s budget request.

---

CRS-15
Figure 5. HHS HIV/AIDS Spending by Program/Function
as a Percentage of Total
100%
80%
60%
40%
20%
0%
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
Discretionary: Research
Discretionary: Prevention
Discretionary: Treatment
Medicaid
Medicare
Source: HHS Budget Office, April 3, 2006. FY2006 is enacted; FY2007 is based on the Administration’s budget request.

---

CRS-16
Table 6. Federal Government Spending on International HIV/AIDS Programs by Function
($ in millions)
FY2005 Actual
FY2006 enacted
FY2007 President’s Budget
Agency/Department
Research
Prevent
Treatment
Total
Research
Prevent
Treatment
Total
Research
Prevent Treatment
Total
Centers for Disease Control
—
124
—
124
—
123
—
123
—
122
—
122
National Institutes of Health
370
—
—
370
371
—
—
371
368
—
—
368
Global AIDS trust fund
—
50
50
99
—
50
50
99
—
50
50
100
Subtotal, HHS
$370
$173
$50
$593
$371
$172
$50
$593
$368
$172
$50
$590
Defense Department
—
7
—
7
—
5
—
5
—
—
—
—
Agency for International
Development
—
509
124
633
—
498
124
621
—
405
50
455
State Department
—
460
916
1,376
—
693
1,284
1,977
—
983
1,913
2,896
Labor Department
—
2
—
2
—
0
—
0
—
—
—
—
Subtotal, Non-HHS
—
978
1,040
2,018
—
1,196
1,407
2,604
—
1,388
1,963
3,351
Total
$370
$1,152
$1,090
$2,611
$371
$1,368
$1,457
$3,196
$368
$1,560
$2,013
$3,941
w
g
p
h
p
s
cr
Source: Table prepared by the Congressional Research Service (CRS) based on analysis from HHS Budget Office, April 3, 2006. May not add due to rounding.
HHS: Department of Health and Human Services.

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