The Obama administration issued a policy statement last night opposing several sections of a DC appropriations bill that would deny funding for needle exchanges, prohibit the District from spending local funds on abortions, and prevent the IRS from using any funds appropriated by the bill to begin implementing the system of premium credits and other provisions that are part of the Affordable Care Act:
District of Columbia Needle Exchange Restriction. Section 807 of the bill restricts the use of Federal funds for the District’s needle exchange programs. This is contrary to current practice and the Administration’s policy to allow funds to be used in locations where local authorities deem needle exchange programs to be effective and appropriate.
District of Columbia Abortion Restriction. Section 810 of the bill prevents the District of Columbia from using its own funds for abortions, which undermines the principle of states’ rights and of D.C. home rule. Longstanding Federal policy already prohibits Federal funds from being used for abortions, except in cases of rape or incest, or when the life of the woman would be endangered.
Department of the Treasury. The Administration opposes sections 107 and 108 of the bill, which would place significant restrictions on the Department’s ability to adequately implement the Affordable Care Act, and would delay the planning and construction of a system to administer the critical premium assistance tax credit and the ability to reconcile it with IRS’s core systems. These sections would prevent both appropriated and transferred funds from the Department of Health and Human Services from being used by the Department to administer the law.
Republicans had included the needle exchange proposal in their 2011 budget, even though the program actually reduces federal spending and helps lower health care costs. As an example, the cost to prevent a single HIV infection by needle exchange “has been calculated at $4,000 to $12,000, considerably less than the estimated $190,000 (listed in 1997 dollars) medical costs of treating a person infected with HIV.” The public health benefits are also substantial. A 2003 study of 99 cities found that HIV prevalence in addicts fell by 18.6 percent in cities which started needle exchanges, while those that failed to do so saw an 8.1 percent increase. Between 1990 and 2001 in New York, the HIV prevalence rate amongst IV drug users entering addiction treatment similarly fell from 54 percent to 13 percent and Hepatitis C prevalence fell from 90 percent to 63 percent.
Meanwhile, denying the District the right to appropriate its funds as it sees fit — in this case to pay for abortions — would disproportionately impact poor women and expose the hollowness of the GOP’s rhetoric about local control and state rights, not to mention their hypocrisy about preventing the federal government from interfering in the doctor-patient relationship.
In its statement of policy, the administration did not threaten to veto the bill over the DC issues, however.