Feb 07, 2026
3 min read
As the spending bill moves through Congress, Carl Schmid of the HIV + Hepatitis Policy Institute offers some insight into recent discussions regarding the HIV bill and domestic programs.
HIV costs for fiscal year 2026: latest update
As the spending bill passes Congress, Carl Schmid of the HIV+Hepatitis Policy Institute provides some insight into the latest debate over the HIV bill and domestic programs.
Politicians are grappling with spending bills, and with regard to domestic HIV spending in fiscal year 2026, the U.S. Congress is considering a lump sum bill from last year.Recently,
The final spending package reflects a bipartisan Senate bill that passed out of committee in July 2025, reflecting months of negotiations and partnerships.1
Carl Schmid, executive director of the HIV+ Hepatitis Policy Institute, discusses challenges in accessing funding.and the consequences when things go awry.
"It's been a tough year, but it looks like the program money is going to be maintained, and now agencies like the Ryan White program and the CDC [Centers for Disease Control and Prevention] HIV prevention programs can go ahead and spend the money...I've had some conversations with the [Trump] administration, and it sounds like they're serious about making sure that the HIV initiative can continue to be spent on the epidemic."
Schmid's organization is involved in monitoring U.S. policies that affect the prevention and treatment of HIV, viral hepatitis and other serious health conditions.They communicate with the HIV, hepatitis, and other patient communities on key policy issues, and educate policymakers and the media about efforts to end HIV and hepatitis, as well as to improve access to high-quality, affordable health care for people living with or at risk for chronic diseases.
While Schmid is happy to see the bill pass successfully, funding still has its challenges, especially as the costs of running the program continue to rise.
"We know that drug inflation increases every year. We know that we need to connect more people to care and treatment. And a few years ago, I know that ADAP [AIDS Drug Assistance Program] increased by 19,000 people. With enough money, this program will have a problem. How are countries going to provide these drugs? And we want to get more people for Pposureexprex and we want more people to research (Pposureexprex). Longer
One positive aspect of the spending package includes long-awaited reforms to regulate pharmacy benefit managers (PBMs), which play a key role in determining prescription drug access and out-of-pocket spending for patients.The proposed bill would decouple PBM compensation from drug prices in Medicare, require full payment of deductibles and charges, and impose increased transparency and reporting requirements.1
"PBMs work with users, but they don't get all the information, so now they have to report to users - their sponsors - how much they spend in reimbursement, how much reimbursement they get. So hopefully this will reduce the cost of prescription drugs in the United States in the long term," said Schmid.
1. Congress funds domestic AIDS programs—the Trump administration must do this immediately.HIV + Hepatitis Policy Institute.January 20, 2026. Accessed 28 January 2026. https://hivhep.org/press-releases/congress-funds-domestic-hiv-programs-trump-administration-must-now-implement-them/
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