Ban on HIV-positive immigrants repealed by Senate
Ban on HIV-positive immigrants repealed by Senate
by Mike Andrew - SGN Contributing Writer

Twenty-one years after it was first enacted and 15 years after it was codified into immigration law, the provision banning people with HIV/AIDS from entering the US was repealed by the US Senate on July 16. The repeal came in the form of an amendment introduced by Senators John Kerry (D-MA) and Gordon Smith (R-OR) to the President's Emergency Plan for AIDS Relief (PEPFAR).

PEPFAR provides funds for AIDS education, treatment, and prevention services worldwide. Its full name, the "Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008" honors the original prime sponsors of the legislation, the late Rep Tom Lantos (D-CA) and the late Rep Henry Hyde (R-IL). The US House of Representatives previously passed a version of PEPFAR without the Kerry/Smith amendment, but Democratic Party leaders in the House have indicated they will accept the Senate version in a House-Senate conference committee.

The repeal of the ban was hailed by activists as a step towards fairness in US immigration policy. Immigration Equality Executive Director Rachel Tiven writes, "Finally the purposeless discrimination that has harmed immigrants and visitors with HIV, and the Americans who love them, is nearing an end. This is a great moment for equality, and everyone who believes in basic fairness has a reason to celebrate."

The ban on people with HIV/AIDS was seen as discriminatory because it unfairly excluded people with a single specific disease, and prevented couples of different national origins from being reunited here in this country. It also prevented people who might be targets of discrimination or violence in their home countries because of their HIV status from seeking refuge in the US. Under the old rules, the US was the only industrialized country in the world that excluded HIV-positive people.

HIV/AIDS advocates say that an administrative decision affecting immigration by the Public Health Service, which is an arm of the US Department of Health and Human Services, should also be reversed once Congress repeals the statutory ban on HIV-positive visitors and immigrants.

In addition to reversing the ban on HIV-positive people entering the US, the new PEPFAR bill increases PEPFAR funding 330%, from $15 billion up to $50 billion over a five-year period. It also increases the program's treatment goal by 50%. The current treatment goal of two million people on lifesaving antiretroviral treatment (ART) would increase to three million people. Most of the remaining increase in funding would go to greatly expanded education and prevention programs, including distribution of condoms. And for the first time in the history of PEPFAR legislation, the new version includes assistance to prevention programs targeting men who have sex with men (MSM).

Senate passage of PEPFAR was never in doubt, even with the Kerry/Smith amendment attached, because of the bipartisan sponsorship of the bill. The final vote was 80-16, with 47 Democrats, 31 Republicans and 2 independents voting Yes. All 16 No votes were Republicans. Both Senators from Washington State, Patty Murray and Maria Cantwell, voted Yes. Both Sen. Obama and Sen. McCain supported PEPFAR, although neither one was on hand for the vote. Several prominent campaign surrogates of Sen. McCain, including Sen. Lindsey Graham (R-SC) and Sen. Kay Bailey Hutchinson (R-TX) were among the No votes, however.

Senate Majority Leader Harry Reid (D-NV) had hoped to pass PEPFAR before the July 4 holiday, but he was stymied by a small group of Republican Senators who filibustered the bill. Under Senate rules, 60 Senators must vote to end debate in order to bring legislation up for a vote, and many Senators are reluctant to force a vote on their colleagues. All of June and the first two weeks of July were taken up with behind-the-scenes negotiations as Reid and his Republican opponents jockeyed for position and assembled their votes.

Sen. Tom Coburn (R-OK), who Sen. McCain has called "the guy I really respect" on AIDS-related issues, emerged as the leader of the anti-PEPFAR Republicans. Because of his strong opposition to condom distribution, Sen. Coburn sought a commitment to allocate at least 55% of PEPFAR funding to treatment for existing cases of HIV/AIDS, as opposed to prevention efforts. A compromise was eventually worked out to allocate "at least half" the funding to treatment goals, and also substantially expand prevention efforts. That got the support of a sufficient number of Senators to close debate.

In an especially bizarre maneuver, Sen. Elizabeth Dole (R-NC) introduced an amendment to rename the bill in honor of her predecessor in office, the late Sen. Jesse Helms (R-NC). During his five terms in the US Senate, Helms was a bitter opponent of all funding for HIV/AIDS programs. "There is not one single case of AIDS in this country that cannot be traced in origin to sodomy," he once said. It was the 1987 Helms Amendment to the Supplemental Appropriations Bill which originally directed the exclusion of people with HIV/AIDS from entry into the US. At Helms' insistence, the ban was codified into US immigration law in 1993.