In the wake of this year's federal budget that had a small increase for AIDS services and a cut in HIV prevention programs, gay and AIDS groups are angrily rejecting a proposed 2009 federal budget that cuts those services.

"We feel it is a rather shameful budget," said Ronald Johnson, deputy director at the AIDS Action Council in Washington, referring to the $3.1 trillion budget proposed by President George W. Bush on February 4.

"In his State of the Union address, he referred to unfinished business and it's clear, according to this budget, that the unfinished business will include the failure to address the health and well-being of people affected by and vulnerable to HIV/AIDS in the United States," Johnson said.

The proposal added just $1 million to the Ryan White Comprehensive AIDS Resources Emergency Act, which funds services for people with AIDS provided by states, cities, and private AIDS groups. The 2008 budget spent just under $2.2 billion on the act.

The budget proposal cut prevention programs at the federal Centers for Disease Control and Prevention (CDC) by $2 million. The 2008 budget spent $692 million on these programs, $3 million less than in the 2007 fiscal year. These cuts come as the CDC is expected to announce an increase in the number of estimated new HIV infections from 40,000 annually, the old estimate, to perhaps as many as 60,000 annually, a 50 percent increase.

"We know that the CDC will soon release data showing that HIV infections are up as much as 50 percent since the start of the Bush presidency," said Marjorie J. Hill, chief executive officer of the Gay Men's Health Crisis (GMHC), in a written press statement. "Data already show significant increases among gay and bisexual men. The proposal to cut CDC prevention funding by $2 million in the face of these data is just incomprehensible."

It is not clear if the increase in the estimated number of new HIV infections due from the CDC comes from an actual increase in new infections, a new way of arriving at the annual estimate, or some combination of the two.

The budget also cut Medicaid, the government health insurance for the poor and disabled, and Medicare, the government health insurance for the elderly and the long-term disabled. Medicare would lose $556.4 billion over ten years and Medicaid would be cut by $46.7 billion over ten years, according to an analysis by GMHC.

Roughly 55 percent of people living with AIDS are covered by Medicaid and an estimated 100,000 people with AIDS are covered by Medicare. A number of AIDS groups and some gay health clinics and groups deliver services funded by these two programs. In some instances, Medicaid can account for as much as 40 percent of an AIDS or gay group's annual budget.

"There is a dramatic level of cuts to Medicare and Medicaid that clearly would hurt AIDS care," said Michael Kink, legislative counsel at Housing Works, an AIDS services group.

The 2009 budget, for the fiscal year that starts on October 1, would have a $407 billion deficit and the deficit for the current fiscal year is an estimated $410 billion.

The federal debt has grown from $5.7 trillion, when Bush first took office in January 2001, to $9.2 trillion today. Just over $5.1 trillion of today's debt is held by the public and the rest is owned by government agencies. The federal government paid $428 billion in interest on that debt in the 2007 fiscal year.

Senate and House Democrats and even some Republicans were quoted in published reports effectively saying that the budget is a non-starter, giving advocates some hope that the cuts could be reversed.

"We've heard statements that suggest that the president's budget is dead on arrival and certainly that is how we feel it should be," Johnson said.

AIDS Action, which has 25 member groups and more than 200 affiliate organizations, has faulted Democrats for being too timid with the White House over budget matters. Housing Works has also been critical of the Democrats.

"It will be important for influential New York legislators... to join together to beat the Bush budget and strengthen rather than weaken HIV care in the US," Kink said.

Press statements coming from some AIDS groups suggested that even though they are not overly optimistic about improving on the 2009 budget, after seven years of the Bush administration they were more than ready to say good riddance.

"While we are not surprised to see another budget that shortchanges people with HIV/AIDS, we take comfort in the fact that it is the final proposal we will have to endure from this president," said Ryan Clary, director of public policy at Project Inform, a San Francisco AIDS group, in a statement. "Congress should reject this budget immediately and show the leadership desperately needed to make sure people with HIV have the care and treatment needed to stay alive and healthy."