H.R. 6651 would reauthorize, through 2023, certain expired provisions of foreign assistance programs to combat HIV/AIDS, malaria, and tuberculosis (commonly known as the U.S. President’s Emergency Plan for AIDS Relief or PEPFAR). CBO estimates that implementing the bill would cost $15 million over the 2019-2023 period, assuming appropriation of the necessary amounts.
Section 2 would extend through 2023 a requirement for the Inspectors General (IGs) of the Department of State and Broadcasting Board of Governors, the Department of Health and Human Services, and the U.S. Agency for International Development to coordinate and conduct oversight of PEPFAR programs. Under current law, that directive expired at the end of fiscal year 2018. According to the Office of the U.S. Global AIDS Coordinator (OGAC)—the office within the Department of State that coordinates all PEPFAR activities—the IGs spent roughly $15 million on such oversight over the past five years. CBO expects that each of the three IGs would require appropriations of roughly $1 million per year to continue such oversight. Thus, implementing that provision would cost $15 million over the 2019-2023 period, CBO estimates.
Section 2 also would extend through 2024 an annual requirement to provide a report on HIV/AIDS treatment providers. OGAC plans to collect and analyze the necessary information in the absence of this statutory requirement. CBO estimates that the additional costs of preparing the report would be less than $500,000 over the 2019-2023 period.
Enacting H.R. 6651 would not affect direct spending or revenues; therefore, pay-as-you-go procedures do not apply.
CBO estimates that enacting H.R. 6651 would not increase net direct spending or on-budget deficits in any of the four consecutive 10-year periods beginning in 2029.
H.R. 6651 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act.
On October 2, 2018, CBO transmitted a cost estimate for S. 3476, the PEPFAR Extension Act of 2018, as ordered reported by the Senate Committee on Foreign Relations on September 26, 2018. H.R. 6651 is similar to S. 3476, and their estimated costs are the same.