President Bush delivered his final budget to Congress last week, and in it he put a period on eight years of malign neglect of AIDS in the United States. That neglect has spawned a heightening treatment crisis right here in America.

There are more Americans living with HIV/AIDS today than at any time in the epidemic, according to Bush’s own Centers for Disease Control and Prevention. The epidemic has grown by an estimated 40,000 people every year, and the CDC is currently completing a study that is expected to put the number of infected Americans even higher.

Nearly half of those people—an estimated half a million—are not receiving care for their infection and, thus, are spiraling toward an expensive and preventable death. There are many reasons why so many positive Americans aren’t in care, including that a huge number are believed to be unaware of their infections. But one reason is surely that they don’t have access.

A look at those who are actually in treatment reveals how hard the epidemic has hit low-income and uninsured people. While two-thirds of the U.S. population is privately insured, only 16 percent of those getting treated for HIV are. Arguably, the difference between the gruesome days of the early 1990s and today is less the discovery of life-saving AIDS drugs than the treatment safety net we created in order to make the drugs accessible to the bulk of HIV-positive Americans.

But as the epidemic has exploded—particularly among African Americans, who account for half of all new infections—Bush and his congressional allies have nickel and dimed the effort to control it. Waiting lists for drug insurance programs have stretched into the hundreds, with states around the country being forced to cap enrollment and limit the meds covered. AIDS clinics and social service providers nationwide have similarly reported being forced to cut programs and limit enrollment.

The response to all of this in the administration’s new budget proposal is, once again, a shrug.

Bush suggested an overall increase of $1.1 million, or less than one percent, for the program that funds AIDS drug insurance programs and public clinics. But as AIDS Healthcare Foundation pointed out, that pittance looks even worse when you account for the annual hike in what drug companies are allowed to charge those programs: It turns into a $27 million cut. If demand rises at the rate predicted by the association of state health departments’ AIDS directors, thousands of patients will be turned away in fiscal year 2009.

This callousness by the Bush Administration cannot be tolerated.

A version of this op-ed was syndicated to daily newspapers around the country via the Progressive Media Project.