Compromise Will Allow AIDS Programs to Be Reauthorized for Three Years
By Alex Wayne
CQ TODAY – HEALTH
December 6, 2006
Senate negotiators reached a deal Tuesday on a bill renewing federal AIDS programs, and Congress is likely to clear the legislation before adjourning for the year.
As recently as Dec. 1, AIDS advocates had despaired of seeing the Ryan White CARE Act reauthorized this year because of a dispute over a change in funding formulas.
But on Tuesday, Edward M. Kennedy of Massachusetts, the ranking Democrat on the Senate Health, Education, Labor and Pensions Committee, announced that senators had achieved a compromise and that the bill would quickly pass.
A spokesman for panel Chairman Michael B. Enzi, R-Wyo., sponsor of the original bill (HR 6143), confirmed the deal.
“After years and years of negotiations, this final proposal clears the way for reauthorization of the Ryan White CARE Act this year so that all people living with HIV/AIDS will get the care and services they need to live long and productive lives,” Kennedy said in a statement.
Under the compromise, the law (PL 101-381) that governs the distribution of about $2 billion for treatment for low-income AIDS and HIV patients would be reauthorized for three years instead of five years.
Under the bill, funds for AIDS programs would shift from states with large populations of AIDS patients to those with growing populations of patients with HIV, the virus that causes AIDS. That had particularly alarmed senators from New York and New Jersey, states with large urban areas and many AIDS patients, and they blocked the bill from being considered by the Senate.
Kennedy’s three-year proposal eliminates the last two years of the original legislation, when New York’s and New Jersey’s financial losses would have been greatest.
Protecting Funding
Additionally, provisions intended to shield states from drastic funding cuts would be strengthened so that no state’s funding would fall under 95 percent of what it received in fiscal 2006, according to aides.
The new compromise also would repeal the Ryan White program after three years, forcing Congress to address the program’s structural issues and write a new law before then, Senate aides said.
“It puts the pressure on us to get a reauthorization done in a timely fashion and not just extend something,” a Senate Democratic aide said.
Money for Ryan White AIDS programs — named after a teenage hemophiliac who went public with his battle against AIDS and died in 1990, when the law was enacted — is distributed through a complex set of formulas that favor states with large cities and many AIDS patients.
Over time, this system has come to be seen as unfair by the leaders of states without large populations of AIDS patients — but which often have growing populations of patients with the HIV virus.
Another issue complicating the law’s renewal was one of its requirements that would base funding, beginning in fiscal 2007, on combined counts of HIV and AIDS patients in each state, instead of on only the number of AIDS patients in each state, as is now the practice.
Seventeen states and the District of Columbia would have seen funding cuts because they do not report the names of HIV patients to the Centers for Disease Control and Prevention, or only recently began doing so.
The compromise legislation averts this problem by giving those 17 states and the District of Columbia four more years to begin reporting the names of HIV patients, according to Kennedy’s announcement.
