AIDS Action Weekly Update
May 16, 1997
Welcome to AIDS Action Council's Weekly Washington Update, an on-line newsletter for Handsnet subscribers that reviews what is happening in Washington on AIDS policy issues each week. If you have any comments or questions, please feel free to contact us at the e-mail address listed below.
Supplemental Funds For ADAP Not Included In Supplemental
The FY 97 supplemental appropriations bill (H.R. 1469) was passed in the House yesterday evening 244-178. A proposed amendment from Representative Nancy Pelosi (D-CA) that would have provided for $68 million in additional funding for the AIDS Drug Assistance Program (ADAP), was not offered due to a procedural move that would have made the amendment subject to a point of order and likely to have been defeated on the House floor. ADAP, which is funded through Title II of the Ryan White CARE Act, provides prescription drugs to low income individuals who are uninsured and underinsured and are ineligible for Medicaid. Because of budgetary shortfalls, this program is extremely overburdened, resulting in individuals being placed on waiting lists or even getting dropped from the program. The additional funding would have provided for drug assistance for approximately 6,800 additional individuals. During floor debate, Representative Pelosi engaged House Labor-HHS-Education Appropriations Subcommittee Chair John Porter (R-IL) in a colloquy on ADAP and ensured his support for additional funding of the program should the Administration request it.
Senate Supplemental Appropriations Repeal Harms Drug Pricing Program
On the Senate side, the FY 97 supplemental appropriations bill (S. 627) contains language that repeals the Federal Cooperative Purchasing Program. This program would allow public hospitals, state and local health departments, and ADAPs to take advantage of even greater discounts than are now available to federally qualified health centers and some ADAPs under the Public Health Service 340-B pricing program. This program, if implemented, could offer cost savings of between 31 percent and 62 percent on major HIV drugs. Other items subject to these discounts are office furniture, computers, software, and other such non-controversial items. Advocates are working on a compromise which would create a demonstration project that would limit the cooperative purchasing program to thee non-controversial schedules and a limited portion of the pharmaceutical schedule relating exclusively to drugs used in the treatment of HIV and HIV-related conditions. Due to the enormous pressure on state ADAPs to provid e combination therapies to eligible individuals and the pressure on federal discretionary spending to increase spending, it is critical that this program that offers deep discounts on AIDS-related drugs be implemented. Advocates will weigh in with the Administration to oppose the Senate repeal language and also with members of the House to ensure that this language is removed and a compromise is worked out during conference.
COBURN BILL CONGRESSIONAL BRIEFING
A Congressional briefing on the HIV Prevention Act of 1997 (H.R. 1062) was held Thursday, May 15. The briefing, sponsored by the Independent Women's Forum, and Americans for a Sound AIDS Policy focused on the legislation, sponsored by Representative Tom Coburn (R-OK), as a "women's issuequot; citing recent statistics that revealed a decrease in AIDS death rates overall, but an increase in AIDS death rates among women. The Coburn bill, which calls for the establishment of a national partner notification program for those exposed to HIV and allows health care workers to withhold medical treatment from a patient until he or she has submitted to an HIV test, was introduced in March of 1997 and currently has 89 cosponsors. AIDS advocates oppose the bill, which would divert federal funding from proven targeted HIV prevention education efforts in order to implement the quot;test and reportquot; measures in the legislation. The bill would hold hostage federal Medicaid funds from states that do not enact its prov isions and, according to the Association of State and Territorial Health Officials (ASTHO) would cost states $420 million to implement.
Budget Slowly Moves Forward
Two weeks following the announcement of a balanced budget agreement, Congressional and White House budget negotiators came to agreement yesterday on the details of a budget resolution. With this additional guidance, budget committees in the House and Senate can move forward to craft the annual budget resolution which provides a blueprint from which appropriators work to mark up their bills. The House Budget Committee passed its version of the budget resolution today, and it is scheduled for full House floor action Tuesday, May 20. The Senate Budget Committee is scheduled to begin work on its bill Monday, May 19, with floor debate to occur later next week.
Morella Introduces Hiv Research Bill For Women
Representative Connie Morella (R-MD), introduced a bill to amend the Public Health Service Act to establish programs of research with respect to women and cases of infection with HIV. The bill, H.R. 1571, calls for increased funding for research on methods of protection from the transmission of HIV and sexually transmitted diseases, with an emphasis on female-controlled methods, and additional funding to continue the Women's Interagency HIV Study, an ongoing study of HIV progression in women, and to conduct other research to determine the impact of potential risk factors for HIV transmission to women. The bill was introduced May 8, with 24 cosponsors and referred to the House Commerce Committee.
Antiretroviral Therapy And Perinatal Transmission
The Antiretroviral Therapy to Reduce the Risk of Perinatal Transmission Workshop sponsored by the National Institutes of Health (NIH), was held last Friday, May 9. The workshop, which involved approximately 40 research scientists, AIDS physicians, and women living with HIV, reviewed the most recent data from the AIDS Clinical Trial Group 076 and looked at other therapies in reducing perinatal HIV transmission. The ACTG 076 protocol guidelines recommends administration of zidovudine (AZT) to women during the latter part of pregnancy, during labor, and to the neonate for six weeks after birth and has been found to lower the risk of perinatal transmission to about eight percent; the risk is about 25 percent without treatment. The advent of combination therapies involving protease inhibitors has posed a dilemma in that many advocates for people with AIDS and women believe that AZT monotherapy is a disservice to pregnant women in that it does not provide optimum care for them. At this point, the effect of combination therapy on the fetus is unknown, and members of the panel were divided on the issue. Results of the panel discussion will be published the Morbidity and Mortality Weekly Report (MMWR) later this summer.
This article was provided by AIDS Action Council. It is a part of the publication AIDS Action Weekly Update.