AIDS Action Weekly Update
Welcome to AIDS Action Council's Weekly Washington Update, an on-line newsletter 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.
Ryan White Care Act Reauthorized
After months of negotiations, action on the Ryan White CARE Act Reauthorization (S.641) is complete. The final bill was approved by the House, May 1, 402-4. The four dissenting voters were: Representatives David Funderburk (R-NC), Ernest Istook (R-OK), Joe Scarborough (R-FL), and Bob Stump (R-AZ). The Senate passed the bill by unanimous consent May 2. One of the more contentious issues during negotiations, that of HIV testing, was settled by a compromise that has caused concern for AIDS advocates. Although conferees worked to shift emphasis to voluntary counseling and testing of pregnant women, and to ensure that provisions to reduce perinatal HIV transmission could be satisfied without ever requiring states to enact mandatory testing laws, advocates for AIDS and women's groups fear that state legislators will view these provisions as encouraging mandatory testing and will enact testing laws to protect themselves against the loss of Title II dollars. The provision differs from the one originally championed by Representatives Tom Coburn (R-OK) and Gary Ackerman (D-NY) in that it does not mandate HIV testing for newborns or pregnant women, but instead emphasizes the importance of voluntary counseling and testing. It does, however, require states to demonstrate by March 2000: 1) a 50 percent reduction (or a comparable measure for states with less than 10 cases) in the rate of new AIDS cases resulting from perinatal transmission comparing most recent data to 1993 data, 2) at least 95 percent of women who have received at least two prenatal visits prior to 34 weeks gestation have been tested for HIV, and 3) a program of mandatory testing of all newborns whose mothers have not undergone prenatal HIV testing. If states cannot demonstrate these things they will lose Title II funding.
Other changes to the bill include formula funding changes for Titles I and II, and the addition of a fifth title comprised of the Special Projects of National Significance, the AIDS Education and Training Centers, and the HIV/AIDS Dental Reimbursement program. For further details about the bill, please see the AIDS Action Network Update posted in AIDS-HIV Issues/Alerts.
FY 97 Budget Negotiations
With the finalization of the FY 96 appropriations process last week, Congress can now concentrate on the FY 97 budget. Budget Committees in the House and Senate will begin to meet to mark up the FY 97 budget resolution. Rather than the drastic cuts that were part of last year's process, Congress is expected to propose a freeze in FY 96 numbers for next year.
With regard to the budget resolution, the GOP leadership intends to split the deficit-reducing reconciliation plan into three packages consisting of the following: 1) the National Governors' Association's welfare/Medicaid plan, 2) cuts in projected spending for Medicare and other entitlement spending, 3) tax cuts. In addition, the Senate Centrist Coaliton, headed by Senators John Breaux (D-LA) and John Chafee (R-RI) are putting together a balanced budget plan as an alternative to the GOP plan, as have the House Blue Dog Democrats, also known at The Coalition. Negotiations are expected to begin in June and wrap up in July so that legislators can begin their campaigns for re-election.
FDA Reform Hearings In The House
The House Commerce Committee's Health and Environment Subcommittee held hearings on the three House bills to reform the Food and Drug Administration earlier this week. The bills which separate the reform into three areas dealing with pharmaceuticals and technology (H.R.3199), regulation of food and drugs (H.R.3200), and oversight of medical devices (H.R.3201), have gathered opposition from patients and consumer groups concerned that the efforts to facilitate rapid approval of drugs could result in the approval of drugs that have not been sufficiently tested. FDA Commissioner David Kessler testified during the hearings that the reform measures lower the current standards of the FDA and will result in weakened authority over the approval process. He further stated that Congress and the agency should find common ground in the overhaul process. Also testifying were Ellen Cooper of American Foundation for AIDS Research, and Michael Langan of National Organization of Rare Disorders, both members of the Patients' Coalition.
MSA'S Continue To Stall Health Insurance Reform Conferee Selection
The process to select conferees to negotiate the differences between the House and Senate versions of the recently passed Health Insurance Reform Act (H.R.3103) continues to be stalled. The impasse is a result of Democratic objections to Senate GOP efforts to load the conference committee with supporters of medical savings accounts (MSAs). President Clinton has also stated his opposition to MSAs and has indicated that he will veto the bill if they are a part of it.
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This article was provided by AIDS Action Council. It is a part of the publication AIDS Action Weekly Update.