Senate Passes Compromise Bill to Reauthorize Ryan White Care Act, Passage in House Uncertain

The Senate on Wednesday passed by voice vote a compromise bill (HR 6143) that would reauthorize the Ryan White CARE Act, which provides funding for HIV/AIDS programs in the U.S., CQ HealthBeat reports (Wayne, CQ HealthBeat, 12/6). Sen. Edward Kennedy (D-Mass.) -- ranking Democrat on the Health, Education, Labor and Pensions Committee -- and HELP Chair Michael Enzi on Tuesday announced that Sen. Hillary Rodham Clinton (D-N.Y.) and other New York and New Jersey lawmakers agreed to the proposal crafted by Kennedy. Senators from California, New Jersey and New York earlier this year blocked Senate consideration of a House-approved bill sponsored by Rep. Mary Bono (R-Calif.) that would change CARE Act funding formulas so that rural areas experiencing increasing numbers of HIV/AIDS cases would receive higher funding amounts and urban areas' funding would decrease. Kennedy's proposal calls for strengthening "hold harmless" provisions and maintaining funding levels so that states would not receive less than 95% of their 2006 funding levels; counting all HIV-positive people for funding regardless of where they live or how the data are reported; maintaining the funding pool for prescription drugs and therapeutics; continuing HHS development of a framework addressing HIV/AIDS in the U.S. and a follow-up report of their progress in 2008; and maintaining a four-year transition period for states with code-based reporting systems to switch to names-based reporting systems without penalization. The compromise also would repeal the Ryan White program after three years, forcing Congress to write a new law and reconsider the program's structural challenges before then, Senate aides said (Kaiser Daily HIV/AIDS Report, 12/6). "We must address the epidemic of today, not yesterday, and make sure the federal funds follow the person being treated -- wherever they live," Enzi in a statement said after the bill was passed, adding, "This bill will modernize the (law) to ensure that federal dollars to treat HIV/AIDS finally go to the people who are most in need" (CQ HealthBeat, 12/6). "The bill turns out to be a far better bill than we anticipated we could get out of this Congress," Ernest Hopkins, director of federal Affairs for the San Francisco AIDS Foundation, said, adding, "We owe much to the advocacy of the New York and New Jersey senators. This revised bill benefits their states and California and San Francisco in particular" (Epstein, San Francisco Chronicle, 12/7).

House Consideration, Comments
Lawmakers in the House have been "noncommittal" about passing the Kennedy bill by the end of the week, CQ Today reports (Wayne, CQ Today, 12/6). Kevin Smith, spokesperson for House Majority Leader John Boehner (R-Ohio), said "no decision" has been made on the legislation. According to CQ HealthBeat, Kennedy's compromise bill "represents a significant departure from the balance [House Committee on Energy and Commerce Chair Joe] Barton [R- Texas] negotiated between urban and rural lawmakers on his committee" (CQ HealthBeat, 12/6). Barton -- who co-wrote and supported the original version of the reauthorization bill, which was passed by the House in September -- said he is dissatisfied with the Senate's amendment of the CARE Act bill and with the Senate's rejection of separate legislation (HR 6164) that would restructure the NIH. Barton said that the revisions to the CARE Act bill are "not as good as the House-passed bill" and that he "could certainly" vote against the bill. However, he first wants to see what happens to the NIH bill -- which he helped to write -- in the Senate. "I want there to be a Ryan White reauthorization," Barton said, adding that the Senators "did the right thing" in passing the bill. Although Barton said he will "try to accommodate them," he added that it would be "much easier" for him to support the legislation if the Senate first passed the NIH bill (CQ Today, 12/6).

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