Congress Passes Ryan White CARE Act Reauthorization Bill; Bush Praises Compromise Measure

Congress on Saturday passed a compromise bill (HR 6143) to reauthorize the Ryan White CARE Act, which provides funding for HIV/AIDS programs in the U.S., by voice vote, the New York Times reports. President Bush "praised Congress for delivering the last batch of bills," including the reauthorization (Hulse, New York Times, 12/10). Sen. Edward Kennedy (D-Mass.) -- ranking Democrat on the Health, Education, Labor and Pensions Committee -- and HELP Chair Michael Enzi (R-Wyo.) last week announced that Sen. Hillary Rodham Clinton (D-N.Y.) and other New York and New Jersey lawmakers agreed to the proposal crafted by Kennedy. Five senators, including those from New Jersey and New York state, 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. House Committee on Energy and Commerce Chair Joe Barton (R- Texas) -- who co-wrote and supported the original version of the reauthorization bill, which was passed by the House in September -- last week said he was 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 (Kaiser Daily HIV/AIDS Report, 12/7). The compromise CARE Act measure and Barton's NIH bill were passed together as part of a "complex" package of health legislation, the Wall Street Journal reports (Lueck, Wall Street Journal, 12/11).

Reaction
"This legislation focuses on lifesaving and life-extending services and increased accountability and will provide more flexibility to the secretary of Health and Human Services to direct funding to areas of greatest need," Bush on Saturday said in a statement (Werner, AP/San Jose Mercury News, 12/9). "Congress put partisanship aside to do the right thing for the health of millions of Americans," Kennedy said (New York Times, 12/10). "We have addressed the epidemic of today, not yesterday, by modernizing the Ryan White CARE Act to ensure federal funds follow the person being treated -- wherever they live," according to Enzi. House Majority Leader Nancy Pelosi (D-Calif.) said, "When the reauthorization of the Ryan White CARE Act was passed by the House earlier this year, I was saddened to vote against it because when it came to meeting the needs of people living with AIDS, it fell far short," adding, "Tonight, we righted that wrong, sending a vastly improved bill to the President that reaffirms our will to fight HIV and AIDS" (AP/San Jose Mercury News, 12/9).

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