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Treatment Action Network Alert: Ryan White CARE Act Reauthorization in Final Stage

Urge Your Representatives to Support Passage without Incentives for Mandatory Testing

Congress has moved quickly on reauthorizing the Ryan White CARE Act, which provides healthcare, treatment, and support services for people living with HIV/AIDS. The CARE Act is due to expire on September 30, 2000. In early June, the Senate voted unanimously in favor of S. 2311, authored by Senators Kennedy (D-MA) and Jeffords (R-VT). This bill would reauthorize (or renew) the CARE Act for another five years.

Shortly after the Senate approved the bill, the House of Representatives introduced its own version (H.R. 4807), authored by Representatives Coburn (R-OK) and Waxman (D-CA). The bill contains some significant differences from the Senate version. H.R. 4807 passed the House of Representatives unanimously on July 25.

Because there are differences between the two bills, a joint House/Senate conference committee will meet in September to negotiate a final bill. After that, the entire House and Senate will vote again on the final product and send it to the President.

Among the differences between the two bills is language in the House version regarding HIV testing of pregnant women and newborns. Currently, the CARE Act allows $10 million to be distributed to states for programs intended to reduce perinatal transmission of HIV. These programs could include voluntary testing, counseling, outreach, and treatment services for pregnant women with HIV, and to help pay for mandatory newborn testing programs.

The House proposal would add another $20 million for this purpose. However, of that $20 million, a gradually increasing proportion must be set aside for states that have either mandatory testing requirements for all newborns or for newborns whose mother's HIV status is unknown. Currently, only New York and Connecticut have such laws. This set-aside starts at 25% in the first year of the bill and rises to 75% by the fourth year. In other words, while the legislation does not require states to adopt mandatory testing programs, it provides significant financial incentives for them to do so.

Project Inform opposes mandatory HIV testing of any individual. We strongly support voluntary HIV testing with appropriate counseling and we support funding for non-coercive programs that improve the care and treatment of HIV positive pregnant women and that reduce perinatal transmission. There is no evidence that mandatory testing will help achieve these goals. Instead, it could discourage pregnant women from accessing the healthcare system. The current emphasis on voluntary testing and treatment has already helped dramatically reduce perinatal HIV transmission in recent years.

Your voice is needed to ensure that Congress reauthorizes this lifesaving program this year and to remove the provision that offers financial incentives for states to adopt mandatory testing programs.

Action Needed for this Alert

Please write your U.S. Representative and two U.S. Senators. Urge them to support reauthorization of the Ryan White CARE Act, but to oppose financial incentives for states to adopt mandatory newborn testing policies.

Ask them to convey their message to members of the conference committee dealing with Ryan White CARE Act reauthorization. (Note: conference committee members have not been determined yet, however likely members include Senators Kennedy and Jeffords and Representatives Coburn and Waxman).

You can find contact information for all your representatives, including email addresses, on Project Inform's website at www.projectinform.org/org/FedLegislative. Another good resource for contacting your elected officials is www.capweb.net.