Ryan White Must Be Extended -- Then Fixed

The Ryan White CARE Act (named after Ryan White, the person, above) has some serious inequities.

The current Ryan White Care Act is up for reauthorization on September 30. So Congress must take action ASAP to make sure the Ryan White CARE Act is extended -- and Obama and Health and Human Services Secretary Sebelius must put pressure on them to do so (see action alert below, for who to call and what to say). But while Housing Works supports the fixes recommended by many in the AIDS advocacy community for this year, Housing Works differs from the "community consensus" in that we believe one year is long enough to hold onto the status quo. Ryan White CARE Act must be fully revised in 2010. A recent Government Accountability Office report notes some of the funding inequeties in Ryan White.

The GAO report, in response to a request by Sen. Mike Enzi (R-WY), explains the stop-loss provision for urban areas that receive funding under the CARE Act. The stop-loss provision serves to minimize the losses in funding to cities that have long grappled with the AIDS epidemic such as San Francisco, New York, and Ponce, Puerto Rico, but also limits increases in funding elsewhere where people are incredibly underserved.

Ryan White's distribution -- essentially pork barrel funding -- is a politically touchy situation that brings up the hot-button issues about how to address the changing geography of new HIV infections, without taking away services that many people have come to depend on (particularly in California which was brutalized by severe cuts to HIV/AIDS services). And because spending levels have not kept pace with the growing number of Americans living with HIV/AIDS, juristdictions are left to fight among themselves for a not-big-enough pie.

And while these problems will not be addressed by September 30, we cannot afford to maintain the status quo with Ryan White for another three years.

"Strategically the community took a gamble by not addressing real changes needed for Ryan White over the last 15 months," said Housing Works Vice President of National Advocacy and Organizing Christine Campbell. "Ryan White has serious problems that need to be addressed. We need to move Ryan White on a parallel track with health care reform and the National AIDS Strategy, not just wait to see what happens."

Within the next year, community-based organizations must have a clear understanding of how health care reform will impact their service delivery and have processes in place to make the systemic changes to adequately meet the needs of people living with HIV/AIDS.

But Here's What To Do Now

While revamping Ryan White deserves some serious discussion, that will have to wait until October 1. Right now, Ryan White needs to be extended for another year, so that thousands of people with HIV/AIDS continue to receive medical services and care.

The Obama Administration has not publicly stated that extension of the Ryan White Program is an urgent priority. President Obama and HHS Secretary Sebelius must tell Congress to extend Ryan White for one year.

Call the White House at 202-456-1414 and Secretary Sebelius at 202-690-7000. Use the talking points in this alert and tell President Obama and Secretary Sebelius why the timely extension of the Ryan White Program is important to you.

1) My name is _____ and I'm from (city/state). The Ryan White Program is critical for people living with HIV/AIDS. Its extension before September 30, 2009 is a top priority for the HIV/AIDS community.
2) The Ryan White Program provides essential medical and support services to hundreds of thousands of individuals each year. The services are a critical part of our health care safety net and will continue to be necessary in a reformed health care system.
3) President Obama must tell Congress that this is a priority for his Administration and Congress must act to extend the Ryan White CARE Act before September 30, 2009.

(See AIDS Action's full alert for more information.)