Lawmakers Criticize Proposed Ryan White Reauthorization Bill, Geographical Change in Fund Allocation

Lawmakers from California, New Jersey and New York on Thursday criticized proposed changes to funding calculations under the Ryan White CARE Act, which they say could move millions of dollars in HIV/AIDS funding from the northeastern and western U.S. to the South, the AP/Seattle Post-Intelligencer reports (Werner, AP/Seattle Post-Intelligencer, 4/27). Sen. Tom Coburn (R-Okla.) in March introduced a bill (S 2339) that would reauthorize and amend the act, which expired on Sept. 30, 2005. Coburn's bill would create new funding formulas that take into account HIV prevalence; require that 75% of CARE Act funding is spent on primary care; require that facilities receiving federal funding conduct mandatory HIV testing; and increase annual funding for AIDS Drug Assistance Programs, federal- and state-funded programs that provide HIV/AIDS-related medications to low-income, uninsured and underinsured HIV-positive individuals. Under the current law, areas with large numbers of HIV/AIDS patients receive more funding (Kaiser Daily HIV/AIDS Report, 3/9). A 2005 Government Accountability Office report finds that some funding calculations favor states with larger urban areas because the system counts AIDS patients twice in 51 metropolitan areas, the AP/Post-Intelligencer reports. At a hearing of the House Committee on Energy and Commerce Subcommittee on Health Thursday, Rep. Charlie Norwood (R-Ga.) said, "The money needs to follow the infection," adding, "No one should receive the short end of the stick because of where they live." Bush administration officials have not clarified how the changes would affect individual states. Some lawmakers from California seeking to refute the GAO report's findings of unequal fund distribution presented a report, released this week by the not-for-profit organization Communities Advocating Emergency AIDS Relief, that finds the distribution of CARE funding to be more balanced than what the GAO report says. Lawmakers on the House Committee on Energy and Commerce have been negotiating with lawmakers on the Senate Health Committee to write a compromise bill that would update the law (AP/Seattle Post-Intelligencer, 4/27).

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