The 2009 budget resolution passed by the Senate on March 14 includes an amendment that would allow states, through Medicaid, to offer low-income people with HIV treatment access before they develop AIDS. The Early Treatment for HIV Act (ETHA), a priority for AIDS activists for over a decade, was sponsored by Sens. Gordon Smith (R-Ore.) and Hillary Clinton (D-N.Y.).

The measure creates a reserve fund for ETHA demonstration projects by state Medicaid offices. An initial version set aside $500 million; the final passed without a dollar figure, which allows the budget chairperson to find offsetting funds for it. Under the "pay as you go" budgetary restraints that Democrats adopted, new spending must be offset by cuts elsewhere or new taxes, and the latter option is not considered realistic during an election year.

The overarching budget measure passed by a largely partisan vote of 51 to 44. A companion ETHA bill introduced in the House last August was not included in its budget resolution, which passed on March 13. However, House Speaker Nancy Pelosi (D-Calif.) promised last August in San Francisco at the National AIDS Memorial Grove she would "do everything possible to make it happen."

It is not clear whether ETHA will emerge intact in the budget during the Senate-House conference to resolve differences in the legislation.

Also in the House, 79 members, including Rep. Maxine Waters (D-Calif.), signed a March 19 letter asking the Appropriations Committee to boost Minority AIDS Initiative funding by about 50 percent, to $610 million for fiscal year 2009.

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