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October 6, 2006
RYAN WHITE REALITY CHECK
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On behalf of New York and New Jersey Senators, Sen. Robert Menendez (D-NJ) maintained the hold on Ryan White. There's time now for one last push to fix the bill. |
The Ryan White reauthorization battles which have divided regions of the country against one another this Fall ground to a halt in DC last Friday, as Senators from New Jersey and New York maintained a "hold" on legislation that would cut federal AIDS funding to the high-impact states they represent. There won't be any further action until at least November 13th, when Congress comes back for a lame duck session after the elections.
Housing Works calls on advocates, activists, and people living with HIV/AIDS to take advantage of this delay to demand immediate bipartisan changes to create reauthorization legislation that everyone across the nation can support:
TWO IMMEDIATE ACTION STEPS TO SAVE RYAN WHITE
In this election season when candidates are on the stump seeking support, it's our job to make them pay attention to AIDS issues - and Ryan White is clearly on the front burner.
1. Call on your Senators, Representatives, and candidates for those offices to demand that:
- appropriators increase Ryan White funding by at least $500 million per year to expand access nationwide and end waiting lists for treatment.
- authorizers amend the bill to extend "hold harmless" provisions, revise "core services" requirements, and strip out harmful HIV testing language
2. Call on the White House and the Office of Management and Budget (OMB) to include that extra $500 million in next year's proposed federal budget, the funding for 2008.
It's in our common interest to demand Ryan White legislation that meets needs all over the country - and it's our job as advocates to make sure that the rhetoric around Ryan White matches reality.
Last Thursday, the U.S. House of Representatives passed the Ryan White HIV/AIDS Modernization Act of 2006 (HR 6143) - the "bipartisan-bicameral" legislation that boosts federal AIDS spending in some states and cuts it in others - by a 325-98 vote.
That same evening, Senator Mike Enzi (R-WY), Chairman of the Committee on Health, Education, Labor, and Pensions, tried to move the Senate version of the bill through that chamber but was blocked by Democrats. Throughout the next day, Senators heatedly took up reauthorization in floor debates.
Senators from New Jersey and New York - including Hilary Clinton (D-NY) and Robert Menendez (D-NJ), both up for reelection this Fall - maintained a hold on the bill and argued against cuts to their states despite withering attack from a number of Senators, including Richard Burr of North Carolina, Orrin Hatch of Utah, and Tom Coburn of Oklahoma (see below).
The hold functioned effectively as a filibuster of the legislation, and Senate Majority Leader Bill Frist (R-TN) did not file for cloture. As a result, the Senate didn't vote on the measure prior to their month-long pre-election recess. Reauthorization is effectively frozen until after November 13th and the start of the lame duck session.
What's next? Forced vote, extender, amendments could be in the mix
Senate Republicans are trying to force the Ryan White bill through "as is," and could slam it into an omnibus spending bill after the elections. Under that scenario, no amendments would be allowed and party discipline would mandate passage.
Senator Frank Lautenberg (D-NJ) introduced a bill (with Sens. Menendez (D-NJ), Clinton (D-NY), Schumer (D-NY), Obama (D-IL), Durbin (D-IL), and Nelson (D-FL) to extend current Ryan White funding for one year. Senate staffers say the extender bill is an attempt to win room in negotiations to improve reauthorization legislation - it has no chance of passage as a stand-alone measure.
It's still possible - though a long shot - that amendments and funding increases could be considered by Senate and House leaders to win passage of the measure without resort to partisan intimidation (which has been absent from the previous legislative history of the CARE Act).
And it's certainly reasonable for advocates to push for a full loaf, rather than half or none - in fact, a full loaf seems to be the only thing that could bring all regions of the country together on this one.
Rhetorical reality check - what the 'bi-bi' bill does and doesn't do
Almost all the members of Congress (and advocates) who spoke about Ryan White reauthorization on the floor (and in emails, phone calls & hallways) this past week exclaimed, "AIDS is a life or death issue!" But they agreed on little else.
AN END TO WAITING LISTS? NOPE.
Claims were made that the "bipartisan-bicameral" reauthorization bill on the floor "will finally bring an end to HIV/AIDS waiting lists, ensuring that all Americans suffering from HIV/AIDS will receive access to treatment and care."
But even Senators themselves admitted that the measure won't end waiting lists and won't provide full access to HIV care and treatment to all who need it. Senator Enzi (R-WY) said it would take billions more to provide full access and that the bill up for discussion wouldn't care for everyone.
$500 MILLION IN CUTS TO NEW YORK? NOPE.
At community meetings in New York City, we heard claims that New York would lose up to $500 million over five years as a result of the "bi-bi" bill.
But the documents and presentations of state and local officials showed that the estimated impact was really about $100 million - certainly significant, but far less than the claimed "half a billion" dollars.
THREE BILLION DOLLARS TO FULLY FUND RYAN WHITE? NOPE.
Senator Enzi admitted on the floor of the Senate that the "bi-bi" bill wouldn't provide full access to treatment and care for everyone in the U.S. who needs it - and he said the price tag for full funding would be $3 billion a year or more.
But activists who've been pushing for "full funding" of the CARE Act to eliminate waiting lists and expand treatment access say just $513 million more would do the trick - that's just about the amount recommended by the Congressional Black Caucus that Housing Works has backed for the last year as part of our recommendations for reauthorization.
It won't be easy to find more money to save the lives of Americans living with HIV/AIDS, but whether it's the cost of two days of the war in Iraq ($500M) or twelve days ($3B), there's no question that the money is there if Senators find the political will to take action.
WHAT CAN WE DO? WE CAN CALL THE APPROPRIATORS AND THE OMB AND TELL THEM: FIND THE MONEY - FIX THE BILL.
The elected officials with power over appropriations can increase funding for Ryan White. They need to hear from you, and they need to hear from the Senators and Representatives who represent you. And the White House needs to hear from all of us on next year's funding.
Senator Thad Cochran (R-MS) chairs the Senate Committee on Appropriations with Robert Byrd (D-WV) as the ranking minority member. On the Subcommittee on Labor, Health and Human Services, Education, and Related Agencies, Arlen Spector (R-PA) chairs and Tom Harkin (D-IA)is the ranking Democrat.
In the House, Representative Jerry Lewis (R-CA) chairs the Appropriations committee, ,Ralph Regula (R-OH) chairs the Subcommittee on Labor, Health and Human Services, Education, and Related Agencies, and David Obey (D-WI) is the ranking minority member for both the overall committee and the Labor, HHS subcommittee.
Call the U.S. Capitol Toll-Free at 888-802-1207 to speak to your Senators and U.S. Representatives and check out www.politics1.com to find numbers for their challengers - tell them to take four steps to fix Ryan White reauthorization legislation:
- EXPAND FUNDING BY $500M TO ENSURE ACCESS TO CARE NATIONWIDE
Stop playing regional politics and get the money we need nationwide.
A total of $500 million in additional funding will eliminate ADAP waiting lists, support areas with emerging epidemics, and protect access and quality in high-prevalence areas. This includes a $70 million increase for Title II base and an additional $197 million for ADAP - the amount identified by treatment experts as needed to allow all states to provide a minimum level of service to those in need.
- EXTEND "HOLD HARMLESS" PROVISIONS TO FIVE YEARS
We must protect lifesaving HIV care systems from dramatic funding cuts that will put lives at risk - adequate new funding for emerging areas and assurance of continued support for high-prevalence epicenters will mean a reauthorization that everyone can support.
- REVISE "CORE MEDICAL SERVICES" REQUIREMENT TO ALLOW SERVICES THAT SUPPORT TREATMENT ADHERENCE AND GOOD HEALTH
Housing, food, transportation and legal services are lifesavers - it's hard to stick to your meds if you're homeless, hungry, can't get to the doctor or are in danger of losing your home or kids. We must modify "core medical services" spending requirements to allow spending on supportive services that save lives.
- KEEP THE FOCUS ON TREATMENT AND CARE - STRIP TESTING LANGUAGE OUT
We must reject attempts to use Ryan White to redirect CDC prevention funding and cement controversial HIV testing policies. Congress should eliminate the "Early Diagnosis Grant Program" section in current drafts of reauthorization legislation.
Call the White House budget chiefs today
Rob Portman directs the White House Office of Management that is now putting together the entire federal budget request for 2008, which gets released in February.
You can reach him directly through the White House switchboard at 202-456-1414 and tell him "we need to add at least $500 million in new funding for the Ryan White CARE Act in the 2007 federal budget to end waiting lists for care and save the lives of Americans living with HIV/AIDS."
Call on Congress and the OMB to build support for a consensus reauthorization plan that will ensure lifesaving, quality HIV care to everyone in our nation living with HIV. Once we've passed the reauthorization, then we can all work towards a plan for universal access to prevention, treatment, care and support by 2010.
EVEN MORE INFORMATION ON RYAN WHITE
How did your Representative vote when Ryan White passed in the House? Check in with Blog to End AIDS to find out; the good folk there even made it so you can click on your Rep and get all their contact information. Send your Rep a note, tell them what you think.