December 8, 2006
RYAN WHITE SURPRISE
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In the very last minutes of a lame-duck session, hard-working staffers for Sen. Ted Kennedy slammed together a compromise Ryan White bill that would reauthorize current CARE Act programs for three years, provide a modest amount of new funding for AIDS drugs, and set the stage for a top-to-bottom rethinking of the domestic AIDS infrastructure in the new Congress.
The three-year compromise measure passed the U.S. Senate by unanimous consent Wednesday morning, and is being considered by the House as the Update goes to press.
House Energy and Commerce Committee Chair Joe Barton (R-TX) has held up the bill, in order to force passage of his own reauthorization legislation for the National Institutes of Health (HR 6164). Barton's bill would allow consolidation or elimination of many NIH research programs - including the Office of AIDS Research. Kennedy opposes the House NIH legislation, and the standoff could block passage of Ryan White until next year. (For some community concerns, download this letter, supporting organizations not finalized at time of press.)
AP: Clinton cements compromise
The Associated Press reported that Senator Hilary Rodham Clinton struck the deal that freed up new money for rural and Southern states while softening cuts to larger states like New York, California and New Jersey that have more HIV infections and AIDS cases.
Elements of the compromise included:
- a three-year reauthorization (until October 1, 2009) with plans for a stronger, broader system of funding for HIV/AIDS care in the future;
- "hold harmless" provisions that guarantee states will receive at least 95% of current federal funding over the next three years;
- a freeze on implementation of a new "Severity of Need Index" that would lead to big cuts in federal funding to states that contribute their own money towards AIDS care;
- report language making it clear that case management services are a "core medical service" that can be funded with Ryan White dollars.
The compromise Ryan White bill still doesn't have enough funding behind it to ensure full access to HIV treatment and care nationwide. While a modest $70 million will be added to ADAP programs, at least $600 million more is necessary to get anywhere near national access to basic care and treatment for everyone who needs it.
Another low point: redirection of $30 million in CDC prevention funding each year to pay for “"incentive grants" encouraging states to adopt bad HIV testing policies, especially no-consent testing for prgnant women and newborns. These testing policy changes are a total waste - they'll drive funding away from proven-effective HIV prevention measures towards conservative faves that don't work as intensive voluntary prenatal testing and counseling.
Up next: a fresh start?
If Barton relents, the compromise Ryan White reauthorization package will pass the House Friday or Saturday and go to President Bush for his signature. (How many Washington-insider AIDS lobbyists will be in the Rose Garden for the signing?) If not, the new Congress will have to pick up reauthorization again in January.
As we reported last week, Senator Kennedy's staff say they'll be holding hearings and convening working groups in the next Congress to review the strengths and weaknesses of the CARE Act and to develop something better, stronger, and more effective.
A good place to start would be last year's report by the Institute of Medicine which called for a new national entitlement to ensure full access to quality HIV treatment and care.
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The report, which was mandated as part of the LAST Ryan White reauthorization, clearly and carefully reviews what Americans living with HIV/AIDS need to survive and the trouble we have getting it. The time for inadequate patchwork systems of care is over - it's time for something strong, comprehensive and nationwide.
We urge Senator Kennedy and his staff to curl up in front of the fire with the IOM report this holiday season and prepare for their return to DC with a gift of universal access to care for the million-plus people living with HIV/AIDS in the U.S. for 2007.