Senate and House Urged to Reconcile Ryan White CARE Act Funding

Filed Under AIDS/HIV, Politics | August 16th, 2007 

Senate Appropriations Bill Must Match House’s Funding Number for Crucial AIDS Program, Says AHF

WASHINGTON, Aug. 16 (PRNewswire-USNewswire) — AIDS Healthcare Foundation (AHF) today urged members of the US Senate to reconcile two versions of federal legislation that will set funding levels for the Ryan White CARE Act (RWCA or the CARE Act), the United States most important HIV/AIDS program.

AIDS advocates note that funding for the CARE Act, which was first introduced in 1990, has not kept pace with inflation, much less with the changing needs of the nation’s HIV epidemic as it grows among rural populations, minorities and women.

AHF is strongly urging the Senate to ensure its proposed AIDS-related funding provisions in Senate HHS Appropriations Bill S1710 match those funding numbers set in House Appropriations Bill H.R. 3043 (the Fiscal Year 2008 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act), which the House passed in late July and which was then placed on the Senate’s Legislative Calendar July 23rd.

Historically, hundreds of millions of dollars in CARE Act funding has been spread among five program categories and disbursed among states and 51 areas hardest hit by the epidemic
nationwide.

More recently, in an effort to reflect and better respond to emerging needs and the changing demographics of the disease, an additional five CARE Act service areas have been added (Charlotte, Baton Rouge, Indianapolis, Memphis and Nashville), and area designations have been further delineated into both EMAs and Transitional Grant Areas (TGAs), which are metropolitan and rural areas that have fewer AIDS cases than the larger EMAs; however, many of those areas are precisely where the epidemic is growing most rapidly.

As the House and Senate work to set funding levels for the CARE Act for FY 2008, funding has in essence remained flat-a turn of events that in reality will lead to funding cuts to many areas.

This is in part due to the addition of the five service areas and an increased number of potential CARE Act beneficiaries nationwide. These looming potential cuts have prompted jockeying and lobbying in Washington among legislators and funding recipients eager to stave off or minimize funding cuts to their respective legislative district, EMA or TGA.

Several key lawmakers expressed concerns about the equitable distribution of federal AIDS funds across the country, and in particular, the potential loss of millions of dollars in HIV/AIDS
funding by urban centers in New York, California, New Jersey and Illinois that have been particularly hard hit by the epidemic.

H.R. 3043, which the House passed July 19th in a 276 to 140 vote, includes language limiting the amount of federal funding which CARE Act jurisdictions nationwide can lose. The House bill limits the potential loss to 8.4% for Eligible Metropolitan Areas and 13.4% for Transitional Grant Areas.

Included in the bill was a $23 million increase for Title I, which would be the largest increase for Title I in seven years. In addition to this amount, $9.5 million was requested to cover the cost of the proposed 8.4% to 13.4% stop-loss to EMAs and TGAs.

“If the present House language prevails without the additional $9.5 million to cover the proposed stop-loss, 21 jurisdictions will suffer cuts to benefit one,” said Michael Weinstein, AHF’s President.

“This House bill could potentially bail San Francisco out at the expense of many other hard-hit jurisdictions if not enough money is appropriated. We urge the Senate to match funding levels set in H.R. 3043 — including the additional monies for the for stop loss and Title I — in its version of the bill”.

“It is well known that a rising tide lifts all boats, and we are certain that if the additional money is allocated, many more people throughout the nation will benefit from the lifesaving prevention, care and treatment services provided under the auspices of the CARE Act.”

In 2006, the Centers for Disease Control (CDC) announced that for the first time more than one million Americans were living with HIV. Almost half of those infected are not consistently accessing care and treatment, and more than one quarter of the million nationwide are unaware they are infected with HIV.

“There is no doubt that an increase in funds for RWCA is always preferable, and that losses to jurisdictions for HIV programs are always bad, but we have concerns that the stop-loss provision is not linked explicitly enough to the $9.5 million proposed increase in the House bill.

That means there is the possibility that the provision could move forward in the Senate without the additional funds,” said Whitney Engeran, III, Director of the Prevention and Testing Department for AIDS Healthcare Foundation.

“We are asking the Senate and House to work together, iron out their differences and come up with a compromise to send to the president to sign.”