Lawmakers Debate Ryan White Reauthorization Bill Funding Proposals for Rural, Urban Areas

Lawmakers representing rural and urban states are debating whether proposed new HIV/AIDS funding calculations under the Ryan White CARE Act would favor one region over another, The Hill reports (Sheffield, The Hill, 3/7). Sen. Tom Coburn (R-Okla.) last week introduced a bill (SB 2339) that would reauthorize and amend the act, which expired on Sept. 30, 2005. Coburn's bill calls for the creation of new funding formulas that would take into account HIV prevalence, would require that 75% of CARE funding is spent on primary care, and would increase annual funding for AIDS Drug Assistance Programs (CQ HealthBeat, 2/28). The bill also addresses the following: expanding access to testing; removing barriers to diagnosis and ensuring that about 1.5 million rapid tests are available annually; making HIV testing a routine procedure in facilities receiving federal funding and for patients covered by federal health programs, specifically pregnant women and newborns; and ensuring that people who test HIV-positive receive appropriate counseling and care (Kaiser Daily HIV/AIDS Report, 3/1). Under the current law, areas with large numbers of HIV/AIDS patients receive more funding, according to the Hill. However, some Senate staff members say the formulas have not been adjusted for changes in demographics, including the movement of HIV/AIDS patients to rural areas. Sen. Richard Burr (R-N.C.) during a Senate Health, Education, Labor and Pensions Committee meeting used the example of HIV-positive patients living in New Orleans being provided $1,200 monthly, with the amount reduced to $1,200 annually after relocating to rural areas after Hurricane Katrina. According to The Hill, Committee Chair Mike Enzi (R-Wyo.) and ranking member Sen. Edward Kennedy (D-Mass.) have said they might introduce a HELP version of a bill to reauthorize the act. Enzi spokesperson Craig Orfield said it is likely that HELP's version will be approved by Congress because the committee has jurisdiction over the issue. John Hart, a spokesperson for Coburn, said, "The competition of ideas is a good thing in a deliberative body." The House Energy and Commerce Committee has held preliminary meetings on the issue, but no hearings have been scheduled (The Hill, 3/7).