Southern Senators Call for Funding Calculation Changes in Rural States in Ryan White Reauthorization Bill

Sens. Jeff Sessions (R-Ala.), Tom Coburn (R-Okla.) and Richard Burr (R-N.C.) at a news conference on Thursday called for changes in funding calculations under the Ryan White CARE Act that would affect the distribution of funding to states without many large urban areas, the Birmingham News reports (Orndorff, Birmingham News, 5/4). Coburn in March introduced a bill (S 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. A 2005 Government Accountability Office report finds that some funding calculations favor states with larger urban areas because the system counts AIDS patients twice in 51 metropolitan areas (Kaiser Daily HIV/AIDS Report, 5/1). According a Burr release, Alabama receives $3,657 in federal funding per AIDS patient, while California receives $5,264 per patient (Burr release, 5/3). However, a report released last month by the not-for-profit organization Communities Advocating Emergency AIDS Relief finds the distribution of CARE Act funding to be more balanced than what the GAO report says. Lawmakers from California, New Jersey and New York late last month criticized the proposed changes to the funding calculations, saying they could move millions of dollars in HIV/AIDS funding from the Northeastern and Western U.S. to the South (Kaiser Daily HIV/AIDS Report, 5/1).

Senators' Comments, Reaction
"Although HIV/AIDS started as a major metropolitan health problem, ... [t]hat's not where it is today," Burr said (Smith, Durham Herald-Sun, 5/4). Sessions said, "The first principle has got to be that the money should follow the disease" (Reilly, Mobile Press-Register, 5/4). Burr, Coburn and Sessions, all members of the U.S. Senate Committee on Health, Education, Labor and Pensions, said they expect the committee to approve a bill on CARE Act reauthorization later this year (Shaffrey, Winston-Salem Journal, 5/4).

Opinion Piece
Although it is unexpected that HIV/AIDS would be "so top-of-mind" for Sessions, "one of the Senate's most conservative members," his advocacy could mean that "Alabama finally will get its fair share of available" CARE Act funds, Huntsville Times columnist David Person writes in an opinion piece. The "outdated funding formulas" of the CARE Act would be "bad enough if all we were talking about is a funding disparity," but HIV incidence patterns are making the "problem ... worse," Person says. If the funding formula is changed, "Alabama will have one of the Senate's most conservative members to thank for showing true compassion," Person concludes (Person, Huntsville Times, 5/5).