Senate Committee Negotiates Proposals for Ryan White CARE Act Reauthorization

The Senate Health, Education, Labor and Pensions Committee on Wednesday is scheduled to mark up a draft bill that would reauthorize the Ryan White CARE Act, which expired on Sept. 30, 2005, CQ HealthBeat reports. Negotiations over the bill's provisions continued Tuesday, and it was not clear which provisions of the bill would be amended, according to a committee spokesperson. The draft bill proposed several changes to the CARE Act, such as revising formulas for funding calculations to include HIV cases and not just AIDS cases; creating a tier system to fund both small and large cities; directing unused funds from states into AIDS Drug Assistance programs -- federal- and state-funded programs that provide HIV/AIDS-related medications to low-income, uninsured and underinsured HIV-positive people; and mandating a minimum AIDS drug formulary list that all state ADAPs would have to provide to patients. Some HIV/AIDS advocates say the draft bill would not adequately address the problem of people waiting to access treatment and that adding new formulas and definitions makes the legislation even more complex (Blinkhorn, CQ HealthBeat, 5/16). Sen. Tom Coburn (R-Okla.) in March also introduced a bill (S 2339) that would reauthorize and amend the act. 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, 5/8).