House Commerce Committee Passes Coburn AIDS Bill
By Crystal Swann
On July 13th, the United States House of Representatives' Commerce Committee passed by voice vote Oklahoma Rep. Tom Coburn's Ryan White CARE Act Amendments of 2000 bill which reauthorizes the Ryan White Comprehensive AIDS Relief Emergency Act. The Ryan White Act is the largest authorization of federal funds specifically designated to provide health and social services to people living with AIDS.
The House bipartisan bill (HR 4807) contains provisions that would revise grant formulas to reflect the prevalence of HIV, not just full-blown AIDS while maintaining the current CARE Act structure. There is also a hold harmless provision in Title I that would allow a metro area to lose up to 25 percent of funding over five years. Most of Title I funded jurisdictions do not fall into this category. The bill also improves access to care for persons who know their status but are not in care, improves the quality of health and ancillary services delivered by Ryan White providers and increases accountability for federal funds.
The major concerns with this bill include provisions that provide preferential funding to states that have laws requiring mandatory testing of all newborn infants or mandatory testing of newborns if the mother's HIV status is unknown and provisions that allow the use of Ryan White funds for community-based prevention programs.
The Senate bill (S. 2311) makes no changes to the basic grant formula and addresses improving access to care in under served urban and rural areas by doubling the minimum base funding available to states through the CARE Act and includes supplemental state funding that will target assistance to rural and under served areas to help them address the increasing number of people with HIV/AIDS living outside urban areas that receive assistance under Title I.
The House is expected to pass the measure before the August recess leaving a House-Senate Conference Committee to work out the differences between the two reauthorization bills. The Conference of Mayors, during the June 2000 68th Annual Meeting in Seattle, passed the "Reauthorization of Ryan White Care Act" resolution which urges swift passage of a reauthorization bill and also urges Congress to, in reauthorizing the Act, modify it to give cities and their communities the proper tools to address new challenges confronting the HIV/AIDS epidemic while maintaining the Act's successful structure, strong local control, and a continuity of care so that life-saving health services are not interrupted.