Washington Blade - October 6, 2006
Joshua Lynsen

The measure, which provides $2.1 billion in federal funding for local programs and services for people living with HIV and AIDS, expired as Congress adjourned Sept. 30.

The soonest the CARE Act can be renewed is Nov. 9, after lawmakers return from their recess.

Michael Weinstein, president of the AIDS Healthcare Foundation in Los Angeles, was among the activists who were upset by the development.

"Sadly," he said, "the delay in the reauthorization process of the CARE Act, be it for another year or just another few months, hampers an opportunity to slow the chain of new infections by reducing our ability to immediately start identifying previously undiagnosed HIV positive individuals and get them into treatment."

Congress has argued for months over how to best distribute the next round of CARE Act funding.

A proposed rewrite approved by the House would allocate money based on a state's total number of individuals with HIV cases, not just those with full-blown AIDS.

But opponents in the Senate have said the revision, coupled with the act's stagnant funding, could take money away from patients in dire need of care.

New York Democratic Sens. Hillary Clinton and Charles Schumer, along with New Jersey Sen. Frank Lautenberg (D), are seeking to extend the current law for another year while a compromise is developed.

Under the proposed CARE Act rewrite, New York could lose $78 million in funding over the next five years.

"I'm committed to the reauthorization of a good bill that strengthens and improves the ability of all Americans to access HIV and AIDS care, support and treatment," Clinton said in comments on the Senate floor Sept. 29. "But a bill that destabilizes existing systems of care and devastates, even destroying the ability of high-prevalence communities to address needs, is unacceptable."

Programs, services continue

Although the CARE Act expired Sept. 30, the programs and services it funds will continue.

Ronald Johnson, deputy executive director of AIDS Action Council in Washington, D.C., said enough funding exists to sustain the programs into early next year.

But it's unclear when Congress will act to renew or extend the CARE Act.

Johnson said Clinton, Schumer and Lautenberg have placed a "hold" on the proposed renewal. The tactic, done to protect New York and other states from losing millions in funding, has precluded senators from voting on the bill.

Johnson said that hurdle could be cleared if the U.S. were to commit another $100 million annually to the CARE Act.

He said that although Congress has been reluctant to make such an expanded commitment, the money would save lives.

"No one wants to see health care systems fail because we couldn't agree on a bill," he said, "and no one wants to punish people living with HIV/AIDS because of a stalled political process."

An uncertain future

Activists were uncertain whether Congress would debate the CARE Act when it reconvenes in November.

Ged Kensla, communications director of the AIDS Healthcare Foundation, said congressional leaders could instead scrap the proposed rewrite, a product of more than two years of bipartisan and bicameral negotiations.

"I'd like to say that I'm hopeful that when they come back they can hammer out a bill," he said. "But I think it is a missed opportunity to really have updated this bill in a very pragmatic way that addresses the disease as a public health issue rather than as a political one."

Others held out hope. Thompson said Congress still has time to pass the CARE Act and benefit the more than 500,000 people who receive treatment and support from it.

"The CARE Act has been reauthorized twice before with broad bipartisan support and nearly unanimous votes and we must do it again," he said.

If lawmakers do not renew or extend the act before year's end, the incoming Congress would inherit the dispute. And if that happens, Johnson said, efforts to renew the CARE Act might have to begin anew.

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