Bay Area Reporter - December 7, 2006
Bob Roehr

Senator Ted Kennedy (D-Massachusetts) played a leading role in hammering out the compromise measure. His office released a statement outlining the major provisions of the changed bill.

Reauthorization will run for three years instead of the five years originally envisioned. The CARE Act will expire at that time and reauthorization will not be allowed, which assures that significant restructuring will occur during the interim. Kennedy has vowed to hold oversight hearings toward a more thoroughly restructured program.

A "hold harmless" provision will maintain funding to cities and states at a minimum of 95 percent of current levels. This will protect states with the most mature epidemic - primarily California, New York, and New Jersey - from losing significant funding over the short term.

Funding for drugs will be protected from being raided to meet hold hold harmless provisions, which might have occurred had the current law been extended.

All persons with HIV will count toward funding, regardless of where they live or how the data was gathered. States that have reported cases with anonymous coding will be protected for four years during a transition to names-based reporting.

The Department of Health and Human Services is mandated to develop a severity of need measure and report that to Congress by 2008. The lack of such details was a concern to many.

"After years and years of negotiations, this final proposal clears the way for reauthorization of the Ryan White CARE Act this year so that all people living with HIV/AIDS will get the care and services they need to live long and productive lives," Kennedy said.

"We must pass this bill now," he added. "It is about more than just money and healthcare services, it's about caring and the American tradition of reaching out to people who are facing health challenges and in need of support."

Senator Hillary Rodham Clinton (D-New York) had been one of four senators staunchly opposed to the earlier five-year reauthorization language. In a statement released by her office she said, "Over the past year, I have been working with my colleagues to reauthorize this important piece of legislation and have been forced time and time again to oppose reauthorization proposals because of their devastating impact on New York, the epicenter of the HIV/AIDS epidemic.

"I am proud that we have forged a three-year compromise that contains essential protections for New York and other hard-hit states; however, this bill alone cannot make up for years of flat-funding for programs that provide essential care and support services across the nation."

Senator Mike Enzi (R-Wyoming), chair of the Senate health committee who played a leading role in reauthorization, called passage "a great victory for people struggling with HIV/AIDS who have not been able to receive the care they deserve due to flawed funding formulas."

"We must address the epidemic today, not yesterday, and make sure the federal funds follow the person being treated, wherever they live," he said. "This bill ensures that federal dollars to treat HIV/AIDS finally go to the people who are most in need."

Carl Schmid, a lobbyist with the AIDS Institute, said the hold harmless provision and three-year term were the main reasons why Clinton and others dropped their opposition.

Extending the current CARE Act "would have been a disaster for those states using non-names based reporting" because it would have denied certain funding to them, he said. Schmid also is pleased that the compromise includes $70 million more for Title II funding to states, though that still has to be secured through the appropriations process when Congress returns next year.

Joe Solmonese, president of the Human Rights Campaign, praised the bipartisan, bicameral efforts that led to the compromise. He, too, remains concerned about inadequate funding and called for more money "so that all Americans living with HIV/AIDS, no matter where they live, have access to life-saving medical care and supportive services."

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