Bay Windows - March 2, 2006
Ethan Jacobs, ejacobs@baywindows.com

The Ryan White Care Act expired last September, but Congress has delayed reauthorizing it. Two committees, the Senate Health, Education, Labor and Pensions (HELP) Committee and the House Committee on Energy and Commerce, have jurisdiction over Ryan White, and Rebecca Haag, executive director of the AIDS Action Committee of Massachusetts (AAC) said she expects those committees to propose their own bill, one that will likely have more traction than Coburn's. AAC has been working with the committees, including with Sen. Ted Kennedy (D-MA), ranking member of the HELP Committee, and Rep. Edward Markey (D-MA), a senior member of the Energy and Commerce Committee, to advocate for a reauthorization bill that reflects the Bay State's priorities.

"Basically what we want is a good bill, not just any bill, and those two committees have been working to incorporate the thinking of advocates from all over the country," said Haag. "We feel confident that there will be a bill that will be reflective of our thinking on reauthorization coming out of those committees.... What we've been hearing is that the committees would have a bicameral, bipartisan bill hopefully before the Easter recess."

Haag, who became executive director of the Washington, D.C.-based organization AIDS Action March 1, said that her comments only reflected the views of AAC, not the D.C. organization. Kevin Cranston, director of the HIV/AIDS Bureau of the Massachusetts Department of Public Health, also believes Coburn's bill will not pass, but he believes it could have an impact on the ultimate reauthorization bill.

That could be bad news for Massachusetts. Cranston said the most worrisome provision in Coburn's bill is the end to a practice that advocates in Southern states call "double-counting." Currently states with large metropolitan areas with high numbers of AIDS cases, called eligible metropolitan areas (EMAs) receive funding based on both the number of AIDS cases in the EMA as well as across the state as a whole, and cases in the EMA are included in both the state and the city count. Advocates in states without EMAs have charged that those with EMAs, such as Massachusetts, New York, California, Florida, and Texas, are receiving more funding per AIDS case than other states. Coburn's bill would eliminate double-counting.

"The redirection of funds to other parts of the country might mean as much as a $2.5 million reduction to the Massachusetts allocation," said Cranston.

Another major concern is that the bill would force Massachusetts to switch its HIV surveillance system to a names-based system by October or risk losing up to $10 million in funding. The CDC has been pressuring states like Massachusetts that track HIV cases using codes rather than names to make the switch or risk losing federal funds (see "Will Bay State switch to names reporting of HIV cases?" Feb. 9, 2006) and Coburn's bill would set a firm deadline of October to put a new names-based system in place.

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