San Francisco Chronicle - Friday, July 20, 2007
Edward Epstein, Chronicle Washington Bureau, eepstein@sfchronicle.com

The effort, which came Wednesday evening during debate on a bill to pay for next year's federal government health programs, was the latest chapter in a long-running battle over HIV/AIDS funding in Congress.

The fight pits cities such as San Francisco, which were the epicenter of the then-new AIDS epidemic in the 1980s and early 1990s, and communities across the country that were hit by the disease later. The communities dealing more recently with the costs of AIDS/HIV cases say the federal funding formula unfairly favors cities such as San Francisco and have been trying to change it, with some success.

But though the issue of fairness is at stake, no one in the House could help but notice that the amendment offered by Rep. Joe Barton, R-Texas, to cut the money was aimed squarely at the Democratic speaker from San Francisco who since she arrived in Congress in 1987 has been a nonstop advocate of AIDS funding for her city.

"What we were trying to do was make more funds available to those areas of the country where the epidemic was still prevalent and growing and less funds on a discretionary basis where the epidemic had once been centered but was now thankfully not as prevalent," Barton told the House as it debated his amendment to the annual Labor, Education and Health and Human Services appropriations bill.

Pelosi didn't speak against the proposed cut in the $18.1 million federal grant to the three Bay Area counties; even before Barton's amendment, that figure represents a 31.4 percent reduction from the previous fiscal year.

Rep. Lynn Woolsey, D-Petaluma, whose district includes Marin County, said 20,000 people have already died from AIDS in the Bay Area and the disease remains the second-leading cause of premature death in the area.

"This amendment will recklessly and irresponsibly put the lives of many of our constituents at risk. The very idea truly astounds me," Woolsey said.

Barton's amendment would have returned funding to the level of the deeper cuts that the Bush administration planned to make, but that Pelosi and other California Democratic congressional leaders reversed earlier this year. Critics of the Bush administration's domestic spending priorities say that cuts in the Ryan White HIV/AIDS care program are pitting one deserving community against another for a steadily shrinking slice of funds -- even as patients are living far longer while requiring continuous and expensive medical care.

Last year, the Republican-controlled House passed cuts for AIDS funding in San Francisco and such other cities hit early as New York and Newark, N.J. But members from the Bay Area, New Jersey and New York restored some of those cuts.

Rep. Anna Eshoo, D-Palo Alto, who represents part of San Mateo County, said Barton's proposal was absurd.

"Any member of Congress want to take a 31.4 percent cut in what their income is to take care of their responsibilities and obligations?" she asked her colleagues.

Rep. Brian Bilbray, R-Carlsbad (San Diego County), said Barton was pointing out that federal dollars should focus on places where the epidemic is growing now.

"We can't solve the problems of the past, but we can solve the problems that face use today, this year, and in the future, and that is by making sure funds are committed to those who are actually sick today," Bilbray said.

When the vote came, only 10 Democrats voted against the funding for the Bay Area counties, while 218 voted with their speaker. A dozen Republicans sided with the Democrats, while 186 voted for Barton's measure, which was defeated 230-196.

The overall bill, containing $152 billion for programs including special education, community health centers, Head Start and health research, easily passed the House on Thursday, 276-140.

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