Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.
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The San Francisco Examiner - June 23, 2000
Judy Holland, Examiner Washington Bureau
Rep. Tom Coburn, R-Okla., said Thursday that San Francisco's share of federal Ryan White program money would be slowly reduced until the city received the same level of funding as other cities with high rates of AIDS.
Nancy Pelosi, D-San Francisco, a longtime advocate for people with AIDS, vowed to fight the House deal and warned that it could cut millions of dollars from The City's $35 million annual funding from the Ryan White program. The program authorizes federal payments for care and medication for people with HIV and AIDS who aren't poor or sick enough to receive Medicaid, but who don't have private insurance.
"We can't live with that," Pelosi said. "This is unfair to us. The fact is, we can never agree to a funding level that stands in the way of meeting the needs of people with HIV/AIDS."
She said she didn't know the exact size of the cut, and Coburn declined to provide it.
"They have the best funding of any place in the country, and they can't document that they have a greater need," said Coburn, a member of the House Commerce Committee's Health and Environment Subcommittee, which oversees the Ryan White Care Act.
Pelosi said she supported a Senate-passed version of the Ryan White care program that would freeze San Francisco's share of the money at no less than 98 percent of the current $35.3 million a year.
Once the House passes its version of the Ryan White program, the House and Senate bills will go to a joint House-Senate conference committee where negotiators will hammer out a compromise.
When the federal program began in 1991, San Francisco's share of the money was relatively large. Originally, the funding formula was based on two factors: the density of AIDS cases in a city (the ratio of people with AIDS relative to the city's total population) and a city's cumulative number of AIDS cases, living and dead.
In 1996, Congress changed the formula so that it was based on the estimated number of people with AIDS in a city. That change would have slashed San Francisco's funds because many AIDS patients had already died, but Congress decided to limit any cuts to The City's funding so as not to disrupt existing AIDS programs.
Because of treatment advances and new drug therapies, San Francisco has a growing population of HIV patients and a shrinking number of people with full-blown AIDS.
San Francisco's need for federal aid "is greater because people are living longer," Pelosi said. "We cannot be penalized for intervening earlier and prolonging life."
Coburn said in an interview that HIV patients in other parts of the country, especially women and minorities, must wait for someone else in their area to die of AIDS before they could get federal funding to pay for medications that can slow the disease.
"It's a hard position for San Francisco to defend," Coburn said, adding that 16 states had run out of Ryan White money last year.
Coburn added that his intention was not to punish San Francisco, "although that's the perception. The perception is that they are being picked on. We're trying to do the right thing for San Francisco as we try to do the right thing for everybody else."
Pelosi said Los Angeles city officials have been leading the charge in trying to cut San Francisco's share of the money, a development she said was "unfortunate."
The Ryan White program is named after the hemophiliac teenager from Kokomo, Ind., who contracted the disease through tainted blood and died in 1990 at age 19.
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