Reauthorizing the Ryan White CARE Act is about a year overdue, and the House took a tentative step towards final enactment by passing H.R. 6143, legislation sponsored by Rep. Mary Bono (R-CA) in the days before the pre-election recess.  The CARE Act provides medical care and support services to more than 500,000 people living with HIV/AIDS each year.  The vote on H.R. 6143 was 325-98 for a five-year renewal of the law, but that masked a fierce controversy over the funding distribution formula.  The bill provides more funding to rural areas, which have experienced growth in HIV/AIDS cases in recent years.  However, the overall funding would be authorized to grow only by 3.7 percent each year from FY 2008 through FY 2011, not enough to cover both the increasing rural cases and the high need in cities.  As a consequence, representatives from urban areas voiced strong opposition to the inadequate total funding in the reauthorization bill.  As quoted in CQ Today, Rep. Engel (D-NY) noted that New York City would lose $17 million in just one year, while New York state would lose $78 million over 4 years because of the new formula.
The funding formula controversy is just as intense in the Senate, which has not yet passed a Ryan White bill.  S. 2823, a bill with a formula similar to H.R. 6143, was stopped from a Senate floor vote by Senators Clinton (D-NY), Schumer (D-NY) and Menendez (D-NJ).  Senator Lautenberg (D-NJ) introduced legislation on September 26 to extend the current formula for Ryan White CARES for a year, with $2.2 billion proposed for FY 2007.  The House and Senate Appropriations Committees’ FY 2007 recommendations for this program are $2.108 billion and $2.139 billion, respectively.  Taking inflation into account, the House Committee’s funding is 4 percent below FY 2005; Senate appropriators recommended an amount 2 percent below FY 2005 levels.  As long as funding fails to keep pace with the growing need, there cannot be any satisfactory resolution to the formula fight.

Subscribe: