Friday, May 19, 2006

Ryan White Moves Forward

The Senate health committee has approved legislation to reauthorize the Ryan White CARE Act until 2011. The bill, which passed by a vote of 19-1, was introduced by the chairman and ranking Democrat of the Senate Health, Education, Labor, and Pensions (HELP) Committee, Senators Michael Enzi (R-WY) and Edward Kennedy (D-MA).

Senators Clinton voted against this bill because early estimations indicated that New York will take a $20 million with this new bill

The legislation amends to the current Ryan White CARE Act by creating a complicated funding mechanism that increases the number of cities that receive CARE Act emergency grants from 51 to 76, and creates a new three-tier structure for cities that report high, medium, and low numbers of HIV and AIDS cases.

Lawmakers and their staff have touted again and again the fact that the bill was drafted in a bipartisan manner. However, there has been heated debate and negotiations over several contentious issues, chief among them is how CARE Act resources are to be allocated across the country. With the high cost of HIV/AIDS drugs, no decline in new HIV infections, and an estimated 1.1 million people living with HIV/AIDS in the U.S.—an all-time high—lawmakers struggled to balance several competing demands on an increasingly small pot of funding.

The GAO has not been able to provide accurate numbers. They have tried TWICE and both times the community pointed out their errors. Its clear that this bill is better than the version introduced by Senator Coburn of Oklahoma and much better than what Representative Joe Barton of Texas wanted but at the same time it seems strange that the GAO can not give us accurate account of how the money will be divided.

I believe that the new funding mechanism is designed to make states cities and providers fight for funds and thus unable to stand united against what is far from a good bill. From the Texas perspective this bill is not great, but I think we can live with it. As I said before, it could have been a lot worse and folks in DC say if this version falls apart we are likely to see another version that could hurt us much more. Based on estimates, the funds to the state of Texas take a hit of over 6 million. Houston and Dallas pick up close to 4 million combined. San Antonio gets a slight bump up in funding while Austin and Fort Worth each take a $250,000 hit. These are just estimates beacuse the GAO can't produce actual numbers.

Stay tuned.

1 comment:

Carolyn said...

Good info, Jake. I'm not sure I'm quite ready to live with this bill. I agree that there may be some element of "divide and conquer" in its underlying philosophy. I also believe that we could get something far worse--so any opposition has to be carefully considered.

Info from DSHS says that THMP will take a major hit (closer to $10 m) in 2007. Word is that the Governor (more likely someone in his office) has actually deigned to recognize the issue. His solution is to tell our senators to "stop it."

I'm still of the opinion that we need a bigger pie.