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Ryan White Care Act Gets Through Congress
  AIDS Funding Bill Sails Through the House
The House on Wednesday overwhelmingly passed legislation allocating billions of dollars in federal money for the treatment of HIV and AIDS.
By a vote of 408-9, the House reauthorized the Ryan White Care Act, first enacted in 1990 and named for the Indiana teenager who died of AIDS. The Senate has already passed the bill by unanimous consent, meaning the legislation now heads to the desk of President Obama, whose administration has indicated strong support for it.
The bill, which has a framework similar to the 2006 legislation that last reauthorized Ryan White funds, approves an additional four years of funding for the program, which is administered by the Department of Health and Human Services to about 500,000 lower-income people each year. It allocates $2.55 billion for fiscal year 2010, with that figure rising to $2.95 billion by the 2013 fiscal year.
The last reauthorization was scheduled to expire on Sept. 30, but was extended for one month.
The measure also mandates that states use a name-based reporting system by the 2013 fiscal year, but allows states to submit code-based data until then at a penalty. And it includes a so-called "hold harmless" provision, which protects communities that see relative drops in the numbers of cases from facing large funding decreases.
The reauthorization was negotiated by lawmakers from both parties in both chambers, making it a stark contrast to not only the rancor enveloping the current debate over health care, but also the acrimony surrounding the last reauthorization.
In 2006, lawmakers from states with large urban areas, like California and New York, quarreled over funding levels with those from more rural states before a compromise plan was approved in December, the month before a new Congress was sworn in.
On Wednesday, Representatives Henry Waxman of California and Joe Barton of Texas - the chairman and ranking member of the House Energy and Commerce Committee, respectively - both praised the reauthorization.
Mr. Waxman, a Democrat, said that lawmakers from both parties realized that AIDS was not a partisan issue. "We all had to compromise," Mr. Waxman said. "This doesn't contain all the provisions I wanted to see, but it's a good solid bill." In a statement, Mr. Barton, a Republican, said he was "proud to be an original co-sponsor of this reauthorization bill, and am glad that we were able to come to agreement on this important legislation."

Ryan White Extension Lacks Provision To Lock In S.F. HIV/AIDS Funds
The Ryan White CARE Act reauthorization that passed the House Wednesday did not include a provision to restore San Francisco's declining share of federal HIV/AIDS funds, the San Francisco Chronicle reports.
San Francisco began losing HIV/AIDS funding after the 2006 reauthorization of the program, which shifted more funds to rural areas and regions with higher HIV/AIDS rates.
House Speaker Nancy Pelosi (D-Calif.) supported a measure that would have permanently locked in San Francisco's funds, but the provision did not make it into the final House bill (Joseph, San Francisco Chronicle, 10/22). Last year, Pelosi backed a similar provision that allocated an additional $7 million to San Francisco (California Healthline, 10/1).
Pelosi's aides say she now is working to grant San Francisco about $5.3 million in HIV/AIDS funding through a separate appropriations process (San Francisco Chronicle, 10/22).
Ryan White Extension Details
The House voted 408-9 to reauthorize Ryan White after the Senate unanimously approved the bill earlier this week. The measure now goes to President Obama, who has said he supports it.
The extension will grant the program an additional four years of funding, starting at $2.55 billion for fiscal year 2010 and rising to $2.95 billion by FY 2013. HHS will administer the program.
In addition, the reauthorization calls for states to adopt a name-based HIV/AIDS reporting system by FY 2013 (Becker, "The Caucus," New York Times, 10/21). In 2006, Gov. Arnold Schwarzenegger (R) signed into law a bill to move California from a code-based HIV/AIDS tracking system to a name-based system (California Healthline, 10/1).
This year's Ryan White extension also sets a national goal of conducting five million HIV tests annually (CQ Today, 10/21).
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