A spending bill
that would send more AIDS money to the South passed a
House committee Wednesday despite opposition from some
big-state lawmakers who said it shortchanged their
states. Representatives from the South and rural
states said revisions to the Ryan White CARE Act of 1990
were necessary because of how the epidemic has changed over
Once a big-city illness mainly infecting gay
white men, AIDS now is prevalent in the South and
among minorities. But according to government studies,
federal support has not kept pace. A patient in California,
for example, gets more money than a patient in
Alabama, by some estimates.
"It shouldn't matter where you live in the
country when it comes to accessing medical care and
therapy," said Rep. Joe Barton of Texas, chairman of
the House Energy and Commerce Committee. "I don't think
The changes to the $2.1 billion annual program,
the largest one specifically for people with HIV/AIDS,
passed Barton's committee in a 38-10 vote. A
similar bill passed the Senate Health, Education, Labor,
and Pensions Committee in May. Prospects for passage before
Congress leaves at month's end to campaign in the fall
elections are uncertain.
The act funds state and local programs for AIDS
drugs and care for the neediest patients. Changes
approved to the spending formulas would cost some big
states tens of millions of dollars while shifting money to
Southern and rural areas.
The law now counts only patients with full-blown
AIDS to determine spending. The revision would also
count patients with HIV who have yet to develop AIDS.
That change would favor areas of the country where the
disease is a newer phenomenon, which tend to be Southern and
That change and others are estimated to cost New
York more than $75 million, lawmakers said.
California's annual amount could drop by some $50
million over the five-year life of the bill, with San
Francisco taking a particularly large hit. Alabama, by
contrast, would go from getting about $11 million a
year to about $18 million a year.
"This makes no sense whatsoever," said Rep.
Eliot Engel of New York.
"We shouldn't be robbing Peter to pay Paul here,
and that's essentially what's happening," said Rep.
Frank Pallone of New Jersey.
A proposal aimed at cushioning the blow for
states set to lose was narrowly defeated, as was a
one-year extension that would have allowed more time
to negotiate changes. (Erica Werner, AP)