On Wednesday, the
House Energy and Commerce Committee voted 38-10 in
favor of a spending bill that would direct more Ryan White
CARE Act funds to Southern states. Lawmakers from
Southern and rural areas said revisions to the
original 1990 act are necessary to keep up with the AIDS
epidemic's changing track. But representatives from
California, New York, and New Jersey voted against it
and complained their states are being shortchanged.
government studies, funding under the act has not kept pace
as AIDS shifted from affecting mainly urban gay white men to
infecting more minorities and people in the South. At
present, the act sets spending levels in locations by
calculating the number of cases that have progressed
to AIDS. The revised funding formula would also count HIV
cases who have not yet developed AIDS, thus favoring regions
where the epidemic is a newer phenomenon.
estimated the new formula would cost New York more than $75
million. Over the act's five-year life, California would
lose some $50 million, with San Francisco alone taking
a $10 million hit. San Francisco currently benefits
from a quirk in the law, eliminated in the proposed
revision, that counts some dead people among AIDS patients.
In contrast, Alabama's share of the funds would climb
from about $11 million to about $18 million annually.
A proposal to
extend the act by one year while negotiations continued was
defeated, as was a provision that would have softened the
blow for states set to lose funds. In May, a similar
Ryan White bill passed the Senate Health, Education
Labor and Pensions Committee. Whether Congress can pass
the legislation before it breaks for the fall elections is