RYAN WHITE CARE ACT: Reauthorization Bill Cuts San Francisco’s Share
The U.S. House of Representatives voted unanimously Tuesday to reauthorize the Ryan White CARE Act, including a funding formula change that would reduce San Francisco's share by as much as 25% over the next five years, the San Francisco Chronicle reports. Written by Reps. Tom Coburn (R-Okla.) and Henry Waxman (D-Calif.), the bill calls for a change in focus from full-blown AIDS cases to HIV cases. Changes to the funding formula are also designed to shift resources to areas where the epidemic is growing. Under current law, San Francisco receives nearly twice as much funding per AIDS case compared to other cities. Jim Driscoll, national AIDS policy adviser for the Log Cabin Republicans, said that when the Ryan White legislation was initially enacted, San Francisco was the at the heart of the AIDS epidemic, so the law "was written in a way that was very favorable to [the city]. That becomes very difficult to maintain as a broader and broader constituency nationally has to be served by the program" (Lochhead, 7/27). Coburn agreed: "Justify why somebody in San Francisco who is HIV-positive has $5,000 spent on them, and somebody in Wyoming has $100 spent on them. You can't justify that." Rep. Nancy Pelosi (D-Calif.) said that when the House and Senate bills are combined, she will fight for the Senate version, which calls for a less extreme funding formula change. That formula would limit San Francisco's potential funding losses to 10% of its current allocation over the next five years. "We just don't think it's fair for [the House] to take money from one place to give it to another," Pelosi said (Lochhead, San Francisco Chronicle, 7/26). But Coburn predicted that the Ryan White money -- which has increased at an average rate of 24% every year since 1991 -- will continue to grow, leaving San Francisco with "no absolute cut in funds," even as its share of the total declines. However, area AIDS advocates argued that resource levels would have to double over the next five years to maintain current funding (San Francisco Chronicle, 7/27).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.