On December 9, 2006, the U.S. Congress passed a compromise bill (H.R. 6143) that would reauthorize the Ryan White Comprehensive AIDS Resource Emergency (CARE) Act. The compromise bill includes certain funding adjustments meant to address the needs of poor, HIV-positive individuals living in rural areas, particularly in southern states. The South collectively represents 46% of all new HIV/AIDS cases in the U.S.

The compromise version of H.R. 6143 was only voted and passed by voice vote after certain specific concerns were incorporated into it. Five key senators--including those from New Jersey and New York--had blocked Senate consideration of the legislation earlier this year. Some of these compromise provisions include sustaining state funding at no less than 95% of the 2006 funding levels; allowing states a four-year, penalty-free transition period to convert from established code-based methods of reporting HIV cases to a more accurate, name-based system; and repealing the program after three years in order for Congress to reassess any structural problems.     

The Ryan White CARE Act was enacted in 1990 to address the health needs of people living with HIV disease, particularly those with low incomes or inadequate health insurance. The Health Resources and Services Administration’s HIV/AIDS Bureau administers the program, which funds primary healthcare and support services for eligible individuals.

One of the main obstacles facing people in rural areas is access to healthcare when transportation options are limited. The Ryan White CARE Act will assist states in rural areas to improve their transportation services. AIDS Alabama, an HIV/AIDS advocacy group in Birmingham, said that it will use the additional $7 million the state will receive through the reauthorized Ryan White CARE Act to expand transportation programs for HIV/AIDS patients.

“If you look at our urban areas, primary care may be available, but if you go out beyond the reaches of cities like Birmingham or Charlotte, NC, or Raleigh-Durham, it is not unusual for people living with HIV/AIDS to travel really far distances to get to a primary care provider,” said Evelyn Foust, CPM, MPH, Branch Head, HIV/STD Prevention and Care of the North Carolina Division of Public Health. “They can have a real difficult time getting primary care, and that access makes all the difference in the world.”       

The U.S. Senate Committee on Health, Education, Labor and Pensions estimates that H.R. 6143 would include an additional $4.1 million annually for Georgia, $1.1 million for Louisiana, $1.7 million for Mississippi, $10.2 million for North Carolina and $2.3 million for South Carolina.      

Source: Kaiser Family Foundation Daily HIV/AIDS Report (online), December 11, 2006  Medical News Today, December 15, 2006