Fairer Ryan White Funding Calculations Needed, Editorial Says
Californians cannot allow proposed changes to the funding calculations under the Ryan White CARE Act to be implemented because they "could mean an enormous loss for California's AIDS patients," according to a San Francisco Chronicle editorial (San Francisco Chronicle, 4/26). Sen. Tom Coburn (R-Okla.) last month introduced a bill (SB 2339) that would reauthorize and amend the act, which expired on Sept. 30, 2005. Coburn's bill calls for the creation of new funding formulas that would take into account HIV prevalence, would require that 75% of CARE funding is spent on primary care, and would increase annual funding for AIDS Drug Assistance Programs (CQ HealthBeat, 2/28). The bill also addresses the following: expanding access to testing; removing barriers to diagnosis and ensuring that about 1.5 million rapid tests are available annually; making HIV testing a routine procedure in facilities receiving federal funding and for patients covered by federal health programs, specifically pregnant women and newborns; and ensuring that people who test HIV-positive receive appropriate counseling and care (Kaiser Daily HIV/AIDS Report, 3/9). Some opponents of the current funding formula want to reduce the importance of "eligible metropolitan areas" because of a 2005 Government Accountability Office report that says states without eligible metropolitan areas are underfunded because states with eligible metropolitan areas can "double-count" HIV-positive people, the editorial says. However, according to a new analysis of the CARE Act by the not-for-profit organization Communities Advocating Emergency AIDS Relief, California is underfunded compared with the national average when all funding factors are taken into account, and changing the funding formula would cut at least $20 million in funding for the state, the editorial says. In addition, California has the third highest number of people living with AIDS nationwide, so "[t]he need here has not declined," according to the editorial. To help rural states cover "far-flung" patients without jeopardizing care in California, the "only amendment that's fair to all" is a National Alliance of State and Territorial AIDS Directors proposal to direct the $70 million in CARE funds for AIDS-related drugs authorized by the White House to states without eligible metropolitan areas, the editorial says (San Francisco Chronicle, 4/26).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.