Ryan White Aids Care Act

RYAN WHITE AIDS CARE ACT -- (House of Representatives - September 28, 2005)

The SPEAKER pro tempore (Mr. Inglis of South Carolina). Under a previous order of the House, the gentlewoman from California (Ms. Waters) is recognized for 5 minutes.

Ms. WATERS. Mr. Speaker, I would like to thank the gentlewoman from the Virgin Islands (Mrs. Christensen) for organizing this series of Special Orders on the reauthorization of the Ryan White CARE Act.

The Ryan White CARE Act is essential for millions of Americans who are living with the AIDS virus and millions more who are at risk of becoming infected in the future.

The Ryan White CARE Act was passed into law in 1990, 10 years after the beginning of the HIV/AIDS epidemic, to provide a comprehensive approach to AIDS prevention, treatment, patient care and community support for people affected by this dreadful disease.

The Ryan White CARE Act provides funding for a variety of programs, including drug assistance, capacity building and planning grants, services for infected people and their families, funding for AIDS Education and Training Centers, and grants to metropolitan areas like Los Angeles that are severely affected by HIV/AIDS.

The Ryan White CARE authorization expires this Saturday, on October 1, 2005. If it is not reauthorized, it will remain in its current form until legislation is approved. The Ryan White CARE Act needs to be updated to address the needs of communities affected by HIV/AIDS today. The people affected by HIV/AIDS have changed tremendously over the course of the epidemic, and HIV/AIDS programs must adapt and change as well.

When the HIV/AIDS epidemic first began in 1980, most Americans with AIDS were white. Today, over 70 percent of new AIDS cases in the United States are people of color. Blacks account for about half of new AIDS cases, and Hispanics account for 20 percent of new AIDS cases. Racial minorities now represent a majority of new AIDS cases, and a majority of Americans living with AIDS, and a majority of deaths among persons with AIDS.

The Ryan White CARE Act is critical for minorities who often lack access to traditional health care and support services. About half of all Ryan White CARE Act clients are black, and that proportion is much higher in some care settings.

Title IV of the Act is especially important for racial minorities. Title IV provides medical care, case management, child care, transportation, and other support services for families affected by HIV and AIDS. Over 80 percent of the clients at clinics funded by Title IV of the Act are minorities.

The Ryan White CARE Act is severely underfunded. In the current fiscal year, the Ryan White CARE Act received a total of just over $2 billion for all programs nationwide. However, it has been estimated that Ryan White CARE programs should receive at least $3 billion in order to address adequately the needs of people affected by or at risk of HIV/AIDS.

In July of this year, the Bush administration released its principles for the reauthorization of the Ryan White CARE Act. Unfortunately, these principles are pitting the most affected communities against one another.

One of the principles is a prioritization of core medical services. This principle could eliminate many of the support services provided under title IV, such as case management, child care, and transportation, which make medical care accessible to people in need. For most title IV clients, medical care is covered through Medicaid, not title IV; but support services provided under title IV are essential to make medical services accessible.

Reducing HIV/AIDS support services in order to prioritize HIV medical services is no way to address the needs of people with HIV/AIDS. I urge my colleagues to reauthorize the Ryan White CARE Act in a manner that will ensure that HIV/AIDS programs will indeed address the needs of all communities in the United States that are affected by the HIV/AIDS epidemic, and I urge my colleagues to make certain that the Ryan White CARE Act programs will be fully funded in future years.

Mr. Speaker, I mentioned the disproportionate number of African Americans and Hispanics that are now HIV/AIDS positive. I would like to share with you what we have attempted to do to address those very special populations.

In 1998, while I was the Chair of the Congressional Black Caucus, I spearheaded the development of the Minority AIDS Initiative, which provides grants to health care providers for HIV/AIDS treatment and prevention programs serving minority communities. The Minority AIDS Initiative enables health care providers to expand their capacity to deliver culturally and linguistically appropriate care and services.

Mr. Speaker, we will not get the increases we need, so we need to pay attention not only to this reauthorization but to the very special needs of those who have suffered the most.

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