AIDS Bill Advances Despite Complaints

A spending bill that would send more AIDS money to the South passed a House committee Wednesday despite opposition from some big-state lawmakers who said it shortchanged their states.

Representatives from the South and rural states said revisions to the Ryan White CARE Act of 1990 were necessary because of how the epidemic has changed over the years.

Once a big-city illness mainly infecting gay white men, AIDS now is prevalent in the South and among minorities. But, according to government studies, federal support has not kept pace. A patient in California, for example, gets more money than a patient in Alabama, by some estimates.

"It shouldn't matter where you live in the country when it comes to accessing medical care and therapy," said Rep. Joe Barton, R-Texas, chairman of the House Energy and Commerce Committee. "I don't think that's right."

The changes to the $2.1 billion annual program, the largest one specifically for people with HIV/AIDS, passed Barton's committee by a 38-10 vote.

A similar bill passed the Senate Health, Education, Labor and Pensions Committee in May. Prospects for passage before Congress leaves at month's end to campaign in the fall elections are uncertain.

The act funds state and local programs for AIDS drugs and care for the neediest patients. Changes approved to the spending formulas would cost some big states tens of millions of dollars while shifting money to southern and rural areas.

The law now only counts patients with full-blown AIDS to determine spending. The revision also would count patients with the HIV virus who have yet to develop AIDS. That change would favor areas of the country where the disease is a newer phenomenon, which tend to be southern and rural areas.

That change and others are estimated to cost New York more than $75 million, lawmakers said. California's annual amount could drop by some $50 million over the five-year life of the bill, with San Francisco taking a particularly large hit.

Alabama, by contrast, would go from getting about $11 million a year to about $18 million a year.

"This makes no sense whatsoever," said Rep. Eliot Engel, D-N.Y.

"We shouldn't be robbing Peter to pay Paul here, and that's essentially what's happening," said Rep. Frank Pallone, D-N.J.

A proposal aimed at cushioning the blow for states set to lose was defeated narrowly, as was a one-year extension that would have allowed more time to negotiate changes.