PI Action alerts & updates ... 2000

Ryan White CARE Act Reauthorization in Final Stage

Urge your Representatives to Support Passage
Without Incentives for Mandatory Testing

Congress has moved quickly on reauthorizing the Ryan White CARE Act, which provides health care, treatment, and support services for people living with HIV/AIDS. The CARE Act is due to expire on September 30, 2000. In early June, the Senate voted unanimously in favor of S. 2311, authored by Senators Kennedy (D-MA) and Jeffords (R-VT). This bill would reauthorize (or renew) the CARE Act for another five years. Thanks to the efforts of many advocates, including the Treatment Action Network, by the time the Senate voted for this bill, there were 50 Senate cosponsors.

Shortly after the Senate approved the bill, the House of Representatives introduced its own version (H.R. 4807), authored by Representatives Coburn (R-OK) and Waxman (D-CA). The bill contains some significant differences from the Senate version. H.R. 4807 passed the House of Representatives unanimously on July 25, with over 250 cosponsors.

Because there are differences between the two bills, a joint House/Senate conference committee will meet in September to negotiate a final bill. After that, the entire House and Senate will vote again on the final product and send it to the President.

As mentioned in the previous TAN update, among the differences between the two bills is language in the House version regarding HIV testing of pregnant women and newborns. Currently, the CARE Act allows $10 million to be distributed to states for programs intended to reduce perinatal transmission of HIV. These programs could include voluntary testing, counseling, outreach, and treatment services for pregnant women with HIV, and to help pay for mandatory newborn testing programs.

The House proposal would add another $20 million for this purpose. However, of that $20 million, a gradually increasing proportion must be set aside for states that have either mandatory testing requirements for all newborns or for newborns whose mother’s HIV status is unknown. Currently, only New York and Connecticut have such laws. This set-aside starts at 25% in the first year of the bill and rises to 75% by the fourth year. In other words, while the legislation does not require states to adopt mandatory testing programs, it provides significant financial incentives for them to do so.

Project Inform opposes mandatory HIV testing of any individual. We strongly support voluntary HIV testing with appropriate counseling and we support funding for non-coercive programs that improve the care and treatment of HIV positive pregnant women and that reduce perinatal transmission. There is no evidence that mandatory testing will help achieve these goals. Instead, it could discourage pregnant women from accessing the healthcare system. The current emphasis on voluntary testing and treatment has already helped dramatically reduce perinatal HIV transmission in recent years.

Your voice is needed to ensure that Congress reauthorizes this lifesaving program this year and to remove the provision that offers financial incentives for states to adopt mandatory testing programs.

Action needed for this Alert:
Congress is on recess for the month of August, so now is a good time to write their offices.

Please write/email your U.S. Representative and two U.S. Senators before August 31. Urge them to support reauthorization of the Ryan White CARE Act, but to oppose financial incentives for states to adopt mandatory newborn testing policies. Letters are much more powerful than phone calls and there is sufficient time during the August recess to write your elected officials.

Ask them to convey their message to members of the conference committee dealing with Ryan White CARE Act reauthorization. (Note: conference committee members have not been determined yet, however likely members include Senators Kennedy and Jeffords and Representatives Coburn and Waxman).

Please spread the word to your friends, family colleagues, etc., and ask them to contact their elected officials also!

Sample letter / email

The Honorable ___________________
U.S. Senate/U.S. House of Representatives
Washington, DC 20510 (for Senate) or 20515 (for House)

Dear Senator/Representative ______________

I am writing to urge you to support reauthorization of the Ryan White CARE Act, which will be discussed in conference committee in September. However, I urge you to oppose language in the House version of the bill (H.R.4807), which provides financial incentives for states to adopt mandatory newborn testing policies. The CARE Act provides health care, treatment, and support services for tens of thousands of individuals living with HIV/AIDS nationwide.

Insert personal statement here. If you or someone you care about uses Ryan White CARE Act services—this includes the AIDS Drug Assistance Program—mention that here.

While I strongly support reauthorization of this program, I oppose language in the House version of the bill that provides financial incentives for states with mandatory newborn testing programs. I strongly support funding for non-coercive programs that improve the care and treatment of HIV positive pregnant women and that reduce perinatal transmission. There is no evidence that mandatory testing will help achieve these goals. Instead, it could discourage pregnant women from accessing the healthcare system.

Again, I urge you to do everything in your power to make sure the Ryan White CARE Act is reauthorized this year without incentives for mandatory testing policies. Please convey that message to members of the conference committee discussing this legislation.

Thank you for your consideration.

Sincerely,
Your Name

You can reach your Senators through the Capitol Switchboard at 202-224-3121. Another good resource for contacting your elected officials is www.capweb.net.