Reauthorization of Ryan White CARE Act Entangled With Unrelated NIH Measure
CQ TODAY – HEALTH
December 6, 2006
CQ TODAY – HEALTH
Dec. 6, 2006 – Updated 9:23 p.m.
Reauthorization of Ryan White CARE Act Entangled With Unrelated NIH Measure
By Alex Wayne, CQ Staff
Passage of a bill renewing federal AIDS programs for low-income patients may have become entwined Wednesday with the fate of a bill that would overhaul the National Institutes of Health.
After months of negotiation, the Senate amended and passed a bill Wednesday (HR 6143) to reauthorize the Ryan White CARE Act (PL 101-381), a 1990 law that governs about $2 billion in federal assistance for AIDS drugs and services — a key legislative goal of AIDS activists and state AIDS programs.
House leaders, however, were noncommittal about clearing the legislation by week’s end.
Barton’s Dissatisfaction
The reason: House Energy and Commerce Chairman Joe L. Barton, R-Texas, who helped write the House version of the AIDS bill, is unhappy both with the Senate’s amendment of the bill and with the Senate’s refusal, to date, to pass separate legislation he wrote that would restructure the NIH (HR 6164).
Michael B. Enzi, R-Wyo., chairman of the Senate Health, Education, Labor and Pensions Committee, “hotlined” the NIH bill late Wednesday, meaning that he relinquished his panel’s jurisdiction on the legislation and designated it as a bill that Senate leaders could attempt to pass quickly.
“We are attempting to pass it,” said Craig Orfield, a spokesman for Enzi. But objection from even one senator would prevent the bill from passing, leaving its fate very much in doubt. It was not among the bills that the Senate passed Wednesday night by voice votes.
Barton has called the NIH overhaul bill the “signature achievement” of his committee in this Congress. Notably, it would create a new “common fund” to finance research that cuts across multiple NIH research centers. It would cap the number of institutes at the current 27 and give the NIH director greater authority to reorganize them.
In an interview, Barton said that the Senate amendments to the Ryan White bill are “not as good as the House-passed bill. My preference would be to have the House-passed bill.”
Asked whether he might vote against the Senate version, he said, “I could certainly do that,” and then said he first wanted to see what the Senate did with the NIH bill.
“I want there to be a Ryan White reauthorization,” he said Wednesday evening. Senators, he said, “did the right thing” in passing the Ryan White bill, “and I’m going to try to accommodate them.”
But, he said, it would be “much easier” for him to support the Ryan White bill if the Senate first passed the NIH bill.
The Senate passed the Ryan White bill by voice vote Wednesday morning, after senators from New York and New Jersey agreed to a compromise version of the legislation and dropped procedural obstacles they had used to stall the bill.
The New York and New Jersey lawmakers were concerned because the House-passed version of the bill would have redirected money from AIDS programs in their states to other states with growing populations of patients with HIV, the virus that causes AIDS.
Changes in Language
The compromise, which the Senate adopted as an amendment to the House-passed bill, made several key changes. Most notably, it reduced the bill from a five-year reauthorization to three. That lopped off the last two years of the renewal, when New York and New Jersey were scheduled to suffer their steepest financial losses under the House version.
The compromise also explicitly repeals the Ryan White law after three years — forcing Congress to more substantively address the way the law distributes grants to states and cities, which emerged as a major point of conflict this year.
And the compromise ensures that no state’s funding under the law will be reduced to less than 95 percent of what it received in fiscal 2006.
