The House on Thursday voted 325-98 to approve a bill (HR 6143) that would reauthorize the Ryan White CARE Act for the next five years, CQ Today reports. The bill -- which is sponsored by Rep. Mary Bono (R-Calif.) -- would authorize funding increases of 3.7% annually from 2008 through 2011, according to CQ Today. The government will allocate about $2 billion for CARE Act programs in fiscal year 2006, CQ Today reports. The bill would change CARE Act funding formulas so that rural areas experiencing increasing numbers of HIV/AIDS cases receive increased funding amounts, which would decrease funding allocated to urban areas, according to CQ Today. Bono's bill also would require that 75% of CARE Act funds be used for "core medical services," while remaining funds would be allocated for care-related services (Wayne, CQ Today, 9/28). The Senate Committee on Health, Education, Labor and Pensions and the House Committee on Energy and Commerce earlier this year voted to approve similar versions of legislation that would reauthorize the CARE Act and change how the grant money is distributed to provide funds to areas with increasing numbers of HIV-positive people. Some legislators from states with large urban areas -- including California, New Jersey and New York -- have opposed the bills, saying they could harm HIV/AIDS programs in areas with higher HIV prevalence (Kaiser Daily HIV/AIDS Report, 9/27). Some Democrats from New York state and New Jersey spoke in opposition to the bill the House approved on Thursday. "There's no question other states have mounting epidemics and absolutely are entitled to increased Ryan White funding," Rep. Eliot Engel (D-N.Y.) said, adding, "A good bill would make sure there was adequate funds to meet every state's needs." House Minority Leader Nancy Pelosi (D-Calif.) opposed the bill, saying in a statement that it has a "number of good provisions" but does not fully "mee[t] the needs of people living with AIDS" (CQ Today, 9/28). Rep. Joe Barton (R-Texas), chair of the House Committee on Energy and Commerce, said, "The HIV/AIDS epidemic is moving. This is a very fair compromise. [The bill] begins to treat all states on an equal footing" (Werner, AP/Pioneer Times-Journal, 9/28). He added that some states could lose funding under Bush administration budget plans for FY 2007 if Congress does not reauthorize the CARE Act before it recesses next week.

Senate Outlook
According to CQ Today, Bono's measure faces "uncertain prospects" in the Senate before lawmakers recess next week because several senators from urban areas are threatening to block passage of the bill (CQ Today, 9/28). Sen. Mark Dayton (D-Minn.) on Thursday objected to a motion from Sen. Mike Enzi (R-Wyo.), chair of the Senate HELP committee, to immediately consider the measure. Enzi said he would call for a procedural vote -- which requires 60 votes to pass -- to block any senator's hold on consideration of the measure if the bill is not passed before the recess (AP/Pioneer Times-Journal, 9/28). Advocates in Ohio, Iowa and South Carolina recently have attempted to persuade Sen. Hillary Rodham Clinton (D-N.Y.) to support revisions to the CARE Act that allocate more federal HIV/AIDS funding to Southern and rural states, The Hill reports (Bolton, The Hill, 9/28). Rodham Clinton has said states with urban centers are most affected by HIV/AIDS and should not have their funding reduced. She is co-sponsoring legislation introduced on Tuesday by Sen. Frank Lautenberg (D-N.J.) that would extend for one year the current CARE Act funding formula (Kaiser Daily HIV/AIDS Report, 9/27). According to The Hill, Rodham Clinton "has the highest profile" of any opponent to CARE Act funding revisions, and those who support CARE Act revisions might be "calculating that they have the most leverage with her" because she is "expected to run for president" in 2008 (The Hill, 9/28).

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