H.R. 3792: Ryan White HIV/AIDS Treatment Extension Act

H.R. 3792

Ryan White HIV/AIDS Treatment Extension Act

Sponsor
Rep. Frank Pallone Jr.

Date
October 21, 2009 (111th Congress, 1st Session)

Staff Contact
Communications

Floor Situation

H.R. 3792 is being considered under suspension of the rules, requiring a two-thirds vote for passage. The legislation was introduced by Rep. Frank Pallone (D-NJ) on October 13, 2009.

Bill Summary

H.R. 3792 would extend the Ryan White HIV/AIDS Treatment program for four years, through Fiscal Year 2013. The program was scheduled to expire on September 30, 2009, but was extended for one month in the continuing resolution (P.L. 111-68).

H.R. 3792 includes a five percent overall increase in authorization levels for each of the four years of the program's extension-from $2.32 billion in Fiscal 2009 to $2.95 billion in Fiscal Year 2013. The bill also authorizes 5 percent increases in funding for the Minority AIDS Initiative.

H.R. 3792 extends for three additional years an exemption period for names-based reporting, to provide a transition for the seven States (plus the District of Columbia) that have yet to convert their systems for reporting HIV/AIDS patients from an earlier code-based system to a newer name-based model. The bill modifies the treatment of transitional grant areas for purposes of receiving formula funding under Part A of the Act, and extends "hold harmless" provisions such that an area's formula funding (based on the number of HIV/AIDS cases) could not fall below 95 percent of 2009 levels in Fiscal 2010, 100 percent of the prior year's levels in Fiscal Year 2011 and 2012, and 92.5 percent of Fiscal Year 2012 levels in Fiscal Year 2013. The bill requires States and localities to obligate 98 percent of their formula funds, up from 95 percent, but exempts balances approved for carryover by the Health Services and Resources Administration (HRSA).

The bill includes provisions regarding additional outreach to individuals unaware of their HIV/AIDS status, clarifies that Part D funds under the program should be used as a payer of last resort when other treatment funding sources are available (including coverage under Medicare, Medicaid, and SCHIP), and sets a goal of 5 million HIV/AIDS tests administered annually through federal programs.

Finally, H.R. 3792 requires the development of a list of potentially infectious diseases to which emergency responders may be exposed, and notification of every instance in which such responders may have been exposed to such infectious diseases. The bill permits the Secretary to seek injunctive relief for violations of this provision, but does not authorize rights of action for damages or other civil penalties for failure to comply.

Background

Originally enacted in 1990, the Ryan White HIV/AIDS program funds grants to States and localities and support services for individuals with immune deficiencies.  The overall program, authorized under Title XXVI of the Public Health Service Act, consists of several parts: Part A provides grants to urban areas, Part B funds grants to States, including AIDS Drug Assistance Programs (ADAPs), Part C provides early intervention services to clinics and other public health providers, Part D authorizes general grants, and Part F includes demonstration and other projects, including the AIDS Dental Reimbursement program and the Minority AIDS Initiative.  According to the Congressional Research Service, the program serves half a million low-income individuals with HIV/AIDS, one third of whom lack health insurance, and has grown from $257 million in federal appropriations in Fiscal Year 1991 to $2.2 billion in the Fiscal Year ended September 30.

Cost

A formal Congressional Budget Office was not available ; however, the plain text of the bill indicates that authorization levels would increase by 5 percent per year through 2013, for a total of nearly $11 billion over the four year period.