By Ann Lefert, National Alliance of State and Territorial AIDS Directors and Bill McColl, AIDS United, Co-Chairs of the Ryan White Work Group, Federal AIDS Policy Partnership
As Co-Chairs of the Ryan White Work Group, we wanted to provide you with an update on the Ryan White Program. As you know, the current authorization ends on September 30, 2013. However, there is no “sunset” provision in the legislation. Therefore even if Congress does not take action, the Ryan White Program will remain a part of the law allowing funding to continue to be appropriated through the annual congressional appropriations process.
This summer, the Ryan White Work Group conducted many Congressional visits to discuss the future of the Ryan White Program. Overwhelmingly, the bipartisan response from Congressional offices has been that reauthorization should wait until the Affordable Care Act (ACA) is implemented and additional details are known about its impacts on individuals living with HIV/AIDS. Both Republican and Democratic offices have stated that the austerity of the current budget environment could mean massive cuts to Ryan White Program funding authorization levels if the Ryan White Program was reauthorized this year. Many programs currently being reauthorized by Congress have received funding levels far below their previously authorized levels. The vast majority of offices state that the Ryan White Program has bipartisan support for continuation even after implementation of the ACA. Many offices also understood that the results of implementation of the ACA would vary around the country depending on Medicaid expansion and other variables.
Although the general consensus of the Ryan White Working Group has been that delaying reauthorization is the optimal choice, other members of the HIV community have been advocating for a reauthorization this year. This has created some confusion on Capitol Hill and within the HIV community. To be clear, we all believe that the Ryan White Program must be continued and in the importance of ensuring access to care for people living with HIV. The Ryan White Work Group believes that the HIV community must first work to ensure continued, adequate funding for the Ryan White Program. We must also fight against sequestration and further budget cuts.
The HIV community also needs to strongly focus on successfully accomplishing implementation of the ACA and the integration of the Ryan White Program into the new health system. The Ryan White Program must be used to dramatically improve both treatment and potential prevention outcomes in communities where people living with HIV/AIDS are not receiving the health benefits of being in care, on treatment and virally suppressed. A valued quality of the Ryan White Program is its responsiveness to the unique needs of individual jurisdictions. This flexibility is essential as communities use the Ryan White Program in conjunction with other resources to increase access to the expanding number of people diagnosed with HIV in need of treatment, care and supportive services.
The Ryan White Work Group continues to work closely with the Administration, Congress and community advocates. We will certainly seek to reauthorize when there is stronger political agreement that it can be accomplished in a constructive manner without the threat of lower authorization levels and when the impact of the ACA is better understood. In the meantime, the Ryan White Work Groups seeks to ensure that the Ryan White Program continues and that the comprehensive services provided to clients today continue to be available as the Ryan White Program is integrated into the coverage offered through the Affordable Care Act.