Ryan White Care Act

  The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act (Ryan White Care Act, Ryan White, Pub.L. 101-381, 104 Stat. 576, enacted 1990-08-18) was an Act of the U.S. Congress passed in honor of Ryan White, an Indiana teenager who contracted AIDS through a tainted hemophilia treatment in 1984, and was expelled from school because of the disease. White became a well-known advocate for AIDS research and awareness, until his death on April 8, 1990.^[1]

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The act is the United States's largest federally funded program for people living with HIV/AIDS. The act sought funding to improve availability of care for low-income, uninsured and under-insured victims of AIDS and their families.^[2]

Unlike Medicare or Medicaid, Ryan White programs are "payer of last resort," which fund treatment when no other resources are available. As AIDS has spread, the funding of the program has increased. In 1991, the first year funds were appropriated, around $220 million were spent; by the early 2000s, this number had almost increased 10-fold. The Ryan White Care Act was reauthorized in 1996, 2000 and 2006. The program provides some level of care for around 500,000 people a year and, in 2004, provided funds to 2,567 organizations. The Ryan White programs also fund local and State primary medical care providers, support services, healthcare provider training programs, and provide technical assistance to such organizations.^[2]

In fiscal year 2005, federal funding for the Ryan White Care Act was $2.1 billion. As of 2005, roughly one third of this money went to the AIDS Drug Assistance Program (ADAP). The primary activity of ADAP is providing FDA-approved prescription medication.^[3]

2006 Reauthorization

The Ryan White Care Act was due to be reauthorized at the end of 2005, but congress could not reach agreement on changes, and the act was extended for one year under the old terms.^[4] In 2006, the act was reauthorized for three more years, ending on September 30, 2009 with a funding level of $2.1 billion.^[5]

Prior to the reauthorization, the act allocated money based on the proportion of patients with full-blown AIDS in each region. The 2006 reauthorization changed this allocation mechanism to also consider the number of people with HIV infection.^[5] A significant portion of funding from the act is emergency relief for Eligible Metropolitan Areas. The 2006 reauthorization redefined EMAs as cities with a population greater than 50,000, instead of previous versions which required 500,000.^[4]

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