The executive director of the National Association for People With AIDS (NAPWA), Frank Oldham, stood in a crowded room on Capitol Hill Monday afternoon, responding to what he and other groups consider a potential HIV disaster: the latest draft of the Ryan White Care Act. The crucial bill, which provides most federally funded AIDS services, expired on September 30, 2005. After haggling for two years, a bipartisan congressional committee finally issued a compromised draft late last week. Oldham says the draft has many good qualities but told the committee, “There are critical improvements in both funding formularies and policy components that must be made prior to passage of this legislation.”

Representing an ad hoc coalition of AIDS groups, including the National Minority AIDS Council, AIDS Action Council and the Southern AIDS Coalition, Oldham went on to assert that because the AIDS community was not sufficiently consulted during the drafting of the legislation, people with HIV will not receive adequate services. The coalition’s largest concern involves the CDC’s controversial new requirement that all HIV cases be reported by name instead of an anonymous code.

Advocates fear that the transition to names-based reporting could cause the underreporting of HIV cases in some hard- hit areas, thereby lowering commensurate funding and redistributing the limited money to other areas. For instance, advocates estimate that New York City stands to lose $78 million. “In this reauthorization, there should be no winners and losers,” he told POZ. “We need to make sure it is the best possible act to provide services for the one million HIV positive Americans.” Oldham’s solution? Give the CARE Act more money—now. “Right now, it’s like trying to pay ten bills but you only have the money for three,” Oldham says. “We are asking the committee to examine the bill’s weaknesses. I hope they will see that the only way to address them is to get more funds. Otherwise, people will get sick and die.”

David Munar, who sits on NAPWA’s board and heads up the AIDS Foundation of Chicago, agrees that the bill is flawed but disagrees that the draft should be sent back to committe. “This bill is a compromise, and we can work with it,” he says. “It’s far from perfect, but it has a lot of strengths, and I don’t know that dragging it on will get a better bill.”

Munar, too, thinks the real issue is money, adding that the act is woefully underfunded and can barely provide care for those currently infected, much less the tens of thousands that will likely be diagnosed each year. “I think our interests would be better served by getting it passed and putting all our energy on getting a funding increase in 2007,” he says.

The committee, which includes senators Kennedy (D-Mass.) and Enzi (R-Wyo.) and representatives Barton (R-Texas) and Dingell (D-Mich.), will review the suggestions and hopes to get a bill onto the floor for a vote by September 30, 2006. POZ contacted the offices of senators Kennedy and Enzi, but they did not respond by press time. Is there a doctor in the House?