Ryan White CARE Act

Ryan White Comprehensive AIDS Resources Emergency Act of 1990

Long title	An Act to amend the Public Health Service Act to provide grants to improve the quality and availability of care for individuals and families affected by HIV, and for other purposes.
Nicknames	AIDS Prevention Act of 1990 Ryan White Care Act
Enacted by	the 101st United States Congress
Effective	August 18, 1990
Citations
Public law	101-381
Statutes at Large	104 Stat. 576
Codification
Titles amended	42 U.S.C.: Public Health and Social Welfare
U.S.C. sections created	42 U.S.C. ch. 6A, subch. XXIV § 300ff et seq.
U.S.C. sections amended	42 U.S.C. ch. 6A, subch. XXIII § 300ee et seq.
Legislative history
Introduced in the Senate as S. 2240 by Ted Kennedy (D–MA) on March 6, 1990 Committee consideration by Senate Labor and Human Resources Passed the Senate on May 16, 1990 (95-4) Passed the House on June 13, 1990 (passed voice vote) Reported by the joint conference committee on July 31, 1990; agreed to by the House on August 4, 1990 (passed voice vote) and by the Senate on August 4, 1990 (passed voice vote) Signed into law by President George H. W. Bush on August 18, 1990

The Ryan White Comprehensive AIDS Resources Emergency Act (Ryan White CARE Act, Pub. L.Tooltip Public Law (United States) 101–381, 104 Stat. 576, enacted August 18, 1990) was an act of the United States Congress and is the largest federally funded program in the United States for people living with HIV/AIDS. In exchange for States adopting harsh criminal laws regulating the conduct of HIV-positive individuals and providing for their public felony prosecution,^[1] the act made federal funding available through contingency grants to states for low-income, uninsured, and under-insured people to be treated with the chemotherapeutic drug AZT.^[2] The act is named in honor of Ryan White, an Indiana teenager who contracted HIV through a tainted blood transfusion. He was diagnosed with AIDS in 1984 at age 13 and was subsequently expelled from school because of the disease. White became a well-known advocate for AIDS research and awareness until his death in 1990 at age 18.^[3]

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 US$220 million were spent; by the early 2000s, this number had almost increased 10-fold. The Act was reauthorized in 1996, 2000, 2006, and 2009. 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 Programs (ADAP) which provides drugs for 30 percent of people living with HIV.^[4] The primary activity of ADAP is providing FDA-approved prescription medication.^[5] The Ryan White CARE Act mandates that EMS personnel can find out whether they were exposed to life-threatening diseases while providing care. (This notification provision was included in the original 1990 act, dropped in the 2006 reauthorization, and reinstated in the 2008 reauthorization).^[6]

By one estimate, the Ryan White CARE Act saved the lives of 57,000 people through 2018. The cost of each avoided HIV/AIDS death was $334,000.^[7]