Health Resources & Services Administration
1990
CARE Act Passes Both Houses by Wide Margins
On August 18, 1990, by wide bipartisan margins, both houses of Congress passed the groundbreaking Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, named for an Indiana teen who lost his life to AIDS. By the time the bill became law, more than 150,000 U.S. AIDS cases had been reported in the United States. More than 100,000 had died.*
At the time, the CARE Act was—and remains today—unique among the Nation’s health care programs.
- The CARE Act is one of only a few disease-specific health programs in the country.
- The 1990 legislation required that people living with HIV/AIDS (PLWHA) be involved in implementing the Title I (Part A) Program for Eligible Metropolitan Areas, the largest CARE Act program at the time. Consumers were also involved in implementing the Title II (Part B) program for States and Territories.
- The CARE Act of 1990 identified a set of services that could be offered to people living with HIV/AIDS using CARE Act funds. However, grantees—particularly those funded through Titles I and II—were given significant latitude to determine which services would be funded in their jurisdictions.
- Through the Title III (Part C) Early Intervention Services Program, awards would be made to clinics and other health care providers with the capacity to reach underserved and disenfranchised populations.
- The Title IV (Part D) program for Women, Infants, Children, Youth, and Their Families was one of many ways in which the CARE Act reflected that specific populations affected by HIV/AIDS have unique needs.
The CARE Act is a discretionary budget program and, unlike Medicaid and Medicare, not an entitlement. The availability of funds is contingent on the Federal budget. The CARE Act intent is that funds be used to serve PLWHA who are low income, are un- or underinsured, or otherwise lack the resources to access services on their own. Thus, the CARE Act was, and still is, the payer of last resort; funds could not be used to supplant other resources.
When enacted in 1990, the CARE Act was adopted for a 5-year period. It was reauthorized in 1996 and again in 2000. In 2006, it was renamed the Ryan White HIV/AIDS Treatment Modernization Act of 2006. In 2009, it became the Ryan White HIV/AIDS Treatment Extension Act of 2009.
Ryan White was an Indiana teenager with hemophilia who contracted AIDS through a blood transfusion. He courageously fought AIDS-related discrimination and helped educate the Nation about his disease. Ryan White died on April 8, 1990, at the age of 18, just a few months before Congress passed the AIDS bill that bears his name.