Objections from a handful of Democratic senators stalled reauthorization of the Ryan White CARE Act when the latest version of the legislation was brought to the floor for immediate action late in the day on Sept. 26.

Mike Enzi, R-Wyo., chair of the Health, Education, Labor and Pensions Committee, tried to move the bill, which had been developed through an arduous series of bipartisan, bicameral meetings between congressional staffers and AIDS advocates.

Sen. Mark Dayton, D-Minnesota, objected on behalf of Democratic senators opposed to the legislation because their states would lose funding. That group includes New York Senators Hillary Clinton and Chuck Schumer, California’s Dianne Feinstein and Barbara Boxer, and Bob Menendez and Frank Lautenberg from New Jersey. They have proposed extending the current funding formula for one year while negotiations continue.

“I’m sorry to hear the objection,” Enzi responded. “If they truly have the HIV numbers, they will get the money. If they don’t have the HIV numbers, yes, they will lose the money.”

The opposition was undercut by Sen. Ted Kennedy, the ranking Democratic member of the committee, who has played a leading role in crafting the legislation. In a statement released later that evening, Kennedy said, “There are few more urgent responsibilities for Congress this week than to pass this bipartisan legislation.”

“Senator Clinton and her five Democratic colleagues should stop playing politics with this life-saving program,” said Log Cabin Republican executive vice president Patrick Sammon. “Failure to pass this law by Oct. 1 will have a devastating impact on tens of thousands of people with HIV/AIDS.”

Enzi and Kennedy are considering other options to getting Ryan White passed. The most likely one is attaching it as an amendment to another piece of legislation, perhaps the spending bill for the Department of Defense.

Last week, the House Energy and Commerce Committee resolved some of the contentious issues in Ryan White, which passed 38 to 10 on Sept. 20.

Some AIDS advocacy organizations support the bill that emerged. The AIDS Foundation of Chicago’s David Munar called it a “vast improvement over the proposal submitted last year by the Bush administration.” He singled out modifications to how coded data of HIV cases are counted toward the distribution of funds as a significant change. He also saw insufficient funds as the root of most of the problems and called for increased spending.

Other advocates remain unhappy, primarily because their jurisdictions are likely to see reduced funding. Hardest hit would be San Francisco, which receives about $28 million each year under the current Ryan White structure. If the new language becomes law, the city would face immediate cuts, but the big hit – an estimated $10.4 million cut – would come in four years, according to Ernest Hopkins, a lobbyist for the San Francisco AIDS Foundation.

New York will lose $17.8 million in Title I funding in the first years and $78 million over four years in Title II funding, according to estimates by the New York City Department of Health and Mental Hygiene.

Clinton’s opposition is longstanding; she was the only senator to vote against the measure in committee. On Sept. 22, Feinstein and Boxer joined her in opposition.

“California HIV/AIDS projects take a big financial hit under the current version of the Ryan White reauthorization bill. Without the opportunity to offer amendments, there is a serious risk that established programs in San Francisco and across the state will be unable to preserve the quality of care they provide to HIV/AIDS patients,” Feinstein said.

“If the Bush administration would put adequate resources into the fight against HIV/AIDS, we wouldn’t be having this argument about a formula.” Boxer added. “It’s unacceptable that California, and therefore our HIV/AIDS patients, will suffer if we don’t go along with every detail of this bill.”

However, Boxer’s comments ignored two very salient points. The first is that the formula she criticized is the product of bipartisan congressional negotiations led by Sen. Ted Kennedy, D-Mass. The second is that the proposed White House HIV/AIDS budget, under both Bush and Bill Clinton, traditionally have been low and they have been increased by Congress, but congressional increases have been minimal in recent years.

Carl Schmid, a lobbyist with the AIDS Institute who has experience with earlier reauthorizations of Ryan White, said it always comes down to last-minute fighting for the best deal for one’s constituents. However, he is convinced Congress will meet the deadline for reauthorizing Ryan White, though he is not sure of the exact path it will take to accomplish that.