The Ryan White CARE Act

Ryan White, an Indiana teenager, contracted AIDS through contaminated blood products used to treat his hemophilia. On 27 August 1985 he was refused entry to his middle school. His family's long legal fight for his right to attend drew national attention, and he began speaking publicly for AIDS education. In March 1988 he testified before the President's Commission on AIDS about the stigma he had faced. He died of an AIDS-related illness on 8 April 1990, at the age of 18.

Four months later, on 18 August 1990, the Ryan White Comprehensive AIDS Resources Emergency Act became law. Its stated purpose was emergency help for localities hit hardest by HIV and money for states and nonprofit groups to organize care for individuals and families with HIV disease. The first year brought $220.5 million in federal funds.

Title I gave emergency relief grants to metropolitan areas with more than 2,000 reported AIDS cases, or with a cumulative incidence of at least 0.0025, and required each to set up an HIV health services planning council to set priorities. Title II gave states grants to run HIV care consortia, pay for home and community-based care, keep people's health insurance going and provide treatments shown to prolong life or prevent serious deterioration. Title III paid for outpatient early intervention: counseling, testing, referral and treatment. Grant money could not pay for any service that an insurance policy or a federal or state health program had paid for or could be expected to pay for.

The Health Resources and Services Administration runs the program. Congress has updated the law four times, including reauthorizations in 1996, 2000 and 2006. By 2018 more than half of people with diagnosed HIV in the United States received its services. In 2024 it served nearly 602,000 clients, and 91.4 percent of those receiving HIV medical care through it had a suppressed viral load.