Table 1.

Five standards of distributional equity in the Ryan White HIV/AIDS Program.

Equity Standard	Description	Origin	Measurement	Data Sources
Higher AIDS Incidence	Additional funds to states representing the “leading edge” of the epidemic	Case counting methodology discussed extensively during 1996, 2000, and 2006 reauthorizations	Annual AIDS incidence, log-transformed	Centers for Disease Control and Prevention (1997-2004)
Disproportionate Prevalence of Lower SES Populations	Additional funds to states with larger minority populations and higher poverty rates	GAO analysis of whether these populations receive services in proportion to their representation; targeting these populations discussed during 2000 and 2006 reauthorizations	Proportion of states' cumulative AIDS cases (through 2005) that were 1) black and 2) Hispanic; proportion of states' residents living in poverty	Henry J. Kaiser Family Foundation (2005); U.S. Census Bureau (2000)
Weaker Program Benefits	Additional funds to states with less generous program benefits through their AIDS Drug Assistance Programs (ADAP)	National ADAP Monitoring Project annual reports (1997-2006); GAO report on wide interstate disparities in ADAPs (2006)	ADAP income eligibility ceiling (as percent of federal poverty level); number of drugs to treat and prevent opportunistic infections (OI) on state formulary, divided by total OI drugs available; presence of at least one cost containment measure that restricts program availability	National ADAP Monitoring Project (1997-2006); Federal Register
Differential Healthcare Costs	“Degree to which federal funds enable each [locality] to purchase a comparable level of services for its HIV population”	GAO analysis of “beneficiary equity” prior to 1996 reauthorization	Medicare Geographic Practice Cost Index (physician work component), aggregated from county to state level	Green Book (1997-2000); American College of Cardiology (2001-2002); Center for Medicaid and Medicare Services (2003-2006); U.S. Census (1997-2006)
Compensation for Unequal Tax Base	“Degree to which [localities] are able to supplement federal funds to finance a comparable level of services with comparable burdens on their taxpayers”	GAO analysis of “taxpayer equity” prior to 1996 reauthorization	Medicare Geographic Practice Cost Index; U.S. Treasury measure of Total Taxable Resources (log-transformed)	U.S. Treasury (1997-2005)