WASHINGTON — With strong bipartisan support, the House on Friday overwhelmingly approved landmark legislation providing $1.2 billion over the next three years for AIDS testing, counseling and research programs.
The bill, which was approved 367 to 13, establishes strict guidelines guaranteeing the confidentiality of AIDS test results and, for the first time, lays out a national policy for responding to the deadly disease.
Sponsors said the House bill will now be sent to a conference committee with Senate members, who already have approved their own, less expansive AIDS legislation. A final version will be sent within two weeks to President Reagan.
Common Sense, Judgment
"The large margin of passage shows that the House believes common sense and good medical judgment is the right course for our nation in dealing with this epidemic," said Rep. Henry A. Waxman (D-Los Angeles), who helped develop the legislation.
"By protecting confidentiality, we've created a real incentive for people to come forward, to be tested and to learn how to stop the spread of the disease. There's nothing to be gained by frightening people away."
But critics said the bill went too far in protecting the rights of acquired immune deficiency syndrome patients. Given the danger of the epidemic, the government should be collecting as much information as possible about the people who contract the disease, including their addresses, said Rep. William E. Dannemeyer (R-Fullerton).
Before the final vote, the House soundly defeated an amendment backed by Dannemeyer and Rep. Bill McCollum (R-Fla.) requiring doctors to make "every reasonable effort" to notify the spouses of people who test positive for the AIDS virus.
"I can't imagine anything more important than this in the context of fighting AIDS," McCollum said. "It's basic, common sense. We need spousal notification, to protect families and keep the disease from spreading."
Waxman said doctors should make such decisions on their own, without interference from Congress. Forcing physicians to make such notifications could expose them to unforeseen liabilities and would "go completely against the grain of this bill," he said.
Under the measure, Congress would provide $400 million in each of the next three years to states and community health programs for AIDS testing and counseling programs, subject to several conditions. To receive funds, states would have to institute testing for all people arrested for prostitution, sexual assault or intravenous drug abuse.
The bill would require community programs conducting AIDS tests to report the results--but not the names and addresses of people testing positive--to state health officials. States would also have to establish civil and criminal penalties for people who knowingly or intentionally transmit the AIDS virus to other people.
The main focus of the legislation, however, would be on treatment, testing and counseling. In a key amendment by Waxman, the House urged federal health officials to speed up testing of new drugs that might help combat AIDS.
The Senate bill, which does not address confidentiality and testing issues, focuses on research.
Few House members disagreed with the broad treatment and counseling provisions. But there was heated debate over federal guidelines guaranteeing the confidentiality of AIDS test results.
For example, the legislation bars the disclosure of test results without an individual's written consent. The only exceptions allowed would include disclosures to health care workers who may come in contact with AIDS patients, to morticians preparing a body for burial and under a court order.
It also would permit disclosure of AIDS test results to the needle-sharing and sexual contacts of someone who has tested positive--but only if the physician believes it is medically necessary and determines that patients themselves will not notify family members.
On Thursday, House members defeated a series of amendments to weaken those provisions. The key vote came on a proposal by Dannemeyer requiring doctors and others conducting AIDS tests to report the names and addresses of all people testing positive to state health officials.
Rep. Edward R. Madigan (R-Ill.) said that requirement would "strongly discourage" people at risk of developing AIDS from coming forward to be tested. Patients might fear that disclosure of the results could lead to the loss of their jobs, home and insurance, he said.
In other votes, the House approved an amendment by Rep. Nancy Pelosi (D-San Francisco) to set up centers offering mental health counseling to people who test positive for the virus. Members also voted for a second Pelosi amendment to set up centers for outpatient monitoring and treatment for people with the virus.