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Senate Eliminates Existing Abstinence-Only Funding; Invests in Evidence-Based Prevention

At the end of July 2009, the Senate began consideration of its version of the Fiscal Year 2010 Labor, Health and Human Services, Education, and Related Agencies (FY10 Labor-HHS) appropriations bill. The $163.1 billion bill was marked up by the Senate Appropriation Labor-HHS Subcommittee on Tuesday, July 28 and by the full Appropriations Committee on Thursday, July 30. The amount of discretionary funding in the bill is $1.6 billion more than President Obama requested, $2.1 billion more than in the House bill, and $3.2 billion more than in the Fiscal Year 2009 Labor-HHS spending bill. The bill was voted out of the full Appropriations Committee by a vote of 29-1, with Senator Sam Brownback (R-KS) standing alone as the only no vote (by proxy).

In a statement released the day of the full Appropriations Committee markup, Labor-HHS Subcommittee Chairman Tom Harkin (D-IA) noted that, “This legislation is about looking to the future – a future where all kids have a chance for a good education and a chance to attend a safe and modern school, where all Americans have a chance for a chance to develop the skills to get a good job and where the most vulnerable Americans have access to the help they need whether it is energy assistance or substance abuse treatment.”[i]
 
The full Senate is expected to vote on the Labor-HHS bill in September, after the August recess. The House and Senate bills will then be sent into conference as there remain several differences between the two chambers’ bills.
 
Abstinence-Only-Until-Marriage Programs and Teen Prevention Initiative
Keeping on course with the actions taken by President Obama in his FY10 budget request and the House Labor-HHS-Education, the Senate spending bill eliminated all funding for existing abstinence-only-until-marriage funds—including funding for the Community-Based Abstinence Education (CBAE) grant program ($104 million). The subcommittee redirected the funds to effective, evidence-based, teen prevention programs and promising prevention models. 
 
In fact, the bill allocates $104.5 million for this new initiative and directs these funds be placed with the Office of the Secretary of Health and Human Services (HHS) and be available to “public and private entities to fund medically accurate and age appropriate programs.” The legislation dictates that $75 million must be utilized for “replicating programs that have been proven through rigorous evaluation to delay sexual activity, increase contraceptive use (without increasing sexual activity), reduce the transmission of sexually transmitted infections or reduce teenage pregnancy” and $25 million shall be available for “research and demonstration grants to develop, replicate, refine and test additional models and innovative strategies for preventing teen pregnancy or sexually transmitted infections.” In addition, the prevention portion of the Adolescent Family Life Act (AFLA, $13.2 million), which was previously tied to the eight-point definition of abstinence-only-until-marriage programs, is now slated for teenage pregnancy prevention programs as well.
 
“We thank Chairman Harkin and his staff for their leadership. We are one step further toward a major national shift in policy that is direly needed,” said William Smith, vice president for public policy at SIECUS. “Earlier this month, the CDC released a wake up call, showing conclusive evidence that we are losing ground when it comes to good reproductive and sexual health outcomes for young people. Ending failed abstinence-only-until-marriage programs and funding programs that work isn’t just the right thing to do, it is what the public health evidence compels us to do,” added Smith.
 
In another win for advocates of comprehensive sex education, Senator Arlen Specter (D-PA) did not request any earmarks for abstinence-only-until-marriage programs for organizations in Pennsylvania in the Labor-HHS bill voted out of Committee. In FY 2003 Senator Specter set a new precedent for the federal funding of abstinence-only-until-marriage programs by securing earmarks of approximately $3.15 million for individual abstinence-only-until-marriage programs in his home state of Pennsylvania.  Senator Specter continued these earmarks in Fiscal Years 2004 and 2005, requesting over $3 million for Pennsylvania-based organizations each year. In FY 2008, 25 organizations in Pennsylvania received earmarks for “abstinence education and related services,” totaling $835,000 in federal funding. And in FY 2009, 22 abstinence-only-until-marriage programs in Pennsylvania received funding totaling $528,000.
 
HIV/AIDS Prevention, Care, and Treatment
The bill increases funding for HIV prevention at the Centers for Disease Control and Prevention (CDC) by only $19 million. This is lower than the $53 million increase in the House bill, which is the same amount requested by the President in his budget. Last year the CDC announced that 56,300 people are infected with HIV every year, which is 40 percent higher than previous estimates. The CDC estimates it needs an increase of $877 million every year for five years in order to reduce HIV transmission by half by 2020.
 
The Senate bill also included a $35 million increase for the Ryan White Care Act, which funds primary healthcare and support services for people living with HIV/AIDS. This is lower than the House’s increase of $54 million. The HIV/AIDS community is hopeful that the higher numbers will prevail, though advocates acknowledge that even these do no meet the true needs for these programs.
 
Unlike the House Bill, the Senate’s bill did not contain language that lifts the ban on federal funding for needle-exchange programs. According to Chairman Harkin, that is “a matter for conference.”
 
Title X Family Planning Program 
The subcommittee allocated $317.5 million for the Title X family planning programs, which reflects a $10 million increase from FY 2009 and is in line with what was proposed in the President’s budget and is in the House bill. Title X is the only federal program exclusively dedicated to family planning and reproductive health services and offers low income women voluntary contraceptive services, prenatal care, treatment for sexually transmitted diseases, and other services.
 
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[i] “Summary: FY 2010 Labor, Health and Human Services, Education and Related Agencies Appropriations,” Press Release, U.S. Senate Committee on Appropriations, 30 July 2009, accessed 6 August 2009, <http://appropriations.senate.gov/News/2009_07_30_Summary_of_FY_2010_Labor_HHS_Appropriations.pdf?CFID=12920425&CFTOKEN=39274066>