On Friday, July 24, 2009, the House of Representatives passed the Fiscal Year 2010 Labor, Health and Human Services, Education, and Related Agencies (FY10 Labor-HHS) appropriations bill. The $160.7 billion FY10 Labor-HHS Appropriations bill spends about $5.6 billion more than the $155 billion provided in FY09.[i]
Appropriations Committee Chair Congressman David Obey (D-WI) took the spending bill, which funds the Departments of Labor, Health and Human Services, and Education, in different directions than he has in the past, investing in evidence-based prevention efforts, shepherding in the elimination of abstinence-only-until-marriage programs, and lifting of the ban on needle exchange funding. Chairman Obey said the bill is fiscally responsible and pointed out that it is $52 million less than President Obama’s discretionary request. The House passed the bill, 264–153, after defeating three Republican amendments, including a proposal seeking to bar funds from being used for needle exchange and an amendment seeking to cut funding for Planned Parenthood.[ii]
Abstinence-Only-Until-Marriage Programs and Teen Prevention Initiative
Following President Obama’s lead, the House Labor-HHS-Education 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 pregnancy prevention programs and promising prevention models. According to the spending bill’s report, the $114.5 million program will “provide funds to public and private entities on a competitive basis for proven-effective or otherwise promising teenage pregnancy prevention programs that provide medically accurate, age-appropriate, and complete information to youths.” 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 “a teenage pregnancy prevention initiative, proposed by the Administration.”
During the full Appropriations Committee’s markup of the legislation on July 17, Representatives Robert Aderholt (R-AL) and Representative Zach Wamp (R-TN) offered an amendment to continue funding of the CBAE program. The amendment aimed to use the funding provided in the teen prevention initiative to “ensure that each organization approved to receive a grant under the [CBAE] program for a certain grant period…receive the grant for the full duration of such grant period.” The amendment failed with 35 Representatives voting against and only 24 voting in favor. Representative Barbara Lee (D-CA) and Representative Jesse Jackson, Jr. (D-IL) spoke against the amendment noting that abstinence-only-until-marriage programs have failed young people and that the scientific evidence does not support their continued funding.
“We commend the House appropriators, led by Chairman David Obey, for not including funding for failed abstinence-only-until-marriage programs in the bill and instead focusing on evidence-based prevention efforts,” said William Smith, vice president for public policy at SIECUS. “Unfortunately, as currently drafted, the bill fails to acknowledge that unintended teen pregnancy is intrinsically linked to other sexual and reproductive health issues facing our nation’s youth, including the epidemic of sexually transmitted infections (STIs) and HIV currently being experienced by America’s teens.” Smith added, “We are hopeful that as the appropriations process continues, we will see an expansion of language that will enable funded entities to use all evidence-based interventions at their disposal, including those that may come first from an HIV/STI-prevention angle, but reduce the same risk behaviors that lead to unintended pregnancy.”
HIV/AIDS Prevention, Care, and Treatment
In a notable shift of policy, the Labor-HHS bill lifted a ban on the use of federal funding for needle exchange programs that has been in place since 1989. In a prepared statement, Chairman Obey commented that:
This bill deletes the prohibition on the use of funds for needle exchange programs. Scientific studies have documented that needle exchange programs, when implemented as part of a comprehensive prevention strategy, are an effective public health intervention for reducing AIDS/AIV infections and do not promote drug use. The judgment we make is that it is time to lift this ban and let State and local jurisdictions determine if they want to pursue this approach.
“Chairman Obey is right,” stated Ronald Johnson, Deputy Executive Director of AIDS Action Council, “the number of individuals who have become HIV positive through injection drug use has been drastically reduced by syringe exchange programs operating with private, state and local funding. We look forward to expanding the reach with the federal resources.”[iii]
During full-Committee markup of the legislation, Representative Chet Edwards (D-TX) offered an amendment to reinsert the ban. The amendment was defeated 24–3. Then on the floor of the House, Representative Mark Souder (R-IN) offered the same amendment. The amendment failed 211–218. While advocates were pleased with that result, in what many considered a counterproductive move, the full Committee accepted, by voice vote, an amendment to the Appropriations bill offered by Chairman Obey that undermines the decision to remove the ban. The amendment restricts federal funding to only SEPs that operate at least 1,000 ft. away from day care centers, schools, universities, public pools, parks, playgrounds, video arcades, and youth centers as well as events sponsored by these organizations. Advocates are hopeful that they will see a full lift of the ban as the appropriations process continues.
The bill increases funding for HIV prevention at the Centers for Disease Control and Prevention (CDC) by $53 million, the same amount requested by the President in his budget request. 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 spending bill also included a $54 million increase for the Ryan White Care Act, which funds primary healthcare and support services for people living with HIV/AIDS. This included a $20 million increase to the AIDS Drug Assistance Program. Many advocates remained concerned this minimal increase will not meet the needs of those living with HIV/AIDS, particularly given the rising cost of health care and the reductions in state budgets across the country.
Carl Schmid, Deputy Executive Director of The AIDS Institute, noted that “proposed funding levels for HIV/AIDS care, treatment, and prevention are insufficient…Although there are small proposed increases, they do not provide the programs with enough money to meet the needs of people living with HIV/AIDS or prevent the spread of HIV, particularly during the current economic downturn and at a time of drastic cuts to state programs.”
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. 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.
On the House Floor, House Republican Conference Chairman Mike Pence (R-IN) offered an amendment to prohibit any funding through the Title X family planning program from going to Planned Parenthood clinics. This would cut off one-third of all current Title X family planning patients from their trusted provider. The amendment was defeated, 247–83.
The Senate began consideration of their version of the Labor-HHS bill on July 21. Check back here next month for a policy update on Senate actions.
For more information:
Labor-HHS-Education spending bill as passed by the House: