President’s Veto Kills Dems’ Ab-Only Fix

Proponents of comprehensive sex education scored a small victory yesterday when the U.S. Senate stripped a $100 million provision to fund a controversial abstinence-only grant program that was tacked onto the State Children's Health Insurance Program (SCHIP) bill.

But the celebration will be short-lived as President Bush renewed his vow late Friday to veto the compromise bill that extends health care coverage to more children.

The SCHIP bill add-on, known by its none-descript name Title V, Section 510, is one of three established federal funding streams for abstinence-only programs and the only one in which states have decision-making authority on grantees. The other two money pots — Community-Based Abstinence Education (CBAE) and Adolescent Family Life Act (AFLA) — are direct federal grants to school districts, health departments, and nonprofit organizations and are not affected by the Senate's action.

While Congress wrangled with the federal budget over the summer, the Title V program was re-upped on an emergency 3-month basis through September 30. In the meantime, the program funding renewal was slipped into an early House version of SCHIP, which was also hotly contested. The reauthorization would have provided a pool of $50 million each in fiscal years 2008 and 2009 for states to distribute to community-based abstinence programs.

Reproductive health advocates condemned the funding proposal as throwing good money at bad programs that endanger young people's lives with inaccurate information and heavy-handed moralizing.

However, the add-on also attempted to deal with some of those serious shortcomings by requiring medically and scientifically accurate curricula, broadening the lessons to include discussions on birth control methods, and mandating that the programs prove they reduce pregnancy, sexually transmitted diseases and HIV/AIDS rates.

The new guidelines were designed to counterbalance political interference with the program by Bush Administration appointees.

In 2005, the White House shifted oversight of Title V from the Maternal and Child Health bureau to the Administration for Children, Youth and Families, which Advocates for Youth calls a more ideologically conservative division of the Department of Health and Human Services.

That shift also meant that newly funded Title V programs must adhere to a strict eight-point definition of abstinence education that reflects ultra-conservative viewpoints and minimizes accepted public health and social science research. Consequently, eight states (California, Connecticut, Maine, Montana, New Jersey, Ohio, Rhode Island and Wisconsin) have refused millions of dollars in federal funds rather than capitulate to non-scientific standards and ignore the need to provide contraception information to young people.

Red tape and bureaucratic bullying aside, abstinence-only programs have also begun to fall out of favor.

Recent independent analyses of abstinence-only programs by the Government Accountability Office, Mathematica Policy Research [PDF] and others have repeatedly found grim problems in the programs' touted effectiveness — from a lack of scientifically-accurate curriculum, little oversight, and the inability to demonstrate a direct, causal reduction in teen sexual activity. A first-of-its-kind study of teenagers also found widely varying views on abstinence and virginity in stark contrast to the messages intended.

But those criticisms haven't put much of a dent in lawmakers with a penchant for pandering to conservative voters.

Since 1982, Congress has appropriated an estimated $1.5 billion for abstinence-only programs that House Energy and Commerce Committee Chair Rep. John Dingell (D-Michigan) describes as "a colossal failure." Dingell's committee co-chair Diana DeGette (D-Colorado) said during an interview on Marketplace in July:

Abstinence-only education doesn't work. A number of studies, as well as common sense, have shown that over the years. So Congress is pouring millions of dollars into this program that's just a waste of money.

Earlier in the spring, Dingell and DeGette successfully eliminated Title V funding from a spending bill before their committee.

But to the great consternation of comprehensive sex education proponents, Title V's sister program, Community-Based Abstinence Education, received a large cash infusion from the House Subcommittee on Labor, Health and Human Services, and Education Appropriations to the tune of $141 million, a 25 percent increase over last year's budget. Rep. David Obey (D-WI), who serves as the subcommittee chair and leads the powerful House Appropriations Committee, argued that the move was a necessary evil to placate conservative lawmakers in order to make the larger spending bill veto-proof.

So in essence, the current de-funding of Title V may have little effect on federal financial support of abstinence-only education while effectively eliminating the states' only direct avenue for approving and supervising the no-sex-until-marriage curricula presented by grantees to young citizens.

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  • invalid-0

    Unfortunately, this story actually has the facts a bit wrong. The Senate’s decision not to include the significantly improved and re-written version of the Title V ab-only program acomplished in the HofR was not a “small victory” at all…in point of fact, it was disasterous because it was the best possible outcome that advocates could have hoped for in this environment. The future promises much less opportunity to fix this program…

    • wendy-norris

      I agree with you, Bill, that the language inserted into HR 3162 to mandate fact-based curricula and evaluative criteria were much-needed improvements. 

      However, other reproductive health groups decried that the Title V abstinence-only program was being funded at all in the House bill and were aiming for the grant pool to expire on Sept. 30.
      That's why I interpreted it as a "small victory" because while the funding was stripped out of S 1893 as some activists had worked for it also limits, as you point out, the ability to make the best of a controversial and ineffective program. I guess it depends on whether one is looking at this outcome with a glass half-full or half-empty viewpoint.
      Unfortunately, it's probably moot if the president vetoes the bill as expected. But thank you for adding another perspective to this story. 
  • invalid-0

    Bill, can you elaborate on why the gutting of Title V, would not ultimately be a good thing? It sounds like the House version allowed for Title V funding to be used for more medically accurate, comprehensive sexuality education and that we should have pushed the Senate to adopt that provision rather than to de-fund Title V altogether? I’m curious! Thanks!

  • invalid-0

    “That shift also meant that newly funded Title V programs must adhere to a strict eight-point definition of abstinence education that reflects ultra-conservative viewpoints and minimizes accepted public health and social science research.”

    This statement is in fact, untrue. The A-H guidelines are both scientifically supported and medically accurate. All 13 points are backed up by peer-reviewed studies and are based on public health principles.

    “Abstinence-only education doesn’t work. A number of studies, as well as common sense, have shown that over the years. So Congress is pouring millions of dollars into this program that’s just a waste of money.”

    Really? Here are nine studies that say it is:

    Surely we can’t rely on the GAO’s report that didn’t define what “medically accurate” is, or the Mathematica report that evaluated only four programs.

  • invalid-0

    The House passed version of the Title V re-write is the best outcome we could have expected at the moment. And getting to this point was an extraoridinary effort on the part of advocates and allies in Congress. I meant that the Senate’s cowardice in not including the House’s rewrite in the base bill was hardly a win as Wendy describes it — it was a huge abandonment of the prevention agenda and the start of getting that program to fund good, more comprehensive programs that work — as you rightly point out. The Title V abstinence-only program must brought into line with the best science of evidence-based prevention — all of which is telling us that the verdict is in and ab-only does not work — that is why every major public health entity in this nation and around the world supports the more comprehensive approach. For the moment, the Senate has abandoned a vital opportunity here and we need to make certain that this abandonmnt does not result in a straightforward extension of the program.. Hope that is helpful.

    • invalid-0

      Thank you, Bill. And thank you, Wendy, for getting this discussion going with your post! I really had no idea how hard advocates had worked to get the House passed Title V provision to where it was – or even that it would fund more comprehensive sexuality education to begin with!

      So the Senate stripped funding for Title V – but did they do it with any kind of a forward thinking plan about how to fund more comprehensive, science based sexuality education? What reasoning did the Senate give for NOT passing the house version- or a similar one?

  • invalid-0

    Thanks Wendy. For clarity, I know there was just one of the leading groups on this issue that spoke out against the House’s improvement of the current program but to my knowledge, no groups worked to actually get the language stripped out of the Senate bill. This was a purely political calculation that was done without the complicty of any groups whatsoever. Additional evidence on this point is that many other important pieces were dropped from the final version so that the President would have to veto as “clean” a bill as possible. Which “activists” or groups are you aware of that “worked” to actually get the House language out?

  • scott-swenson

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