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PrEP
March 2009 (To print, click the print icon on your browser
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Obama Signs Fiscal Year 2009 Spending Bill; Provides First-Ever Cut to Abstinence-Only Programs

On March 11, 2009, President Barack Obama signed into law a $410 billion omnibus appropriations bill (HR 1105) to fund most government agencies through the end of this fiscal year.[1] The bill includes the Fiscal Year (FY) 2009 Labor, Health and Human Services, and Education appropriations bill and the eight other unapproved FY 2009 appropriations bills. Since October 2008, the federal government has operated under a continuing resolution that funded most Cabinet departments and federal agencies at FY 2008 levels. The newly signed omnibus appropriations bill will fund departments and agencies from March 7 through September 30, the end of the fiscal year.

The legislation included the first-ever cut to abstinence-only-until-marriage programs—a cut of $14.2 million to the Community-Based Abstinence Education (CBAE) program. While advocates agree that there is much to celebrate in this cut, the appropriations bill does continue to waste just over $160 million dollars of tax-payer money on these programs that have been proven by overwhelming evidence to be ineffective.

“We applaud President Obama for taking this first, much-needed step in ending abstinence-only-until-marriage programs,” said William Smith, vice president for public policy at SIECUS. “More than a quarter century after this flawed approach was set into place, its demise is long overdue,” continued Smith, adding, “This would not have been possible without the leadership of many friends in Congress. We are especially grateful to Senator Tom Harkin (D-IA) for his efforts in negotiations with his colleagues and for working toward an even larger cut to these programs.”

President Obama called the omnibus measure “imperfect” and used the occasion of the bill signing to criticize the more than $7.7 billion in more than 8,500 earmarks that lawmakers inserted into the bill. While noting that the bill needed to be signed into law to keep the government running, President Obama declared: “this piece of legislation must mark an end to the old way of doing business and the beginning of a new era of responsibility and accountability that the American people have every right to expect and demand.” Twenty-two of the earmarks included in the bill are designated to support abstinence-only-until-marriage programs in Pennsylvania to the tune of $528,000. The abstinence-only-until-marriage programs earmarks were all requested by Senator Arlen Specter (R-PA), ranking member of the Labor, Health and Human Services, and Education appropriations subcommittee.
 
In a piece on Huffington Post, Smith pointed to Republic Senator Tom Coburn, who has been outspoken in his criticism of earmarks, and posed the question: “If Coburn and the rest of the crew are serious about cutting wasteful spending, why not start with the abstinence-only-until-marriage earmarks in the bill sponsored by Senator Specter, a fellow Republican from Pennsylvania…Why should we turn a blind eye to the inconsistency of their posturing when they throw an additional $528,000 into the bill, in pork-laden earmarks nonetheless, for failed abstinence-only-until-marriage programs?” The answer: “We shouldn’t.”
 
This same legislation also includes other important elements which begin to undo some of the damage to sexual and reproductive health programs that occurred during the last eight years under the Bush administration. As a start, the law will provide additional family planning resources, increased resources to address the neglected HIV/AIDS epidemic here at home, and a down payment to create our nation’s first National AIDS Strategy.
 
For example, the final FY2009 spending bill included a $71.6 million increase for the Ryan White Care Act, which funds primary healthcare and support services for people living with HIV/AIDS.  While HIV/AIDS advocates were pleased with the increase for care and treatment programs, they were disappointed with Congress’ decision to provide only level funding for domestic HIV prevention at the Centers for Disease Control and Prevention. Particularly in light of the fact that HIV- and related-prevention programs received a $3.5 million cut last year and a recent report by the CDC revealed that new HIV infections stand at 56,300 per year or 40 percent higher than previous estimates.
 
The final legislation also included an increase of $7.5 million for Title X bringing the total appropriated for FY2009 to $312 million.  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.
 
Advocates were thrilled with the inclusion of a provision known as the “Affordable Birth Control Act,” that will make birth control more available and affordable for women who obtain contraceptives at community health centers and college clinics. According to Planned Parenthood Federation of America, the Deficit Reduction Act, which Congress passed in 2005, tightened eligibility for nominally priced drugs.  In passing the legislation, Congress inadvertently cut off safety-net providers as well as every college and university health center from obtaining contraception at a low cost, and passing on those savings to their patients. As a result, women have been paying up to 10 times more each month for basic contraception.
On the international front, the bill both appropriates $50 million for the United Nations Population Fund and includes language ensuring funding for critical programs, such as provision of safe delivery kits in areas affected by conflict or natural disaster.  Also included were an increase of $150 million for the United States Agency for International Development (USAID) reproductive health and family planning programs and an increase of $498 million dollars for U.S. global AIDS funding (PEPFAR) (over the FY 2008 appropriation of $5.99 billion). The legislation also included a contribution of $900 million dollars for the Global Fund to Fight AIDS, Tuberculosis and Malaria, the highest contribution ever made by the U.S. to the Global Fund since its inception in 2002 and an increase of $60 million over the U.S. contribution for 2008.  Advocates are hopeful that these international funding levels signal the United States’ renewed commitments to international family planning and HIV-prevention efforts and a return to proactive engagement by the U.S. in multilateral partnerships that were often undercut during the previous administration.
“The President will soon present a more detailed budget to Congress and we call on him to ensure that it contains adequate funding for effective programs that have been starved or unfunded for far too long,” said Smith. “The administration and Congress need to invest in comprehensive health prevention and care programs that invest in our nation’s future.”


[1] Paul Kane and Scott Wilson, “Obama Signs Spending Bill, Vowing to Battle Earmarks,” Washington Post, 12 March 2009, accessed 18 March 2009, <http://www.washingtonpost.com/wp-dyn/content/article/2009/03/11/AR2009031101499.html?hpid=topnews>.
 

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