On Thursday, July 19, 2007, the House of Representatives approved the $152 billion Fiscal Year (FY) 2007 Labor, Health and Human Services and Education (Labor-HHS; HR 3043) by a vote of 276–140.  The bill included increases for the Community-Based Abstinence Education (CBAE) program, for the Title X family planning program, and for the Ryan White CARE Act.

Abstinence-Only-Until-Marriage Funding

The final House bill allocated an additional $28 million for the CBAE account, for a total of $141 million for FY 2008 under the measure.  This was exactly what the President had requested for this program.  Despite several members’ objections, Democrats, led by David Obey (D-OH), Chairman of the Appropriations Committee and the Subcommittee on Labor, Health and Human Services and Education, stood firm in his hope that the increased funding for abstinence-only-until-marriage programs will give them the leverage they need with their Republican allies in Congress in the fights that are sure to come over other aspects of this legislation, particularly the price tag.  President Bush has threatened to veto any spending bill that provides funding in excess of what he requested and the House Labor-HHS bill currently provides over $10 billion more than Bush requested in his proposed budget.¹  Representative Nita Lowey (D-NY) expressed her disapproval for the increase to the CBAE program on the House floor, as did Representative Barbara Lee (D-CA) in her remarks for the official record.

Much to the chagrin of many sexual and reproductive health and rights advocates, Mr. Obey once again couched abstinence-only-until-marriage program funding as part of the “Reducing the Need for Abortions Initiative” when he spoke on the House floor, as he had done in subcommittee and full committee hearings on the bill.  Report language for the CBAE program, as well as several other programs in the bill, says that, “The Committee’s recommended increase is part of its initiative to help reduce the number of abortions in America by alleviating the economic pressures and other real life conditions that can sometimes cause women to decide not to carry their pregnancies to term.”  Other programs married under this Initiative include Title X family planning, Head Start, Child Care Development Block Grant, and Adoption awareness campaign, Teen Pregnancy Prevention Grants, and Healthy Start, among others.  Advocates for comprehensive sexuality education also support reducing the need for abortions but are greatly concerned that the CBAE program was said to be part of this initiatives.  Abstinence-only-until-marriage programs like those funded by CBAE have not been proven to be effective, censor information, and should not be part of any larger prevention initiative.

 “It is nothing short of shameful that the House moved forward with an increase to CBAE—an ineffective program with no basis in public health or evidence-based prevention—particularly as it is now clear that an increase to abstinence-only programs will not stop the President from wielding his veto pen,” said William Smith, vice president for public policy at SIECUS. 

Title X Family Planning

The FY 2008 appropriations bill would allocate $311 million for Title X, an increase of $27.8 million from FY 2007.  While some family planning advocates note that even with this increase, the total allocation is less than historic levels of funding, adjusted for inflation, many are pleased as the House Subcommittee on Labor-HHS provided the largest proposed increase to Title X funding in 25 years.  Title X is the only federal program dedicated solely to funding family planning and reproductive health care services.  Title X clinics offer low income women voluntary contraceptive services, prenatal care, treatment for sexually transmitted diseases (STDs), and other services. 

As part of debate on the legislation, Representative Mike Pence (R-IN) offered an amendment which would have prohibited Planned Parenthood clinics from receiving any of the bill’s Title X family planning funds.  The amendment failed by a vote of 231–189.  While Representative Trent Franks (R-AZ) called Planned Parenthood a “death dealing organization,” several members, including Representatives David Obey (D-WI), Rosa DeLauro (D-CT), Tim Ryan (D-OH), and Chris Shays (R-CT), expressed their strong support for Planned Parenthood receiving Title X funds and spoke out against the amendment saying that, if passed, it could have denied millions of low-income women access to contraceptive services.  Rep. Rosa DeLauro (D-Conn.) said, “If we value, as we say we do, women’s health….we cannot strip Planned Parenthood of funding.”

HPV Vaccine Amendment

The House bill also included an amendment, introduced by Rep. Phil Gingrey (R-GA) that would prohibit federal funds from being used by states to require human papillomavirus (HPV) vaccinations for school attendance.  Offering his amendment, Mr. Gringey said, “I applaud the development of an HPV vaccine…But for states to mandate vaccination for young women is both unprecedented and unacceptable. Whether or not girls get vaccinated against HPV is a decision for parents and physicians, not politicians and bureaucrats.”²  

The amendment passed by voice vote with little-to-no argument from Democratic Members of the House.  Many public health advocates were disappointed that the Democrats and Mr. Obey did not fight this amendment as, if enacted, this measure could severely limit HPV vaccines to low-income children who rely on such programs as Medicaid, SCHIP, or Vaccines for Children in order to obtain vaccines.  Others are fearful that this would signal the end of state vaccine mandates for HPV because states are often unwilling, or unable, to forgo considerable state funds.

Ryan White CARE Act

The final House bill increased funding for the Ryan White CARE Act, which funds primary healthcare and support services for people living with HIV/AIDS, by just over $100 million.  Members offered various amendments on the CARE Act including one that would decrease and one that would increase funding for different areas of the program.

The amendment to increase funding for Part D (Title IV) of the CARE Act, which provides HIV care and services to women, children, youth, and families, by $3.5 million dollars was offered by Representative Debbi Wasserman Schultz (D-FL) and was approved by a voice vote.  This resulted in a 4.8% increase over the FY 2007 funding level and brings total funding for Part D (Title IV) to $75.3 million.

The House voted 230–196 to defeat another amendment offered to the CARE Act which would have reduced funding for some geographic areas, including San Francisco.  The amendment, which was introduced by Representative Joe Barton (R-TX), centered on the debate over funding formulas which some believe favor cities, such as San Francisco, which were at the epicenter of the HIV/AIDS epidemic when it first emerged in the 1980s and early 1990s rather than other communities nationwide that have just recently been hit with large numbers of infections.   In May 2007, the Bush administration announced funding reduction for some areas—including an $8.6 million reduction for funding in the San Francisco metropolitan area.  House Speaker Nancy Pelosi (D-CA) and Representative Obey included language in the FY 2008 Labor-HHS that would have restored $6.3 million for San Francisco.  The amendment offered by Representative Barton would have reinstated those cuts.

Next Steps

The Senate has not yet completed its own version of the FY 2008 Labor-HHS spending bill.  It is expected that the Senate will either bring its companion bill to the floor in September or that the bill may be rolled into an omnibus, or a package of several appropriations bills, that will be passed later in the year.
“Going forward, we are hopeful that the House and Senate will work out their differences and that we will emerge with the best pieces from each bill—a decrease to abstinence-only programs, the larger increase to Title X and to all Ryan White CARE Act programs, and language that has the best prevention and public health needs in mind,” said Smith.

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