In early June, the United States Congress began consideration of the Labor, Health and Human Services, and Education (Labor-HHS) spending bill, which, among other things, decides funding levels for such accounts as abstinence-only-until-marriage programs; HIV/AIDS prevention, care, and treatment; and family planning services.  The House and Senate Labor-HHS Subcommittees each must create and vote on their versions of the Labor-HHS spending bills before the bills move to their respective Appropriations Committees for a vote, and then to the full House and Senate floor for votes.  Once both the House and Senate have approved their versions of the bills, the two bills will go to conference, where final funding level decisions will be made. 

The results for sexual and reproductive health and rights have, thus far, been mixed, and much still remains to be seen as the final bill will not be completed until late July, at the earliest. 

Abstinence-Only-Until-Marriage Programs

On June 7, the U.S. House of Representatives Subcommittee on Labor, Health and Human Services, and Education Appropriations decided to increase funding for the Community-Based Abstinence Education (CBAE) grants despite overwhelming scientific evidence that the abstinence-only-until-marriage programs it supports do not work.  It was widely believed that the programs would be cut or eliminated by the new Congress, but the House instead added $27.8 million, matching President Bush’s requested increase for the programs and bringing CBAE funding to a total of $141 million. 

According to Congressional Quarterly, this appears to be a ploy by the Democratic majority designed to swing enough Republican votes to make the spending bill veto-proof.  Democrats, led by David Obey (D-OH), Chairman of the Appropriations Committee and the Subcommittee on Labor, Health and Human Services and Education, 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.  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 $10 billion more than Bush requested in his proposed budget.

William Smith, vice president for public policy at SIECUS said of the increase, “There is no other way to describe this concession but as shameful. The House Appropriations Subcommittee overseeing this bill is using abstinence-only funding as a carrot to draw votes when the same thing could have been accomplished without an increase.”  He went on to say, “Even the previous Republican Congress flat-funded these programs two years in a row despite Bush’s request for increases.  How is it then that the Democrats are now delivering up cash directly to the most extreme elements of America’s right-wing movement?”   

When the Senate convened to decide funding levels for its version of the Labor-HHS bill, it did not follow the lead of the House.  In fact, the Senate cut CBAE’s funding by $28.4 million, leaving only $84.8 million available through CBAE for Fiscal Year 2008.  In its report on the bill, the Senate noted that the recent evaluation of the Title V abstinence-only-until-marriage programs, conducted by Mathematica on behalf of the Department of Health and Human Services, found that the federally funded programs were ineffective at delaying sexual initiation.  The Appropriations Committee explained that its recommended $28 million cut to the program would allow for the continuation of current CBAE grantees, but would not provide new funding for additional programs.

“We are pleased that the Senate has decided to follow the research and cut funding for the most restrictive of the abstinence-only-until-marriage funding streams,” Smith said.  “We are hopeful that clearer minds will prevail and that there will be a cut to CBAE at the end of the day,” continued Smith.

Title X Family Planning

While sexual and reproductive health and rights advocates were displeased with the increase from the House for CBAE, they were gratified with Congress’ decision to increase funding for the Title X family planning program.  The President had requested level funding for the Title X program. However, the House Subcommittee on Labor-HHS provided the largest 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, and other services.  The $27.8 million increase included in the House’s bill would bring Title X funding to a total of $311 million. The Senate also increased funding for the program but by a smaller amount—$16.8 million.  Advocates are hopeful that the larger House increase will prevail.

Domestic HIV/AIDS Programs

While the President proposed, for the most part, flat-funding for the Ryan White CARE Act, which funds primary healthcare and support services for people living with HIV/AIDS, Congress did provide some increased funding for the program, which advocates see as a step in the right direction.  The House provided an increase of $99.3 million; however the Senate provided an increase of only $33 million for the CARE Act.  In particular, one aspect of the CARE Act, Title IV, was treated differently by the House and the Senate. Title IV of the CARE Act, which focuses on providing services to children and families affected and effected by HIV/AIDS, received an increase of $3.2 million in the Senate but level funding in the House. Advocates are hopeful that the final numbers will provide an increase to all aspects of the CARE Act.
While the Ryan White CARE Act focuses on care and treatment for those living with HIV/AIDS, advocates were also concerned about HIV-prevention funding, particularly that which comes through the CDC.  While still woefully inadequate, advocates were pleased with the House’s decision to increase funding for HIV/AIDS-prevention programs by $63 million.  The Senate, on the other hand, did not provide any additional funding for these programs.  Since 2003, close to $100 million for HIV prevention has been cut by Congress.

A Mixed Bag

The preliminary House and Senate numbers were a bit of a mixed bag for sexual and reproductive health and rights advocates.  “Our hope was that the ‘Prevention First’ message touted by new Congressional leaders was more than a bumper sticker slogan,” said Mr. Smith.  “Congress needs to fully fund HIV prevention, fully fund the Minority AIDS Initiative, and fully fund Title X family planning, just for starters.  Vital and scarce resources should not be spent on extreme programs that do not work and are on the verge of collapse, but on programs with proven effectiveness and a proven track record of success,” concluded Smith.

The House is expected to take its next action on the Labor-HHS spending bill in the full Appropriations Committee on July 17th.  Consideration by the full House and full Senate is expected shortly thereafter and the two bills will be reconciled later this summer.