Appropriations Bill Ends Abstinence-Only Funding, Increases Family Planning

There was a lot of good news packed into the 2010 Omnibus Appropriations bill which was passed by Congress over the weekend. For the first time ever, the appropriations bill eliminated all funding for abstinence-only sex education programs in favor of evidence-based programs that focus on preventing unintended pregnancy.

The bill, which still requires the president's signature to become law, allocates $114.5 million for teen pregnancy prevention programs, including discussion of both contraceptive use and abstinence.  These funds will be overseen by the newly established Office of Adolescent Health (OAH) within the Office of the Secretary of Health and Human Services.

"This bill marks the first time since 1981 that abstinence-only-until-marriage programs will not receive dedicated federal funding in the coming fiscal year," says Jen Heitel Yakush, assistant director for public policy at SIECUS.

Yakush broke down the allocations.

• Of the $114 million appropriated, $110 million will go towards "competitive contracts and grants to public and private entities to fund medically accurate and age appropriate programs that reduce teen pregnancy."

• Of this $110 million, a minimum of $75 million must be used to replicate teenage pregnancy prevention programs proven effective through rigorous evaluation. Programs that address the behavioral risk factors that underlie teen pregnancy can also receive funding.
• In addition, at least $25 million must be available for "research and demonstration grants to develop, replicate, refine, and test additional models and innovative strategies for preventing teenage pregnancy."
• The conference report language states that this smaller pot of funding is intended to go to programs that stress the value of abstinence and provide age-appropriate information to youth that is scientifically and medically accurate.
• The remaining $4.5 million is provided for program evaluation funding, including longitudinal evaluations, of teenage pregnancy prevention approaches.

Yakush explained that in order to qualify for funds programs must have "reducing teen pregnancy" as the primary goal.  The framework for "reducing teen pregnancy" is narrower than that for comprehensive sex education, because such programs do not have as primary outcomes reductions in transmission of sexual infections, nor measures for the needs of gay, lesbian, and transgender youth, among other missing pieces.  However, Yakush believes that as long as pregnancy prevention is the key outcome, the funding stream doesn't prohibit funded programs from discussing STD prevention or other sexual health topics.

All in the all, the 2010 appropriations bill is a huge step forward for schools that wanted to stop using long-derided abstinence-only-until-marriage sex education programs that have been tied to a strict eight-point definition of abstinence.

International HIV and AIDS and family planning programs

U.S. global AIDS programs received modest gains in funding. 

Yakush explains the allocation for international programs.

• The final funding level for HIV/AIDS programs came in at $5.709 billion which was only $200 million above 2009 and $100 million above the request, for international HIV/AIDS prevention, treatment and care programs.  Of this total, $750 million were allocated to multilateral programs through the Global Fund to Fight HIV/AIDS, tuberculosis and malaria.

• Bilateral and multilateral funding for Family Planning/ Reproductive Health programs totals $648.5 million, an increase of more than $103 million above the FY 2009 enacted level and $55 million more than requested by the president.

In another positive step, for the first time in many years the U.S. will contribute $55 million to the United Nations Population Fund (UNPF). Funding to UNFPA was withheld during George W. Bush's administration.

Unfortunately an attempt to permanently eliminate the global gag rule - also known as the "Mexico City policy" was passed by the Senate but pulled out during conference committee.  When he first took office President Obama, like his predecessor Bill Clinton, used an executive order to rescind the global gag rule - which severely limited how funds that could be used for international family planning. Since Ronald Reagan first established the rule successive Democratic presidents, Bill Clinton and Barrack Obama, have put it on moratorium while Republican presidents, George H. Bush, George W. Bush, reinstated it.

Domestically the appropriations bill also reverses a ban on use of local funds by the District of Columbia to pay for abortions for low-income women and also removed a ban on funding for needle-exchange programs to limit the spread of HIV and AIDS.