The Health Energy and Commerce Subcommittee on Health held an April 23 hearing to discuss two welfare programs: abstinence-only education and Transitional Medical Assistance (TMA). Both programs were created under the 1996 welfare reform law (P.L. 104-193), which is set to expire on September 30. The hearing was held the day before the full committee marked up measures to reauthorize the programs (see related story).
While the committee heard testimony on both programs, much of the debate centered around the abstinence-only education program. The members of the subcommittee expressed bipartisan support for TMA, although several Democrats questioned why the program was being reauthorized for one year, rather than five years.
Subcommittee Chair Michael Bilirakis (R-FL) noted that the title of the 1996 law, the Personal Responsibility and Work Opportunity Reconciliation Act, accurately portrayed the issues discussed at the hearing, particularly with respect to abstinence. “Personal Responsibility is encompassed by the funding provided through Title V of the Social Security Act related to abstinence-only education.” In each of FY1998 through FY2002, Title V allocated $50 million for block grants to the states for the development of abstinence-only education. Programs eligible to receive Title V funding must meet eight criteria stipulated in the law, and states are required to contribute $3 for every $4 provided by the federal government.
Adding that 49 of the 50 states have elected to participate in the program, Rep. Bilirakis said, “This suggests that states have a high interest in abstinence-only educational programs.”
Ranking Member Sherrod Brown (D-OH) disagreed, saying that a recent poll showed that 90 percent of parents want their children’s sex education to cover abstinence and contraception. He argued that states needed flexibility in implementing the program. “Sometimes we want states’ rights. Other times, when it doesn’t serve our purpose, we don’t,” he said, adding that with the abstinence-only education program “it is ok for…the federal government to put a choke hold on the states.”
The bill’s cosponsors, Reps. Fred Upton (R-MI) and Ralph Hall (D-TX), expressed their support for the bill. “Anyone who doesn’t think that abstinence education works should examine the Michigan program,” said Rep. Upton, noting that Michigan has continually received the annual bonus, as created under the 1996 law, for decreasing its out-of-wedlock births while cutting its abortion rates.
Rep. Hall stated that the bill “doesn’t threaten other family planning programs,” saying that “funding abstinence education programs simply expands the option available to teens.”
The subcommittee heard from witnesses on both sides of the issue. Jacqueline Jones Del Rosario of ReCapturing the Vision International, a non-profit organization working in the field of abstinence-only education, shared her personal experiences with the subcommittee. “I initially entered abstinence-only education purely as a skeptic,” she said, but “I quickly became an ardent believer in the abstinence message.”
Ms. Del Rosario said that Title V money “allows us to build human character,” adding, “We need programs that are going to enable us to teach to the whole person.” She said that her program “teaches kids that they do not need to have sex, nor do they have to.” The program also teaches the “consequences of sexual involvement and educates students on STDs, but most of all, we build personal value….” She urged the subcommittee to keep abstinence and contraception curriculum separate, saying it sent children “a mixed message.”
In expressing support for abstinence-only education programs, Dr. Joe S. McIlhaney, Jr., of the Medical Institute for Sexual Health said that while there has been a decline in sexual activity among teenagers, the prevalence of sexually transmitted diseases (STDs) among adolescents has increased. “Three to four million STDs are contracted yearly by 15 to 19 year-olds, and another five to six million STDs are contracted annually by 20 to 24-year-olds,” he said.
“Many have suggested that so-called ‘abstinence plus’—dual message programs discussing abstinence while also teaching about contraception—is the appropriate answer to the twin epidemics of sexually transmitted diseases and out-of-wedlock pregnancies,” stated Dr. McIlhaney. However, he said, “There is no abundance of evidence that ‘dual message’ or ‘comprehensive’ programs are effective at preventing teen pregnancies and STDs.”
Dr. David W. Kaplan of the University of Colorado disagreed. “As a physician who sees the realities of adolescent life on a daily basis…,I wish to appeal to the subcommittee—and, indeed to the Congress as a whole—to be realistic and responsible when it comes to sex education and to provide young people with all the information they need to protect their health and lives in the era of AIDS.”
Saying that this should not be “an either/or issue,” Dr. Kaplan added, “Young people should get abstinence education….but as it is impossible to predict who will be abstinent, additional information should be provided.”
Dr. Kaplan also added that “there is a clear consensus among the experts that abstinence-only education that censors information about contraception does not constitute sound public health policy.” He urged the subcommittee to “do no harm” and “provide medically accurate information about abstinence and contraception.”
Rep. James Greenwood expressed his support for comprehensive sexual education programs, adding that he is the father of two teenage girls. “I truly believe in abstinence…. I think education about abstinence is necessary, but I don’t think it is sufficient,” he said. “Why can’t we tell kids the truth, the whole truth, and nothing but the truth?”
Ms. Del Rosario responded that it sent kids a mixed message: “You can’t tell kids don’t do this, but if you do, this is how to be safe.”
“I understand the concern about dual message, but I also think I can remember enough about my own teenage years,” stated Rep. Greenwood. “If they [teenagers] don’t think they are getting the full story from you, they’re not going to believe you.”