[House Report 107-462]
[From the U.S. Government Publishing Office]



107th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 2d Session                                                     107-462

======================================================================



 
             EXTENSION OF FUNDING FOR ABSTINENCE EDUCATION

                                _______
                                

  May 14, 2002.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

 Mr. Tauzin, from the Committee on Energy and Commerce, submitted the 
                               following

                              R E P O R T

                             together with

                             MINORITY VIEWS

                        [To accompany H.R. 4585]

      [Including cost estimate of the Congressional Budget Office]

  The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 4585) to amend title V of the Social Security 
Act to extend abstinence education funding under maternal and 
child health program through fiscal year 2007, having 
considered the same, report favorably thereon without amendment 
and recommend that the bill do pass.

                                CONTENTS

                                                                   Page
Purpose and Summary..............................................     2
Background and Need for Legislation..............................     2
Hearings.........................................................     3
Committee Consideration..........................................     3
Committee Votes..................................................     3
Committee Oversight Findings.....................................     8
Statement of General Performance Goals and Objectives............     8
New Budget Authority, Entitlement Authority, and Tax Expenditures     8
Committee Cost Estimate..........................................     8
Congressional Budget Office Estimate.............................     8
Federal Mandates Statement.......................................     9
Advisory Committee Statement.....................................     9
Constitutional Authority Statement...............................     9
Applicability to Legislative Branch..............................     9
Section-by-Section Analysis of the Legislation...................    10
Changes in Existing Law Made by the Bill, as Reported............    10
Minority Views...................................................    11

                          Purpose and Summary

    The purpose of H.R. 4585 is to maintain the current funding 
level of $50 million for each of the fiscal years 2003 through 
2007 for abstinence-only education programs under title V of 
the Social Security Act.

                  Background and Need for Legislation

    The landmark 1996 welfare reform law, the Personal 
Responsibility and Work Opportunity Reconciliation Act, P.L. 
104-193, provided a permanent appropriation of $50 million for 
each of the fiscal years 1998 through 2002 to enable states to 
provide abstinence-only education. Such funding also allows 
states the option to fund mentoring, counseling, and adult 
supervision to promote abstinence from premarital sexual 
activity.
    This funding is known as the title V abstinence education 
state block grant program. As part of the National Strategy to 
Prevent Teen Pregnancy developed by the Department of Health 
and Human Services, the program is administered by the Health 
Resources and Services Administration.
    The title V abstinence education state block grant program 
is a formula grant program. State funding is allocated based on 
the proportion of low-income children in the state as compared 
to the national total. For example, in fiscal year 2001, 
federal abstinence education funding under this program ranged 
from $69,855 in Vermont to $4,922,091 in Texas. Funds must be 
requested by states when they solicit Maternal and Child Health 
block grant funds and must be used exclusively for the teaching 
of abstinence-only education.
    States are not required to apply for this funding. However, 
those that do choose to participate are required to match every 
four federal dollars they receive with three non-federal 
dollars. In fiscal year 2001, every state except California 
(and five territories) sponsored an abstinence education 
program under title V. In an era of tight budgets, the fact 
that nearly every state has met the high matching requirement 
for title V funding suggests high state interest in using 
abstinence-only education as one way to address teen pregnancy. 
The funding allocation for those states that choose not to 
apply is returned to the federal treasury.
    As part of their title V abstinence education programs, 
states have launched media campaigns to influence attitudes and 
behavior, developed abstinence education curricula, revamped 
sexual education classes, and implemented other activities 
focused on abstinence education. To ensure that the abstinence 
message is not diluted, the 1996 welfare reform law defined 
``abstinence education'' as an educational or motivational 
program that (a) has as its exclusive purpose, teaching the 
social, psychological, and health gains of abstaining from 
sexual activity; (b) teaches abstinence from sexual activity 
outside of marriage as the expected standard for all school-age 
children; (c) teaches that abstinence is theonly certain way to 
avoid out-of-wedlock pregnancy, sexually transmitted diseases, and 
associated health problems; (d) teaches that a mutually faithful 
monogamous relationship within marriage is the expected standard of 
human sexual activity; (e) teaches that sexual activity outside of 
marriage is likely to have harmful psychological and physical effects; 
(f) teaches that bearing children out-of-wedlock is likely to have 
harmful consequences for the child, the child's parents, and society; 
(g) teaches young people how to reject sexual advances and how alcohol 
and drug use increases vulnerability to sexual advances; and, (h) 
teaches the importance of attaining self-sufficiency before engaging in 
sex.
    In 1997, Congress funded a scientific evaluation of the 
abstinence education programs funded under title V. The final 
evaluation report is due in 2005. An interim report, which was 
to be delivered to Congress by January 1, 2002, was required in 
subsequent legislation. It was issued on April 23, 2002. As an 
early step in the overall evaluation, the interim report did 
not present programmatic findings but indicated that the 
foundation for a careful, comprehensive, and rigorous impact 
study has been put in place. A report on the success of 
programs in achieving their short-term goals is expected in 
winter 2003.

                                Hearings

    The Subcommittee on Health held a hearing on ``Welfare 
Reform: A Review of Abstinence Education and Transitional 
Medical Assistance'' on Tuesday, April 23, 2002. The 
Subcommittee received testimony from Jacqueline Del Rosario, 
Executive Director, ReCapturing the Vision International; Joe 
S. McIlhaney Jr., M.D., The Medical Institute for Sexual 
Health; David W. Kaplan, M.D., Head of Adolescent Medicine and 
Professor of Pediatrics, University of Colorado School of 
Medicine; Cindy Mann, J.D., Senior Fellow, Kaiser Commission on 
Medicaid and the Uninsured; and William J. Scanlon, Ph.D., 
Director, Health Care Issues, U.S. General Accounting Office.

                        Committee Consideration

    On Wednesday, April 24, 2002, the Full Committee met in 
open markup session and favorably ordered reported a Committee 
Print to amend title V of the Social Security Act to extend 
abstinence education funding under maternal and child health 
program through fiscal year 2007, without amendment, by a roll 
call vote of 35 yeas and 17 nays, a quorum being present. The 
Committee also agreed to a unanimous consent request by 
Chairman Tauzin that the Committee Print would be introduced as 
a bill, H.R. 4585, and to allow for this report to be filed on 
that bill.

                            Committee Votes

    Clause 3(b) of rule XIII of the rules of the House of 
Representatives requires the Committee to list the record votes 
on the motion to report legislation and amendments thereto. The 
following are the recorded votes on the motion to report H.R. 
4585 and on amendments offered to the measure, including the 
names of those Members voting for and against.


                      Committee Oversight Findings

    Pursuant to clause 3(c)(1) of rule XIII of the Rules of the 
House of Representatives, the Committee held an oversight 
hearing and made findings that are reflected in this report.

         Statement of General Performance Goals and Objectives

    The objective of H.R. 4585 is to extend level funding for 
five years for abstinence-only education programs funded under 
title V of the Social Security Act in an effort to allow these 
programs to continue to be a viable alternative to more 
comprehensive contraception-focused education programs.

   New Budget Authority, Entitlement Authority, and Tax Expenditures

    In compliance with clause 3(c)(2) of rule XIII of the Rules 
of the House of Representatives, the Committee finds that H.R. 
4585, to amend title V of the Social Security Act to extend 
abstinence education funding under maternal and child health 
program through fiscal year 2007, would result in no new or 
increased budget authority, entitlement authority, or tax 
expenditures or revenues.

                        Committee Cost Estimate

    The Committee adopts as its own the cost estimate prepared 
by the Director of the Congressional Budget Office pursuant to 
section 402 of the Congressional Budget Act of 1974.

                  Congressional Budget Office Estimate

    Pursuant to clause 3(c)(3) of rule XIII of the Rules of the 
House of Representatives, the following is the cost estimate 
provided by the Congressional Budget Office pursuant to section 
402 of the Congressional Budget Act of 1974:

                                     U.S. Congress,
                               Congressional Budget Office,
                                       Washington, DC, May 2, 2002.
Hon. W. J. ``Billy'' Tauzin,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 4585, a bill to 
amend title V of the Social Security Act to extend abstinence 
education funding under maternal and child health program 
through fiscal year 2007.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Alexis 
Ahlstrom.
            Sincerely,
                                          Barry B. Anderson
                                    (For Dan L. Crippen, Director).
    Enclosure.

H.R. 4585--A bill to amend title V of the Social Security Act to extend 
        abstinence education funding under maternal and child health 
        program through fiscal year 2007

    H.R. 4585 would authorize direct appropriations totaling 
$250 million for the abstinence education program, which is 
administered by the Health Resources and Services 
Administration, through 2007. The program was established by 
the Welfare Reform Act of 1996, which appropriated mandatory 
funds of $50 million each year from 1998 through 2002.
    CBO estimates that implementing H.R. 4585 would cost $185 
million over the 2003-2007 period (with the remainder of the 
$250 million to be spend after 2007). However, CBO assumes that 
mandatory appropriations for this program would have continued 
under current law (i.e., the program is assumed in our 
baseline) based on the provisions in the Balanced Budget and 
Emergency Deficit Control Act for projecting direct spending 
for expiring programs. Therefore, CBO estimates that 
implementing H.R. 4585 would have no effect on direct spending 
and thus would not be subject to pay-as-you go procedures.
    H.R. 4585 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act. By 
extending the authorization of funding for abstinence education 
programs through 2007, grants currently available to states 
would continue.
    The CBO staff contact for this estimate is Alexis Ahlstrom. 
This estimate was approved by Peter H. Fontaine, Deputy 
Assistance Director for Budget Analysis.

                       Federal Mandates Statement

    The Committee adopts as its own the estimate of Federal 
mandates prepared by the Director of the Congressional Budget 
Office pursuant to section 423 of the Unfunded Mandates Reform 
Act.

                      Advisory Committee Statement

    No advisory committees within the meaning of section 5(b) 
of the Federal Advisory Committee Act were created by this 
legislation.

                   Constitutional Authority Statement

    Pursuant to clause 3(d)(1) of rule XIII of the Rules of the 
House of Representatives, the Committee finds that the 
Constitutional authority for this legislation is provided in 
Article I, section 8, clause 3, which grants Congress the power 
to regulate commerce with foreign nations, among the several 
States, and with the Indian tribes.

                  Applicability to Legislative Branch

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

             Section-by-Section Analysis of the Legislation


Section 1. Extension of abstinence education funding under Maternal and 
        Child Health Program

    Under current law, funding for abstinence-only education 
programs under title V of the Social Security Act lapses on 
October 1, 2002.
    This section extends level funding--$50 million--for each 
of the fiscal years 2003 through 2007 to be used exclusively 
for the teaching of abstinence from premarital sexual activity.

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italic, existing law in which no change is 
proposed is shown in roman):

                 SECTION 510 OF THE SOCIAL SECURITY ACT


               separate program for abstinence education

  Sec. 510. (a)  * * *

           *       *       *       *       *       *       *

  (d) For the purpose of allotments under subsection (a), there 
is appropriated, out of any money in the Treasury not otherwise 
appropriated, an additional $50,000,000 for each of the fiscal 
years 1998 through [2002] 2007. The appropriation under the 
preceding sentence for a fiscal year is made on October 1 of 
the fiscal year.

                             MINORITY VIEWS

    We submit these minority views because H.R. 4585 was 
reported by the Committee on Energy and Commerce without the 
adoption of three common sense amendments offered by our 
colleagues Representatives Harman, Capps, and Waxman. The 
purpose of these amendments was not to decrease or discontinue 
the allocation of federal funds in the sum of $50 million per 
year for each of the fiscal years 2003 through 2007, under 
Title V of the Social Security Act. The purpose of these 
amendments was merely to provide states with the flexibility to 
offer programs that are best suited to the needs and desires of 
their citizens and to ensure that federal funds are spent on 
effective programs that provide medically accurate information.
    Representative Harman's amendment would have provided 
states with the flexibility to choose the type of abstinence-
based sex education programs appropriate for their citizens. 
Currently, no federal funding is provided for comprehensive sex 
education programs, while funding for abstinence-only education 
will exceed $100 million this year alone. A recent study by the 
Kaiser Family Foundation found that 84 percent of parents 
support age appropriate comprehensive sex education programs 
over restrictive abstinence-only programs.\1\ The Harman 
amendment would have allowed the scarce school-based teen 
pregnancy prevention resources provided by Title V to be used 
by each state in a manner consistent with the desires of its 
citizens.
---------------------------------------------------------------------------
    \1\ Kaiser Family Foundation (KFF), Sex Education in America: A 
View From Inside the Nation's Classrooms, Chart Pack, Charts 12, 14 
(2000).
---------------------------------------------------------------------------
    Abstinence is an important message to send to all teens, 
but it should not be the only message sent. Many leading 
medical experts agree that teenagers need comprehensive sex 
education. A National Academy of Sciences' Institute of 
Medicine report, ``No Time to Lose: Getting More from HIV 
Prevention,'' supported comprehensive sex education programs as 
an effective way to reduce high-risk sexual behaviors among 
adolescents. Other respected health organizations including the 
National Institutes of Health, the American Academy of 
Pediatrics, the American Medical Association, and the American 
Public Health Association, recommend school districts offer 
comprehensive sex education as a way to impart this important 
public health information to students, as well as reduce risky 
behavior. The Harman amendment would have allowed states to use 
federal funds under Title V for a choice of abstinence-based 
curricula.
    Representative Capps' amendment would have required that 
federal funding only be dispensed to educational programs 
deemed ``medically accurate'' by leading medical, 
psychological, psychiatric, and public health organizations and 
agencies. Some abstinence-only programs are actually harmful to 
teenagers because they provide incomplete, inaccurate, and 
misleading information with regard to contraceptives, 
pregnancy, and sexually transmitted diseases (STDs). Some 
curricula promote the idea that contraceptives fail so often as 
to be worthless, yet such claims are statistically unfounded 
according to the Centers for Disease Control and Prevention 
(CDC).
    Some curricula sensationalize depictions of late-stage 
STDs, but do not inform teens to the first symptoms of 
treatable STDs. Anyone receiving medical services or public 
health education is entitled to receive medically accurate 
facts. Depriving teens of medically accurate information will 
not protect them; it will only make them more vulnerable to the 
very problems that sex education programs are supposed to 
address.
    Finally, Representative Waxman's amendment would have 
required that federally funded programs be based on models that 
have demonstrated effectiveness in reducing unwanted 
pregnancies or in reducing the transmission of STDs or HIV/
AIDS. To date, there are no studies that have proven 
conclusively that abstinence-only education programs actually 
fulfill their stated goals of reducing teen pregnancy and 
decreasing the incidences of HIV/AIDS and other STDs. A recent 
study found no credible evidence that abstinence-only education 
has any significant impact on participants' initiation of or 
frequency of sexual activity.\2\ This amendment would have 
simply required that federal funding only be distributed to 
programs which have undergone a review process and which have 
demonstrated an ability to decrease teenage pregnancy and STD 
rates. Continuing to support programs, with no proven efficacy 
is fiscally and socially irresponsible.
---------------------------------------------------------------------------
    \2\ Douglas Kirby, The National Campaign to Prevent Teen Pregnancy, 
Emerging Answers: Research Findings on Programs to Reduce Teen 
Pregnancy (2001), at 88, 95.
---------------------------------------------------------------------------
    Unfortunately, all three of these amendments were defeated, 
essentially ensuring that states will not have the flexibility 
to accept federal dollars for a comprehensive sex education 
program of their choice, ensuring that there is no requirement 
for schools to teach medically accurate facts with regard to 
sex education, and ensuring that unproven, potentially 
detrimental programs will continue to receive large amounts of 
federal funding.

                                   John D. Dingell.
                                   Peter Deutsch.
                                   Ed Towns.
                                   Henry A. Waxman.
                                   Lois Capps.
                                   Karen McCarthy.
                                   Tom Sawyer.
                                   Frank Pallone, Jr.
                                   Albert R. Wynn.
                                   Jane Harman.
                                   Sherrod Brown.
                                   Diana DeGette.
                                   Ted Strickland.
                                   Anna G. Eshoo.
                                   Bill Luther.
                                   Gene Green.
                                   Edward J. Markey.
                                   Bobby L. Rush.

                                  
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