Capitol Hill forecast: What’s on tap for 2000

By Cynthia Dailard

Senior Public Policy Associate

Alan Guttmacher Institute, Washington, DC

While only time will tell what this legislative year has in store for family planning programs, one thing is clear: On a wide range of social issues — including but not limited to family planning — partisan lines will be drawn more sharply than ever as Democrats and Republicans position themselves in preparation for the 2000 presidential and congressional elections. As a result, 2000 promises to be a year more about political pos turing than thoughtful policy debates.

Interestingly, 1999 was a year of major legislative developments, both positive and negative, for domestic and international family planning programs. To some extent — particularly on the domestic front — social conservatives refrained from promoting their anti-family planning agenda.

Historically, social conservatives have attempted to attach hostile amendments to the Title X family planning program designed to impair the program’s ability to deliver contraceptive services to low-income women and teen-agers in need of subsidized care. Two perennial favorites have included a requirement that Title X clinics obtain parental consent before dispensing contraceptives to minors and prohibiting Title X funds from going to clinics that perform abortions with their own funding.

Funding hikes for abstinence programs

In 1999, House Republican leaders asked Title X opponents to refrain from offering those and other controversial policy "riders" that often bog down the annual funding bill for the Department of Health and Human Services. In exchange for doing so, House conservatives demanded that funding for abstinence-only education programs under the Adolescent and Family Life program (AFL) be more than tripled and earmarked that funding for programs teaching that "sexual activity outside the context of marriage is likely to have harmful psychological and physical effects."

When the final bill emerged from a joint House-Senate conference, it doubled funding for AFL, raising the funding level from $17.7 million to $39.7 million (although $20 million will not be available until Oct. 1, 2000). And despite the Senate’s proposal to increase Title X funding by $7 million (above its existing level of $215 million), the House leaders also insisted on eliminating any increase for the Title X program.

President Clinton vetoed the initial version of the bill and cited insufficient funding for family planning among his many reasons. Ultimately, a revised version of the bill emerged from negotiations between the administration and congressional appropriators with a dramatic change. Funding for the Title X program was raised to $239 million — just $1 million short of the president’s request of $240 million and the largest funding increase in more than two decades. The AFL funding increase, however, remained intact.

After conservatives in 1998 cut off all U.S. funding for the United Nations Population Fund (UNFPA), the largest multilateral population assistance agency in the world, family planning advocates began a concerted campaign early in 1999 to reverse the move. Much to the surprise of both sides, proponents of family planning in Congress ultimately succeeded in restoring $25 million in funding for UNFPA.

International family planning programs funded through the United States Agency for International Development (USAID), however, did not fare nearly as well. For five years, family planning opponents had attempted unsuccessfully to reimpose the "Mexico City" gag rule policy, in place throughout the Reagan and Bush administrations but revoked by President Clinton during his first days in office. The policy would block foreign nongovermental organizations (NGOs) that — with their own funds — provide abortion services or lobby on abortion from receiving U.S. funds for family planning.

In 1999, however, family planning opponents held hostage $1 billion in back dues owed by the United States to the United Nations until the Clinton administration finally agreed to the Mex ico City policy. While the president was given authority under this agreement to waive the restriction and ultimately did so, it came at a significant price: $12.5 million was deducted from the $385 million appropriated for USAID’s population aid program, and no more than a total of $15 million may go to foreign NGOs that provide legal abortions or engage in legal lobbying on abortion.

What will happen to funding?

Clearly, recent developments in domestic and international family planning have significance beyond the 1999 budget cycle. On the domes tic front, presidential candidate and Republican frontrunner George W. Bush has stated in his campaign that promoting abstinence is the only way to reduce teen-age pregnancy, and he has promised that his administration would boost funding significantly for abstinence-only programs.

Additionally, Secretary of State Madeleine Albright, in a highly unusual move, announced within days of the Mexico City agreement that the Clinton administration will ask that funding for USAID’s program be $542 million — a 40% increase. Together, those actions set the stage not only for 2000 budget battles, but the presidential campaign as well.

Association of Professors of Gynecology and Obstetrics, 409 12th St. S.W., Washing ton, DC 20024. Telephone: (202) 863-2507. Fax: (202) 863-2514. Web: www.apgo.org.