Proponents of sex education classes that focus on encouraging teenagers to remain virgins until marriage are hoping that the rescue plan for the nation's health-care system will also save their programs, which are facing extinction because of a cutoff of federal funding.
The health-care reform legislation pending in the Senate includes $50 million for programs that states could use to try to reduce pregnancies and sexually transmitted disease among adolescents by teaching to them to delay when they start having sex.
Under the federal budget signed by President Obama, such programs would no longer have funds targeted for them.
"We're optimistic," said Valerie Huber of the National Abstinence Education Association, which is lobbying to maintain funding for the programs. "Nothing is certain, but we're hopeful."
Critics of sex education programs focused on abstinence, however, are fighting to permanently end funding, saying there is clear evidence that the approach is unsuccessful.
"This is a last-ditch attempt by conservatives to resuscitate a program that has been proven to be ineffective," said James Wagoner, president of Advocates for Youth, a Washington-based advocacy group. "This is the failed abstinence-only model that research has shown is ineffective."
During President George W. Bush's administration, abstinence programs received more than $100 million per year directly in federal funding and about $50 million in federal money funneled through the states. But the effort came under mounting criticism when studies concluded that the approach was ineffective and signs indicated the long decline in teen pregnancies was slowing.
As part of Obama's first budget, Congress approved a request for more than $110 million for a new "teenage pregnancy prevention" initiative that would only fund programs that have been "proven effective through rigorous evaluation," which would effectively eliminate abstinence programs. The program would be run by a new Office of Adolescent Health in the Health and Human Services Department.
"This not only marks the return of science and evidence back to health policy but also provides a critical infusion of funding to implement comprehensive sex education and teen-pregnancy-prevention programs," Wagoner said.
The initiative includes $25 million for new, innovative programs that could potentially embrace those encouraging abstinence. But it does not earmark funding for programs focused on maintaining virginity. Some said the move was aimed at mollifying conservative critics, but Huber and others remained skeptical.
"There is absolutely no priority given to risk avoidance," Huber said. "So there is no certainty that even one dollar would go to this approach."
Huber estimated that more than 130 programs around the country, serving perhaps 1.5 million youths, will lose funding by September unless at least some money is restored through the health-reform legislation.
"The tragic part is a number of these programs provide services in very at-risk communities where students don't have positive role models. They really depend on the mentoring and skills they receive through these programs," Huber said.
Funding could be restored as part of the health-reform package. Sen. Orrin G. Hatch (R-Utah) won inclusion of an amendment in the Senate Finance Committee bill that would provide $50 million to states to use for abstinence programs, and the funding survived the version of the legislation that emerged from Senate Majority Leader Harry M. Reid (D-Nev.)
"I was as surprised as anyone to see abstinence-only education programs funded in the final Reid health care bill. There must have been some Democrats who wanted to see the abstinence-only language included," Hatch said in a statement.
It remains unclear what will happen once the House and Senate meet to reconcile their versions of health-care legislation. The House version contains no earmark and instead includes $50 million for states to fund comprehensive sex education programs. The Senate bill includes $75 million for such comprehensive sex education programs administered by the states.
"It's appalling that Republicans are using health-care reform to continue their campaign to fund abstinence-only programs that don't work," said Cecille Richards, president of the Planned Parenthood Federation of America. "Congress should strip the Hatch amendment providing funding for failed abstinence-only programs from the health-care reform bill."
Huber and other defenders disputed that studies had shown abstinence programs were ineffective. They argued that research had shown the programs were superior to comprehensive efforts when administered in the schools. In addition, they said many programs were just beginning to gather data that would further validate the approach.
"It's disingenuous to use data from a clinic-based setting and say it will be effective in school-based setting," she said.
Vernita Griffith, who runs the Youth Awake abstinence program in Raleigh, N.C., said her group is among those hoping their funding will continue. It is in the second year of what was supposed to be almost $500,000 in annual funding for five years to encourage teens to remain abstinent.
"What we talk about are refusal skills," Griffith said. "We talk to them about the clothes they wear, and the images they see in the media and how to chose healthy relationships. We're talking about it being cool to be abstinent. People don't understand the misconceptions these kids have. . . . I feel like they're really missing the mark if they cut off the funding."
But critics such as Wagoner contend the evidence is clear: Programs that include education about contraception are the most effective. Abstinence programs "deny young people life-saving information about condoms and other forms of prevention," Wagoner said.