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A Review of Abstinence Education and Transitional Medical As- Sistance

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WELFARE REFORM: A REVIEW OF ABSTINENCE EDUCATION AND TRANSITIONAL MEDICAL AS- SISTANCE HEARING BEFORE THE SUBCOMMITTEE ON HEALTH OF THE COMMITTEE ON ENERGY AND COMMERCE HOUSE OF REPRESENTATIVES ONE HUNDRED SEVENTH CONGRESS SECOND SESSION APRIL 23, 2002 Serial No. 107–104 Printed for the use of the Committee on Energy and Commerce ( Available via the World Wide Web: http://www.access.gpo.gov/congress/house U.S. GOVERNMENT PRINTING OFFICE 79–467CC WASHINGTON : 2002 For sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800 Fax: (202) 512–2250 Mail: Stop SSOP, Washington, DC 20402–0001 VerDate 0ct 02 2002 09:18 Oct 05, 2002 Jkt 010199 PO 00000 Frm 00001 Fmt 5011 Sfmt 5011 W:\DISC\79467 79467 COMMITTEE ON ENERGY AND COMMERCE W.J. ‘‘BILLY’’ TAUZIN, Louisiana, Chairman MICHAEL BILIRAKIS, Florida JOHN D. DINGELL, Michigan JOE BARTON, Texas HENRY A. WAXMAN, California FRED UPTON, Michigan EDWARD J. MARKEY, Massachusetts CLIFF STEARNS, Florida RALPH M. HALL, Texas PAUL E. GILLMOR, Ohio RICK BOUCHER, Virginia JAMES C. GREENWOOD, Pennsylvania EDOLPHUS TOWNS, New York CHRISTOPHER COX, California FRANK PALLONE, Jr., New Jersey NATHAN DEAL, Georgia SHERROD BROWN, Ohio RICHARD BURR, North Carolina BART GORDON, Tennessee ED WHITFIELD, Kentucky PETER DEUTSCH, Florida GREG GANSKE, Iowa BOBBY L. RUSH, Illinois CHARLIE NORWOOD, Georgia ANNA G. ESHOO, California BARBARA CUBIN, Wyoming BART STUPAK, Michigan JOHN SHIMKUS, Illinois ELIOT L. ENGEL, New York HEATHER WILSON, New Mexico TOM SAWYER, Ohio JOHN B. SHADEGG, Arizona ALBERT R. WYNN, Maryland CHARLES ‘‘CHIP’’ PICKERING, Mississippi GENE GREEN, Texas VITO FOSSELLA, New York KAREN MCCARTHY, Missouri ROY BLUNT, Missouri TED STRICKLAND, Ohio TOM DAVIS, Virginia DIANA DEGETTE, Colorado ED BRYANT, Tennessee THOMAS M. BARRETT, Wisconsin ROBERT L. EHRLICH, Jr., Maryland BILL LUTHER, Minnesota STEVE BUYER, Indiana LOIS CAPPS, California GEORGE RADANOVICH, California MICHAEL F. DOYLE, Pennsylvania CHARLES F. BASS, New Hampshire CHRISTOPHER JOHN, Louisiana JOSEPH R. PITTS, Pennsylvania JANE HARMAN, California MARY BONO, California GREG WALDEN, Oregon LEE TERRY, Nebraska ERNIE FLETCHER, Kentucky DAVID V. MARVENTANO, Staff Director JAMES D. BARNETTE, General Counsel REID P.F. STUNTZ, Minority Staff Director and Chief Counsel SUBCOMMITTEE ON HEALTH MICHAEL BILIRAKIS, Florida, Chairman JOE BARTON, Texas SHERROD BROWN, Ohio FRED UPTON, Michigan HENRY A. WAXMAN, California JAMES C. GREENWOOD, Pennsylvania TED STRICKLAND, Ohio NATHAN DEAL, Georgia THOMAS M. BARRETT, Wisconsin RICHARD BURR, North Carolina LOIS CAPPS, California ED WHITFIELD, Kentucky RALPH M. HALL, Texas GREG GANSKE, Iowa EDOLPHUS TOWNS, New York CHARLIE NORWOOD, Georgia FRANK PALLONE, Jr., New Jersey Vice Chairman PETER DEUTSCH, Florida BARBARA CUBIN, Wyoming ANNA G. ESHOO, California HEATHER WILSON, New Mexico BART STUPAK, Michigan JOHN B. SHADEGG, Arizona ELIOT L. ENGEL, New York CHARLES ‘‘CHIP’’ PICKERING, Mississippi ALBERT R. WYNN, Maryland ED BRYANT, Tennessee GENE GREEN, Texas ROBERT L. EHRLICH, Jr., Maryland JOHN D. DINGELL, Michigan, STEVE BUYER, Indiana (Ex Officio) JOSEPH R. PITTS, Pennsylvania W.J. ‘‘BILLY’’ TAUZIN, Louisiana (Ex Officio) (II) VerDate 0ct 02 2002 09:18 Oct 05, 2002 Jkt 010199 PO 00000 Frm 00002 Fmt 0486 Sfmt 0486 W:\DISC\79467 79467 C O N T E N T S Page Testimony of: Del Rosario, Jacqueline Jones, Executive Director, ReCapturing the Vi- sion International ......................................................................................... 41 Kaplan, David W., Head of Adolescent Medicine, Professor of Pediatrics, University of Colorado School of Medicine ................................................. 53 Mann, Cindy, Senior Fellow, the Kaiser Commission on Medicaid and the Uninsured ............................................................................................... 57 McIlhaney, Joe S., Jr., the Medical Institute for Sexual Health .................. 47 Scanlon, William J., Director, Health Care Issues, U.S. General Account- ing Office ........................................................................................................ 64 Material submitted for the record by: American Civil Liberties Union, prepared statement of ............................... 107 American Hospital Association, prepared statement of ................................ 109 Diggs, John R., prepared statement of ........................................................... 109 Golden, Alma L., prepared statement of ........................................................ 112 Richards, Cory L., Alan Guttmacher Institute, letter dated May 1, 2002 ... 114 (III) VerDate 0ct 02 2002 09:18 Oct 05, 2002 Jkt 010199 PO 00000 Frm 00003 Fmt 0486 Sfmt 0486 W:\DISC\79467 79467 VerDate 0ct 02 2002 09:18 Oct 05, 2002 Jkt 010199 PO 00000 Frm 00004 Fmt 0486 Sfmt 0486 W:\DISC\79467 79467 WELFARE REFORM: A REVIEW OF ABSTI- NENCE EDUCATION AND TRANSITIONAL MEDICAL ASSISTANCE TUESDAY, APRIL 23, 2002 HOUSE OF REPRESENTATIVES, SUBCOMMITTEE ON HEALTH, COMMITTEE ON ENERGY AND COMMERCE, Washington, DC. The subcommittee met, pursuant to notice, at 3 p.m., in room 2322, Rayburn House Office Building, Hon. Michael Bilirakis pre- siding. Members present: Representatives Bilirakis, Upton, Greenwood, Norwood, Buyer, Pitts, Tauzin (ex officio), Brown, Waxman, Strick- land, Barrett, Hall, Stupak and Green. Also present: Representative Harman. Staff present: Erin Kuhls, majority counsel; Steven Tilton, health policy coordinator; Eugenie Edwards, legislative clerk; Amy Hall, minority professional staff member, John Ford, minority counsel; Bridgett Taylor, minority professional staff member; Karen Folk, minority professional staff member; and Jessica McNiece, staff as- sistant. Mr. BILIRAKIS. I now call to order this hearing of the Health Sub- committee and would like to thank our witnesses for taking the time to appear before us today and I feel sure that your testimony will prove valuable as we consider reauthorizing our Nation’s wel- fare laws. The Personal Responsibility and Work Opportunity Reconcili- ation Act of 1996 reformed our Nation’s welfare laws to put an em- phasis on work and end the seemingly endless cycle of dependence that was present under the old Aid to Families with Dependent Children program. The Health Subcommittee has jurisdiction over two areas of this landmark legislation which will be the focus of today’s hearing. The issues that we’re considering today are accurately captured, I feel, by the title of the 1996 law. Personal responsibility is encompassed by the funding provided to Title V of the Social Security Act related to abstinence only education. Title V allocated $50 million for fiscal years 1998 to 2002 for block grants to States for development of ab- stinence only education programs. To date, 49 of the 50 States have elected to participate in this program and I think this suggests that States have a high interest in abstinence only education programs. I’m very pleased that my own Satte of Florida has elected to par- ticipate in this program. In fact, today we will hear from Jac- (1) VerDate 0ct 02 2002 09:18 Oct 05, 2002 Jkt 010199 PO 00000 Frm 00005 Fmt 6633 Sfmt 6633 W:\DISC\79467 79467 2 queline Del Rosario who will provide our subcommittee with valu- able real world and I underline real world data on Florida’s experi- ence. So often up here in Washington we don’t have the oppor- tunity to hear from experts like Ms. Del Rosario who have real world exposure. Again, I welcome you particularly Ms. Del Rosario. I’m anxious to hear more about the near 100 percent success that your program has achieved with respect to limiting teen pregnancy rates. Transitional medical assistance is the second component, God knows, a very significant one the 1996 law that is under this sub- committee’s jurisdiction. As we all know, the costs of health insur- ance continue to rise. Many low income individuals who move from welfare to work often take low wage jobs that do not offer private health insurance coverage. Transitional medical assistance extends Medicaid coverage to these former welfare recipients for up to 1 year after they leave the rolls. Obviously, the potential loss of one’s health insurance would be a significant disincentive to leaving wel- fare and entering the work force. Transitional medical assistance removes this barrier and ensures people do not have to sacrifice their health care in order to enter the work force. I would like to again thank our witnesses for appearing before us today and now I’m pleased to recognize the ranking member, Mr. Brown, for his opening statement. Mr. BROWN. Thank you, Mr. Chairman, I want to welcome our witnesses, thank you for joining us today. Although there’s no funding for the transitional medical assist- ance program in the Republican budget blueprint, reauthorization of this program isn’t or shouldn’t be a partisan issue. I appreciate your willingness, Mr. Chairman, and Chairman Tauzin’s willing- ness to focus on TMA this afternoon. The President’s budget includes funding for 1-year extension of TMA because to quote their budget document ‘‘this coverage helps ensure the work pays for families by preventing them from losing their health coverage when they start jobs.’’ Well put, but actually, the fundamental goal of welfare to work is not to increase the num- ber of individuals who enter the workplace, it’s to increase the number of individuals who stay in the workplace. Employers
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