Last week, the Trump administration unveiled an initiative to "improve teen pregnancy prevention and sexual risk avoidance programs." The goal, according to the announcement from the Department of Health and Human Services, was to "help improve our children's future." This goal is so important that the agency is spending $10 million to reach it.
Here's what HHS didn't say: That $10 million was a mere distraction to make people forget that the Trump administration thus summer abruptly cut off more than $200 million in funding for 81 existing teen pregnancy prevention programs. That move wrecked programs from coast to coast that in some cases had been functioning for years.
One other important point: "Sexual risk avoidance" is code for "abstinence." It's the term preferred by Ascend, the abstinence-only advocacy group formerly headed by Valerie Huber, who was appointed chief of staff to the assistant secretary for Health at HHS on June 5. Another point: Abstinence-only teen pregnancy programs consistently have been shown not to work.
The administration never has adequately explained the reason for its cutoff of funding. "We don't know, nor do our colleagues in the teen pregnancy prevention community, exactly why these cuts were made," Marvin Belzer and Arlene Schneir, who oversaw a program at Children's Hospital of Los Angeles that supported the other grantees, wrote in August. They've never received an explanation, Schneir told me. But the indications are that the administration's goal was to shut down programs with multiple approaches to teen pregnancy prevention and substitute abstinence-only.
Efforts to get to the bottom of the decision have come up empty. That's the experience of Democracy Forward, a Washington advocacy group that filed a freedom of information request for related documents on Aug. 14. A few weeks later, HHS acknowledged that it had identified "a large volume of responsive records" but said they had to be reviewed by a political appointee in the agency.
Since then, not a single document has been produced. "We find it incredibly curious that the government hasn't provided the documents they say they've identified," Skye Perryman, the organization's lawyer, told me.
In a demand letter sent Nov. 2, Perryman gave HHS until the close of business Thursday to fulfill the request. Nothing arrived, although an HHS official left a voicemail at Democracy Forward's number on Wednesday stating that a further response would be coming. HHS officials didn't respond to our request for comment.
Democracy Forward listed among its requested documents information related to the role of Huber in the shutoff of teen pregnancy funding.
"Our thesis is that all of the scientific evidence has pointed against Valerie Huber's belief in abstinence-only education," said Corey Ciorciari, policy and strategy director at Democracy Forward. "She came in, got rid of the funding, and now she's trying to spend $10 million to build some sort of research justification for her theory. This signals her desire to bend the research to her liking."
The funding shutdown was a remarkably wasteful act. Some programs were told that their multiyear grants would end next June, but others were cut off immediately. Among those immediately cut off was a $2.8-million, five-year program at Childrens Hospital of Los Angeles, which advised the 81 grantees on how to set up their services.
Childrens Hospital put in a request for an extension that would have allowed it to wind down its services through the end of the year, at a cost of about $54,000 in funds that already had been allocated.
"We had all sorts of material in development, training planned, conferences booked," Schneir says. HHS denied the request on Sept. 25.
"There will be a ripple effect nationally" from the shutdown of all these programs, Schneir says. She adds that the programs weren't all focused narrowly on teen pregnancy, but "were about helping vulnerable young populations make healthy choices about their future. We're worried about what's going to happen when they're gone."
"It's likely that all the work spent investigating what is effective and what isn't will be lost," Aaron Carroll, a professor of pediatrics at Indiana University and prominent commentator on healthcare issues, observed earlier this month. "The money already invested would be wasted as well."
Carroll noted that the administration's underlying goal seemed to be the substitution of ideological nostrums for science-based policy. The last time that approach was in place, under the administration of George W. Bush, it led to a drop in the percentage of schools requiring education in human sexuality to 48% from 67%, Carroll reports.
That approach was reversed under the Obama White House. After the establishment of the Teen Pregnancy Prevention Program in 2010, teen pregnancy and birth rates fell faster than ever before. The Trump administration's actions to kill this successful program demands an explanation. It's hardly surprising that Trump's people are reluctant to give it.