LegiStorm

Summary:

The Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended) established the Pregnancy Assistance Fund (PAF) to assist vulnerable individuals and their families during the transition to parenthood. Specifically, the program serves expectant and parenting teens, women, fathers, and their families. This includes women of any age who are survivors of domestic violence, sexual violence, sexual assault, and stalking. The PAF program focuses on meeting the educational, social service, and health needs of eligible individuals and their children during pregnancy and the postnatal period. The research literature indicates that pregnancy has high costs for individuals eligible for the PAF program. Teenage mothers and fathers tend to have less education and are more likely to live in poverty than their peers who are not parenting. Nearly one-third of adolescent females who have dropped out of high school cite pregnancy or parenthood as a reason. Parenthood can also influence whether students pursue postsecondary education. One analysis found that single young women who had children after enrolling in community college were 65% more likely to drop out than their same-age peers who did not have children after enrolling. The research literature further indicates that approximately 3% to 9% of women experience domestic violence during pregnancy. Some studies indicate that this risk is greater among low-income women. The PAF program is administered by the Office of Adolescent Health (OAH) in the Department of Health and Human Services’ (HHS’) Office of the Assistant Secretary for Health (OASH). HHS distributes PAF funding on a competitive basis to the states, the District of Columbia, U.S. territories, and tribal entities. Through FY2018, HHS has awarded PAF funding to 30 states, the District of Columbia, and five tribal entities (“grantees”). These grantees can decide how to use funding under four purpose areas. Three of the purpose areas focus on providing services to the eligible expectant and parenting population through subgrants and partnerships. The fourth category focuses on public awareness about such services; however, HHS advises that grantees may not use funding solely for public awareness activities. In general, grantees have provided subgrants to school districts, community service organizations, and institutions of higher education (IHE) that directly serve the expectant and parenting population. Subgrantees have most frequently provided case management, referral services for other supports, group workshops on specific topics (e.g., pregnancy prevention), and home visiting services. The PAF statute and the program grant announcements include requirements for state grantees and subgrantees in carrying out activities under the program. The authorizing law requires each subgrantee to provide an annual report to the grantee about expenditures, fulfilling program requirements, and how it meets the needs of participants. Grantees must prepare an annual report to HHS on information provided by subgrantees, including participant data. In FY2016, grantees (17 states and 3 tribal entities) reported serving 16,053 individuals. Of these participants, 55% were expectant or parenting mothers, 37% were children, and 8% were expectant or parenting fathers. Most expectant or parenting participants were ages 16 through 19, and nearly half of all participants were white, about one-third were black, and the remaining share were another race or multiracial. About half of all participants were Hispanic. The ACA provides mandatory PAF funding of $25 million annually from FY2010 through FY2019. If Congress considers reauthorizing the program, it may look to emerging findings from a recent evaluation that may indicate the program is helping to keep pregnant and parenting students in the District of Columbia connected to their high schools. Among other topics, Congress may consider whether to establish guidelines regarding how the PAF program should interact with other, similar federal programs in the areas of education, health, and social services.