OP said:
Since the compressive and tension reinforcement is the same, I find this somewhat confusing.
I suspect that much of your confusion may be mitigated by knowing what an experienced designer's intent would normally be with the doubly reinforced sections:
1) These are generally roughly designed and roughly constructed elements. There's usually just no great benefit to having discontinuous top steel as you might expect in above grade structure.
2) In addition to the compression steel being flexurally ineffective, it may also be flexurally invalid depending on your stirrup spacing. Most folks feel that compression steel cannot be relied upon unless less it's tied back to the body of the section at sufficiently small intervals. Most designers will not be doing that in these situations.
3) One of the main reasons for using grade beams is to smooth out any potential differential deflection between piles. Or at least smooth out the effect that such deflection would have upon the structure above. If you imagine what your moment diagram would look like under this load case, you'll see a demand for reinforcing on both sides of the beam for pretty much the entire length. Obviously, it's not possible to know in advance if a particular pile will be a high point or a low point.
4) Grade beams are often exposed to temperature change and can be highly restrained axially by the lateral restraint provided at each pile. This means that there's a high probability of developing axial tension stresses and cracking in the grade beams. Viewed in that light, having some rebar on both faces makes sense.
5) Because of #4, it's entirely possible that grade beams will have full depth tension cracking present when they are called upon to resist transverse loads from the stuff stacked upon them. When that happens, it is nice to be able to utilize your compression steel for flexural stiffness prior to closing of those tensile cracks in bending.
Because we suck at mentoring junior engineers these days, many designers assume that the only loads on their grade beams are the transverse ones induced by gravity acting upon the stuff stack upon them. Not so.