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What Mike Pence’s public health record says about his ability to lead on coronavirus

Nothing good.

Mike Pence at National Defense University at Fort McNair on October 23, 2018, in Washington, DC.
Alex Wong/Getty Images
Anna North is a senior correspondent for Vox, where she covers American family life, work, and education. Previously, she was an editor and writer at the New York Times. She is also the author of three novels, including the New York Times bestseller Outlawed.

In 2011, a Congress member from Indiana helped pass federal legislation to strip funding from Planned Parenthood.

Two years later, the last Planned Parenthood affiliate in Scott County, Indiana, closed its doors because of budget cuts. It was also the last HIV testing center in the county. By 2015, an HIV outbreak was brewing in the state. At the peak of the outbreak, 20 new cases were being diagnosed per week, with a total of nearly 200 cases eventually reported, according to HuffPost.

But that Congress member, who became Indiana’s governor, didn’t want to authorize a needle-exchange program to stop the spread of the virus.

“I don’t believe effective anti-drug policy involves handing out drug paraphernalia,” he said.

That Indiana governor was, of course, Mike Pence. Now he’s the vice president, and on Wednesday, President Trump put him in charge of fighting coronavirus in the US.

“He’s got a certain talent for this,” Trump said.

But others say the opposite is true. In Indiana, cuts to Planned Parenthood meant that “when the state experienced an HIV outbreak, they were unprepared to respond to it,” Mary Alice Carter, a senior adviser at Equity Forward, a reproductive-health watchdog group, told Vox. Pence’s role in cutting Planned Parenthood funding showed a “short-sightedness” that makes Trump’s decision to put him in charge of coronavirus response concerning, Carter said. (The White House has not responded to a request for comment from Vox on the selection of Pence for the position.)

Moreover, Pence and his history are part of a bigger problem in the Trump administration, Carter and others say. In general, the administration has sought to restrict funding to Planned Parenthood and other groups, reproductive health advocates say, without regard to the public health implications. The administration’s policies have already made it harder for low-income Americans to get screening for conditions like breast and cervical cancer. And some fear that, especially with Pence in charge, the administration could put politics over science when it comes to coronavirus response too.

“The ongoing concern is whether you let science and medicine lead an effort or whether you let ideology run your policy,” Carter said.

Pence was among the first Republicans to advocate cutting funds to Planned Parenthood

Planned Parenthood has long been a target for anti-abortion groups because some of its affiliates offer the procedure, but for years, it has also functioned as a safety-net health care provider for millions of Americans, offering STI testing, cervical cancer screening, and other services at low or no cost. In order to do this, the group has received public funding from a number of state and federal sources.

Cutting that funding has been a Republican priority for years. The Hyde Amendment already bans federal funding for nearly all abortions, but for many years, Planned Parenthood was still able to use federal funds for other health services. Getting rid of that funding, abortion opponents argued, would indirectly make it harder for the group to perform abortions.

Pence was essentially the architect of this strategy, as Sarah Kliff reported at Vox in 2016. In Congress, he proposed bills to cut funding to the group repeatedly beginning in 2007, and one finally passed the House in 2011.

“If Planned Parenthood wants to be involved in providing counseling services and HIV testing, they ought not be in the business of providing abortions,” Pence told Kliff. “As long as they aspire to do that, I’ll be after them.”

The 2011 legislation did not make it through the Senate. But states also joined in the effort, with Indiana chief among them. In 2005, Planned Parenthood got $3.3 million from the state of Indiana; in 2014, it got just $1.9 million, according to Indy100.

Those cuts started before Pence became governor, but they continued under his administration. Indeed, during his governorship, overall funding for public health in the state decreased, Beth Meyerson, a research professor at the University of Arizona’s Southwest Institute for Research on Women and co-director of the Rural Center for AIDS/STD Prevention at the Indiana University School of Public Health, told Vox.

In 2013, Pence’s first year as governor, the only Planned Parenthood in Scott County closed, leaving 24,000 people without an HIV testing center.

By 2015, health officials were seeing HIV infections linked to intravenous drug use in Scott County, Erin Schumaker reported at HuffPost: “Scott County residents were sharing needles to inject their opioids, and nobody was getting tested.”

Public health experts called for a needle-exchange program to make sure people got clean needles, but Pence refused, Meryl Kornfield reports at the Washington Post. He said he would veto any bill for such a program.

Finally, over two months after the HIV outbreak was reported, Pence said he would pray on the issue, according to the New York Times. Two days later, he issued an executive order for syringes to be distributed in Scott County.

The distribution helped stop the epidemic, according to the Times. But Pence didn’t actually allocate new money for the program, or for fighting the epidemic generally, forcing state officials to cut other health programs, Meyerson said: “overall, his governorship showed that he did not commit to an adequately funded public health infrastructure.”

Then, in 2016, Pence was elected vice president. And the effort to cut funding to Planned Parenthood that he had championed for nearly a decade became a priority for the Trump administration.

Last year, the administration issued a rule barring Planned Parenthood and other groups that perform or refer for abortions from getting federal funding through Title X, a program aimed at providing family planning services to low-income Americans. As a result, nearly 1,000 health centers around the country have lost funding, making it harder for many Americans to get necessary services like cancer screening or HIV tests.

The move was doubly concerning because for many people, Title-X-funded clinics “are really the first line of defense in public health,” Carter said. For many low-income patients, their health-care provider at such a clinic may be the only provider they see all year.

“You may go in for birth control and come out knowing you need to get a flu shot,” Carter said, and family planning clinics can also help patients sign up for Medicaid and other services.

Meanwhile, Planned Parenthood has played a crucial role in previous public health crises, doing outreach around prevention of the Zika virus and offering water filters in Michigan during the Flint water crisis.

The Trump administration’s record on public health raises concerns about its handling of coronavirus

Today, the Trump administration is tasked with responding to coronavirus, with Pence, one of Planned Parenthood’s most long-standing opponents, at the head of that effort. It’s not clear yet how the group will be involved, if at all, in fighting coronavirus. But its leadership has already expressed concern over the selection of Pence to lead the government’s response.

“Pence has long been obsessed with defunding Planned Parenthood, even when Planned Parenthood closures in the state affected one of Indiana’s worst public health crises,” said Jacqueline Ayers, vice president of government relations and public policy at Planned Parenthood Action Fund, in a statement on Thursday. “There’s no evidence he has learned any lessons since then.”

Carter also noted the administration’s attitude to Planned Parenthood raises questions about how it will respond to coronavirus. For example, she asked, would it ship a virus testing kit to a Planned Parenthood facility?

More broadly, the administration and its officials have a record of disregarding medical evidence or the advice of experts, Carter and others say. Pence, for example, went against the guidance of public health officials when he opposed a needle-exchange program. (And in 2000, he claimed in an op-ed that “smoking does not kill.”) Later, when the American Academy of Pediatrics and other groups asked the Trump administration not to bar Planned Parenthood and other groups from getting Title X funds, arguing that the move would harm public health, the administration did it anyway.

The issue goes beyond Planned Parenthood. In 2017, the Trump administration reinstated and expanded the “global gag rule,” which bars health care providers abroad that receive US government aid from providing, referring for, or discussing abortion.

Experts have long said the rule, enacted by previous Republican presidents but broadened by Trump to apply restrictions to a larger share of government funds, would not reduce abortions but would instead jeopardize providers’ ability to offer cancer screenings, contraception, and prenatal care. Indeed, a 2019 study found that access to HIV testing and screening for breast and cervical cancers, among other services, had been reduced across several countries as a result of the rule.

Also in 2017, six members of the Presidential Advisory Council on HIV and AIDS resigned in protest, with one writing in Newsweek that “the Trump administration has no strategy to address the ongoing H.I.V./AIDS epidemic, seeks zero input from experts to formulate H.I.V. policy, and — most concerning — pushes legislation that will harm people living with H.I.V. and halt or reverse important gains made in the fight against this disease.”

Then, in 2019, the Trump administration cut funding for fetal-tissue research, despite long-standing arguments by scientific and medical experts that such research is crucial for developing vaccines and treatments for diseases. Research into AIDS and other conditions has already suffered as a result, Carter said.

The failure to listen to experts in the past raises questions about the administration’s coronavirus response today, Carter said. For example, “are we going to see immigration policies put in place, or travel restrictions put in place, that are scientifically based or based on race or country of origin?”

Moreover, the research on coronavirus is constantly evolving, and Americans need someone in charge of the response who can sift through it with a focus on data, not ideology, Meyerson said.

“We need a strong, clear, transparent, public health evidence-based communicator who will coordinate among agencies and who will manage upward in our current draconian administration,” she explained. When it comes to Pence, “there’s no evidence that he will handle that job and do it in the way the American people need.”