The Trump administration’s newly released draft plan for Health and Human Services suggests the federal health agency will now be focused on protecting unborn Americans starting as early as conception.
HHS, according to the plan, will also be in the business of supporting strong family values and “healthy marriages,” empowering faith-based groups that receive federal dollars with the freedom to exercise their morals and beliefs, and looking after American lives all the way to “natural death.”
Language about human life starting with conception (the fertilization of an egg) is usually reserved for religious groups and anti-abortion activists, not government documents that will guide federal policy, according to several women’s health and policy experts Vox contacted. The notion that life starts at conception runs counter to federal law — as well as the medical community’s consensus — that recognizes pregnancy as beginning with the implantation of a fertilized egg in the uterus, they said.
“This document has a very different frame from previous strategic plans,” said Alina Salganicoff, vice president and director of women’s health policy at the Kaiser Family Foundation. “This is a significant departure, and the question is what does this mean for health care.”
Every four years, HHS publishes a strategic plan reflecting the priorities of the administration. Barack Obama’s 2014-’18 plan focused on getting the health care markets stabilized and more people enrolled in insurance plans. In that document, the administration described HHS as “accomplishing its mission through programs and initiatives that cover a wide spectrum of activities, serving Americans at every stage of life.”
The new Trump 2018-’22 draft plan — which is out for public comment until October 27 — seems determined to take health care in a more ideological direction, starting by rewriting the definition of American life. HHS will now be “serving and protecting Americans at every stage of life, beginning at conception.” The plan’s repeated references to “natural death” also suggest the agency may now be opposed to assisted suicide.
“Conception and natural death — that’s not the legal standard for anybody,” said Kathleen Sebelius, the former head of HHS under Obama. “There are states that allow assisted suicide. This does not seem to recognize the law. And protecting women and unborn children does not seem to give any issue around what happens to same-sex parents, same-sex families, single families.”
No mention of birth control in the 2018-2022 HHS strategic plan. None. https://t.co/EFjHeudBOE— Jennifer Gunter (@DrJenGunter) October 10, 2017
When it’s finalized, the document would serve as a road map for HHS agencies — which include the Centers for Medicare and Medicaid Services, the Food and Drug Administration, and the Centers for Disease Control and Prevention — but does not have the force of law. HHS could, however, permit nonprofits and providers that receive federal funding to deliver only services they are comfortable with providing, such as abstinence-only education or health care for individuals in heterosexual marriages. Providers could also refrain from giving condoms to people who want them, or referrals to organizations that provide abortions to women in need.
This signals a shift at the agency toward faith-based decision-making in health care, said Adam Sonfield, senior policy manager at the Guttmacher Institute, a nonprofit research organization that supports legal abortion. Even the socially conservative George W. Bush administration did not employ such stark pro-life language in its guidance, ThinkProgress pointed out.
“The argument that life begins at conception has long been used by socially conservative activists to attack birth control access,” Sonfield added. “It could now form the basis of a new wave of attacks against publicly funded family planning services, for instance, by attempting to redirect funding to entities that do not offer the full array of birth control methods.”
It’s also more evidence of the religious right’s growing influence at the highest levels of government and Trump’s desire to fulfill campaign promises to expand religious freedom.
Echoing comments on the 2016 campaign trail, Trump promised in June to "battle for every American of faith who has lost their rights and lost their freedom."
“As long as I'm president,” he said, “no one is going to stop you from following your faith or preaching what is in your heart.”
The HHS document mentioned the world “faith” 46 times
The HHS draft plan was released days before the administration also put out new regulations that relax the Obama-era birth control mandate, which required employers to offer insurance that covered contraception for women. (The birth control change was justified in part by the false notion that giving women free birth control makes them more promiscuous.)
Also on Friday, the DOJ put out a memo directing government departments, including HHS, to make a priority of preserving religious liberty even if it means violating anti-discrimination laws. Some have noted this too empowers religious groups to discriminate against LGBTQ people.
The new document mentions the word “faith” 46 times. (The last Obama strategic plan included three mentions of the word faith, in the context of working with faith-based groups to promote and deliver health care.)
The draft document also repeatedly mentions “removing barriers for health care providers with religious beliefs or moral convictions,” which would empower nonprofits and clinics that receive federal dollars to discriminate against patients or employees whose values or beliefs conflict with them.
HHS is now staffed by several anti-abortion activists
The new language in the HHS strategic plan — and the rollback of the birth control mandate — is less surprising when you take a look at the ideological views of some of the people who now hold important positions at the agency.
The list of former activists now in HHS include:
- Matthew Bowman, a lawyer at the Department of Health and Human Services, is reportedly one of the architects behind the new birth control rules and previously worked for Alliance Defending Freedom, a Christian legal advocacy (and anti-choice) group.
- Another top Trump adviser on health care is Katy Talento, an anti-abortionist who has claimed that side effects of hormonal birth include cancer and miscarriages.
- Trump put Teresa Manning, an anti-abortion lawyer who once said giving people easy access to the morning-after pill was "medically irresponsible" and "anti-family,” in charge of Title X, HHS’s federal family planning program.
- Charmaine Yoest, who is now assistant secretary at HHS, was the president and CEO of the anti-abortion group Americans United for Life.
- Valerie Huber, the former president of an abstinence-only association, is the chief of staff to the assistant secretary for health at HHS.
Trump’s positions on abortion have been wishy-washy, but it’s well known that Vice President Mike Pence has been crusading against reproductive rights and access to contraception for years. For this reason, activists on all sides of the abortion debate told Politico they have “never seen a legislator pursue Planned Parenthood with such a single-minded focus.”
“This [new HHS] plan might be a nod to anti-abortion activists who supported the president, some of whom are in this administration,” said Sonfield. “Or it may be a signal that they’re trying to look at more anti-abortion policy changes.” With its emphasis on family values, religious freedoms, and assisted suicide, the changes afoot will affect much more than women’s health.