Not even the coronavirus pandemic has prevented the Trump administration from continuing to roll back gender protections in health care. Last week, Politico reported that the Department of Health and Human Services is gearing up to release a final rule revising a key nondiscrimination regulation.
American Oversight recently published the calendars of key officials involved in the revision, showing a number of meetings on the subject from 2017 to 2019. The rule in question implements Section 1557 of the Affordable Care Act, the part of the health-care law that prohibits discrimination. The Obama administration had issued a rule in 2016 saying those protections covered gender identity; the Trump administration, namely Roger Severino, the head of HHS’s Office of Civil Rights, has long been developing a rewrite of that rule.
As seen from the department’s initial proposal last year, the new rule is expected not just to scrap the previous rule’s nondiscrimination protections for transgender patients and women who have had abortions (protections that a federal judge vacated in late 2019). It also is expected to ease requirements for providing language assistance for those with limited English proficiency, narrow the provision’s reach (including by saying it doesn’t apply to short-term health insurance policies and other types of insurance), and eliminate prohibitions on intimidation and retaliation, all actions that experts worry would be especially harmful to vulnerable people during the public health emergency the nation is now facing.
The calendars American Oversight has obtained and published include those of Severino as well as two other OCR officials, Outreach Adviser Arina Grossu and Senior Adviser Maya Noronha. Prior to joining HHS, Grossu worked as director of the Family Research Council’s Center for Human Dignity, where she advocated for anti-abortion rights initiatives. Noronha previously worked for various conservative organizations opposed to abortion rights and the Affordable Care Act.
According to the OCR calendars, nearly two dozen meetings about Section 1557 took place between April 2017 and April 2019 — the month before the administration officially proposed the rule overhaul. A number involved outside groups, other HHS officials, and discussions of press strategy or reduced language requirements. In one instance, Severino received a letter from the National Association of Chain Drug Stores on the subject of language requirements, and subsequently scheduled a meeting regarding a change to related regulations.
OCR’s efforts to roll back protections for LGBTQ people and for those who have had abortions is part of the administration’s wider effort to allow groups or companies — even those receiving federal funding — to deny services, employment, or contraception or other health coverage to people on “religious freedom” grounds. In 2018, the administration created the HHS Conscience and Religious Freedom Division, and according to other documents obtained by American Oversight, staffing and funding for this new division came at the expense of OCR’s civil rights work. And in May 2019, shortly before the new Section 1557 regulations were proposed, HHS announced its final “conscience rule,” allowing health-care workers to opt out of providing certain procedures for religious reasons.
The OCR calendars contain a number of meetings related to “religious freedom,” the conscience rule, or involving the CRFD. In addition to numerous internal meetings, Grossu attended a February 2018 “Religious Liberties Forum” at the Heritage Foundation, and Severino spoke at a May 2019 National Institute of Family and Life Advocates conference, during a session called “Protecting Rights of Conscience and Religious Freedom in Health Care and Human Services.” Other meetings on the subject are listed here.
American Oversight has received numerous other calendar productions from HHS and its component agencies that demonstrate the administration’s elevation of conservative interests and distaste for nondiscrimination protections. Calendars from the HHS Administration for Children and Families include a number of meetings with right-wing Christian groups and anti-abortion rights advocates, many of them arranged by Shannon Royce, the director of HHS’s Center for Faith and Opportunity Initiatives.
Also included is a January 2019 memo from Severino and ACF official Steven Wagner regarding South Carolina’s request for federally funded religious adoption agencies to be exempted from certain nondiscrimination regulations (HHS granted the request that same day). And another set of HHS documents contains the agenda from a July 12, 2019, meeting at the White House, attended by Secretary Alex Azar and numerous outside groups, regarding “the principles of the Administration’s view for insurance reform.” The meeting’s agenda takes issue with the Affordable Care Act’s individual mandate, and attendees included a long list of conservative groups, many dedicated to dismantling the ACA.