On November 14, President Trump nominated Alex Azar to replace Tom Price as U.S. Secretary of Health and Human Services (HHS). The U.S. Senate Committee on Health, Education, Labor & Pensions held a hearing on the Azar nomination on November 29, followed by a Finance Committee hearing on January 9. As Azar awaits further consideration, People For the American Way, Planned Parenthood, and more than twenty other organizations want senators to consider the extreme actions HHS has taken since Trump took office and the type of leader the agency needs in order to fully and faithfully return to its core mission of protecting and expanding health care for all. PFAW agrees that neither Azar nor any other nominee is fit to lead HHS unless they make such a commitment. You can download our January 9 letter, with footnotes, here.

Dear Chairman Hatch and Ranking Member Wyden:

As you consider the nomination of Mr. Alex Azar for Secretary of the U.S. Department of Health and Human Services (HHS), the undersigned health care providers, civil rights, and social justice organizations on behalf of reproductive rights write to share serious and significant concerns. At minimum, for this critical agency, its secretary must commit to upholding, or as is the present case, returning to basic pillars to protect and expand health care for all. Any nominee who cannot commit to the below requirements is unfit to lead HHS.

Within the past year, HHS has taken extreme steps, ignoring its stated mission ‘to enhance and protect the well-being of all,”¹ and instead limiting access to health care for many individuals. The new secretary must take immediate action upon being confirmed to return to the department’s mission to protect and enhance the health of all individuals. For example, if confirmed, Mr. Azar must denounce the newly created HHS Strategic Plan and all related policies, from this misguided political publication that is full of anti-science, anti-woman, and anti-LGBTQ doctrine.²

HHS has also unilaterally shortened the duration of grant agreements for the Teen Pregnancy Prevention program and the Title X family planning program by the end of June of 2018, risking the health and wellbeing of those that benefit from these important programs. HHS has also issued guidance in an effort to ban certain words in budget proposals including “fetus, vulnerable, and transgender,” at the Centers for Disease Control and Prevention.³ In just 12 months, HHS has clearly demonstrated its eagerness to abandon its mission in favor of ideology.

Upon entering the White House, the Trump-Pence administration immediately filled key HHS positions with anti-women’s health, anti-science officials and people who directly oppose the programs they oversee. With the confirmation of anti-women’s health Congressman Tom Price as the first Secretary of HHS, it was no surprise to see continued efforts to fill the agency with officials who have attempted to translate their own ideological and personal positions into dangerous public policies for millions of individuals within months of taking office.

At a baseline, in order to be qualified to run this failing agency, any secretary must first commit to removing some of the political appointees upon confirmation. The following officials must include, but are not limited to:

Scott Lloyd,⁴ Director of the Office of Refugee Resettlement, who has instructed his department to go to extreme lengths to block young immigrant women in the care of the government from accessing abortions, including physically holding them hostage, as seen in the three legal cases of Jane Doe, Jane Roe, and Jane Poe. Although court orders forced the agency to allow these young women to obtain medical care, Lloyd continues to carry out this cruel and unconstitutional policy restricting the rights of other young women;⁵

Teresa Manning, who oversees the Title X program—the nation’s only federal program dedicated to family planning serving four million people—has previously stated on C-SPAN that she does not believe the federal government should run family planning programs.⁶ The head of the Title X program should believe in the core services it is designed to provide for; and,

Charmaine Yoest, a top spokesperson at HHS who has previously touted dangerous and blatantly untrue claims that abortion causes breast cancer.⁷ As the HHS Assistant Secretary for Public Affairs, Yoest should be held to professional standards and not spreading medically inaccurate information to the public.

Valerie Huber is Chief of Staff in the Office of the Assistant Secretary of Health at HHS, and she is an anti-sex education activist.⁸ She was formally the CEO of a national abstinence-only organization, and is now responsible for key programs to reduce unintended pregnancy and ensure young people’s health. As Chief of Staff she has had an instrumental role in cutting the TPPP grants and increasing national funding for abstinence-only programs.⁹

If Mr. Azar is confirmed, a decision not to remove unqualified and extreme HHS staff like Lloyd, Manning, Yoest[, and Huber] would make him complicit in their actions and policies and undermine any other attempts by him to redirect the agency towards its public health mission.

In the past year, HHS has also taken alarming steps to diminish health care access for millions of people, with access to birth control being a primary target. The Trump-Pence administration and HHS have attempted to erase progress by issuing illegal and discriminatory interim final rules to roll back the Affordable Care Act’s (ACA) birth control benefit. The popular benefit¹⁰ requires insurance coverage for all FDA-approved birth control methods for women without cost-sharing with over 62 million women eligible for this coverage.¹¹ Access to affordable birth control is critical to the continued efforts to reduce unintended pregnancies, including teen pregnancies, across the country.¹² The administration seeks to undermine these positive trends by allowing employers and universities to deny insurance coverage of contraception for any religious or moral objection. The next HHS secretary must reverse these actions and commit to protecting and expanding insurance coverage of and access to birth control.

Mr. Azar made it clear during his nomination hearing with the Senate Health, Education, Labor, and Pensions committee, that he supports the administration’s decision to allow religious and moral objections to insurance coverage of basic health care saying, “we have to balance a woman’s choice of insurance with the conscience of their [employer’s choice].”¹³ This offensive belief would allow employers to discriminate against women by denying them insurance coverage of birth control and take these women back to a time in which one in three women reported difficulty in affording contraception.¹⁴

The attempt by the administration to deny contraceptive coverage is already being challenged in the courts and is currently subject to two nationwide injunctions. If confirmed, Mr. Azar should immediately rescind these rules.¹⁵

Efforts to block patients from health care programs and providers or preventing public health work that is based in science may lead to fatal consequences for millions of people across the country. Any nominee for secretary must commit to reversing course on these new policies and ensuring that health care access is at the center of all policy considerations.

We strongly urge that Mr. Azar is questioned extensively about these actions and asked if he will commit to the HHS mandate to ensure individuals have the ability to live healthy lives, which includes access to reproductive health care.

On behalf of the millions of individuals we represent, we continue to be gravely concerned about the actions coming out of HHS and Mr. Azar’s ability to implement better policies. We appreciate your committee thoroughly reviewing these qualifications as part of Mr. Azar’s nomination hearings.

Sincerely,

Advocates for Youth
American Bridge 21st Century
Black Women’s Health Imperative
Catholics for Choice
Feminist Majority Foundation
In Our Own Voice: The Black Women’s Reproductive Justice Agenda
Keep Birth Control Copay Free Campaign
NARAL Pro-Choice America
National Abortion Federation
National Asian Pacific American Women’s Forum (NAPAWF)
National Council of Jewish Women
National Institute for Reproductive Health (NIRH)
National Latina Institute for Reproductive Health
National Network of Abortion Funds
National Organization for Women
National Women’s Health Network
People For the American Way
Physicians for Reproductive Health
Planned Parenthood Federation of America
Population Connection Action Fund
Sexuality Information and Education Council of the United States (SIECUS)
UltraViolet
URGE: Unite for Reproductive & Gender Equity