Project 2025 - 14. Dept. of Health and Human Services (HHS) - Part 2
...Continuing on from Part I
The HHS section of Project 2025 is written by Roger Severino, a former trial attorney and tapped by Donald Trump to be Director of the Office of Civil Rights at the U.S. Department of Health and Human Services in 2017. He left that position in 2021. The Human Rights Campaign described Severino as a "radical anti-LGBTQ activist," and in an op-ed co-written by former U.S. Senator Jim DeMint, Severino said that "transgender rights supporters see sex as 'merely a placeholder' assigned at birth." He is quoted as saying his anti-LGBT views are "actually decent and honorable beliefs based not on any sort of hatred but, in fact, out of love. It’s a vision of human flourishing, people who believe in marriage and believe in a biblical view of human sexuality." He was allegedly fired by President Joe Biden.
EMERGENCY PREPAREDNESS
Severino would like to "bolster" non-clinical laboratories to do the footwork in case of another pandemic, which he says have "demonstrate(d) their technical expertise through online training and certification programs."
LIFE, CONSCIENCE, AND BODILY INTEGRITY
Here's where we get down to the nitty-gritty when it comes to states' rights and women's healthcare, and what actual rights states will have moving forward.
Severino wants to cut any funding allowing for women to travel out of state to get an abortion because it "violates the conscience and religious freedom rights of Americans who object to [abortion]." He accuses Planned Parenthood of the now broken-record category of "waste, abuse, and fraud," and wants to defund their medical facilities of all Medicaid payments.
Half of all patients of Planned Parenthood use Medicaid.
Severino goes on to describe the Emergency Medical Treatment and Active Labor Act (EMTALA) as used to "explicitly protect unborn children," and if a facility is found to be in violation it "could lose all…federal health funding--Medicare, Medicaid, (and) CHIP." However, according to the ACLU, this act protects a woman's right to an emergency abortion, regardless of a state's abortion ban. Severino claims this is a baseless stance, and says there is no such requirement.
He veers off-course just a bit to make sure we know that gender reassignment surgery is not covered for Medicare beneficiaries, before redirecting to all of the children who are born alive after incomplete abortions, and "left untreated."
Important to note here that 93% of all abortions in the U.S. happen in the first trimester (up to 13 weeks' gestation), and the abortion failure rate is roughly .2%, in which case the fetus is not extracted at all, but remains inside the uterus. A born-alive fetus is generally viable, and if so a physician will take life-saving measures.
"No. Killing a baby is a homicide. States can and do punish people for killing children who are born alive.” - Mary Ziegler, Florida State University’s College of Law
Severino then discusses the "Radical Redefinition of Sex," referring to the Affordable Care Act's anti-discrimination policies, which include gender identity. He claims this is a special privilege for "new classes of people" who are "highly ideological and unscientific." This, along with all abortion coverage, he says, should be removed from the HHS and CMS programs, including children's health coverage.
Severino moves on to the COVID-19 debate, unsurprisingly asking for the removal of mask and vaccine mandates, and asking that the government pay damages to all medical professionals dismissed due to lack of cooperation with said mandates.
ADMINISTRATION FOR CHILDREN AND FAMILIES (ACF)
Severino claims there is waste, fraud, and abuse in the Temporary Assistance for Needy Families (TANF) program and references Donald Trump's Supplemental Nutrition Assistance Program (SNAP) rules that would put greater limits on who qualifies for these programs, including rejection for families laid off from their jobs, and making elderly Americans go back to work in order to receive food benefits.
Currently the average amount allotted per person on SNAP benefits is roughly $2.70 per meal. The Trump Administration wants to reduce this by $1.40/day, leaving just $2.23 per person, per meal.
Severino goes on to discuss Teen Pregnancy Prevention, insinuating that the current methods "serve as an advocacy (tool) to promote sex, promote prostitution, or provide a funnel effect for abortion facilities and school field trips to clinics."
Again, important to note here that teen pregnancy has taken a dramatic decline in the past 15 years, down from 60.8 pregnancies per 1000 females in 2010 to 13.6 in 2022. The programs in place, both in schools and medical facilities, are clearly working.
Severino discusses the greater need for adoption services, and how children are going unhoused because religious adoption agencies require a mother and a father in order to place a child. According to the U.S. Census Bureau, there are 128.7 million households in the U.S. (2023), 47% of which (60.489 million) include a married couple. HOWEVER, the number of foster homes in the United States has dropped nearly every year, with only 195,404 homes registered to foster in 2023.
Where are all these two-parent households that are so eager to adopt?
Severino equates HHS's current care, custody, and placement role for immigrant children to illegal trafficking, claiming they are "accomplices in illegal immigration." He includes in this "pregnant, unaccompanied girls" who are "trafficked across state lines to be victimized by the abortion industry." He wants a ban on immigrant children seeking elective abortion.
Severino wants to put a cap on the Child Tax Credit, which currently allows an income limit of no more than $400,000 if filing a joint return (with a maximum of $2000 per child), to $47,646 for married couples and $41,756 for single parents (with a maximum of $538 per child). A blaring example of where taxes will hit the middle class the hardest.
For single-parent families, the tax credit will go to the "non-resident" parent paying child support (i.e. without custody), rather than the parent who has full custody of the children. That parent will receive no tax breaks.
Much of Severino's discussion of child support and "non-resident" dads is in favor of fathers (and sometimes-sperm-donors) and not mothers, giving them more opportunities to use "informal gifts" such as "sports gear" as write-offs of child support payments. He wants increased visitation, without increased safety-vetting, and fails to discuss the mother's role at all, other than to insinuate that most child abuse comes from single-parent homes and that more funding needs to go into "marriage and relationship education." This includes his assessment of same-sex marriages lasting "half that of heterosexual marriages."
Gay marriage wasn't legalized in the U.S. until 2015. Maybe we check those stats again when people have had the opportunity to be married for 50 years.
ADMINISTRATION ON CHILDREN, YOUTH, AND FAMILIES (ACYF)
Severino either wants "especially fathers" to engage with their children while in foster care, or to have both parents' rights terminated swiftly. Currently a parent has 2 years to show income and stability in order to bring their child back into the home, and many are active in their children's lives while in foster care, but often participate in inpatient and outpatient programs for extended periods of time in order to become a healthier caregiver.
OFFICE OF HEAD START (OHS)
"Fraught with scandal and abuse," Severino wants this program eliminated all together, claiming it has "little or no long-term academic value for children."
"The Head Start program promotes school readiness for children from birth to age 5 in low-income families through services that support early learning and development, health, and family well-being. Head Start staff actively engage parents, recognizing family participation throughout the program as key to strong child outcomes. Since its inception in 1965, the Head Start program has served about 39 million children and their families. In fiscal year (FY) 2022, the Head Start program was funded to serve about 833,000 children, pregnant women in centers, family homes, and family child care homes. The program is rooted in urban, suburban, and rural communities throughout the nation." - HeadStart.gov
Severino also wants physician-assisted suicide (PAS), legal in 10 states and the District of Columbia, to be rescinded, replaced with palliative care. He also claims that the current National Strategy to Support Family Caregivers emphasizes "racial and LGBTQ+ equity," suggesting these regulations need review. He mentions the need for increased telehealth opportunities, especially for those living in rural areas, though it can be considered "interstate commerce," which then must be regulated by the federal government (i.e. no more states' rights).
When it comes to the contraceptive mandate issued under the Affordable Care Act in 2012, Severino states that it is a "source of years of egregious attacks on many Americans' religious and moral beliefs." However, this had nothing to do with women’s rights. It has to do with the business, the health facility, and the physician. And like the argument of the baker not wanting to make wedding cakes for gay couples, if you're in the industry, this is the industry. Obama's mandate made nearly all forms of preventative birth control free or covered without cost-sharing for anyone in need.
Surprise surprise, unwanted pregnancies and abortions went down almost immediately after the induction of the Affordable Care Act. Because you can't have your cake and eat it, too, folks.
Severino wants the courts and health insurance companies to emphasize "fertility awareness-based methods of family planning," including the "calendar method," taking your temperature, observation of cervical mucus, and fertility tests, which can be pricey and are not currently covered by insurance.
Okay, men, are you ready to participate in the observation of your partner's cervical mucus?
Did I mention Severino wants to eliminate men's contraceptive services from the conversation (i.e. goodbye, condoms)? He also talks about eliminating the "week after pill" (which isn't a thing—he means “morning after pill”) as a form of emergency contraceptive for women.
Removal of all guidance for gender-affirming care
Training medical professionals (doctors, nurses, doulas) to not participate in abortion services
Reinforcing the Coats-Snowe and Church Amendments
Making medical school abortion training opt-in, rather than opt-out
*pops extra-strength Tylenol*
Severino discusses the importance of a doula at birth in reducing C-sections by 50%, the use of oxytocin by 40%, and request for an epidural by 60%.
As a mom of three kiddos born in my home or at a birth center, let's clarify these stats. Doulas, while they are available in hospitals, are often a resource used by parents in home-births and birth-center settings, which are options for non-high-risk pregnancies. Thus most mothers giving birth at home or in a birth center do not require a C-section, and also don't have the option of oxytocin or epidural outside of a hospital.
Severino wants better access for the Indian Health Service, which he says was abandoned by the Biden Administration during the pandemic. However, in 2021 the Biden Administration invested an "additional $1.8 Billion in American Rescue Plan funding to combat COVID-19 in Indian Country."
“This investment from the American Rescue Plan will strengthen the public health workforce in Indian Country, support mental health and substance abuse prevention and treatment, continue efforts to detect and treat COVID-19, and meet facility and equipment needs related to the COVID-19 pandemic." - Elizabeth Fowler, IHS acting director.
OFFICE OF THE SECRETARY
Severino discusses the role of the Secretary, emphasizing the importance that they (now Robert F. Kennedy Jr.) set policies, not their operational divisions. This includes restricting HHS's ability to declare health emergencies within 48 hours to Congress, opposing any censorship of COVID-related dissenting opinions (with or without scientific basis), and preventing "colluding with abortion...and LGBT advocates."
Ultimately Severino wants a pro-life task force, "rejecting the notion that abortion is health care," and dedicating a "Special Representative for Domestic (and Global) Women's Health." This includes the "Family Agenda," which emphasizes the need never to conflate sex with gender identity or sexual orientation, and "proudly stat(ing) that men and women are biological realities" and that "married men and women are the ideal."
OFFICE OF THE ASSISTANT SECRETARY FOR HEALTH (OASH)/OFFICE OF THE SURGEON GENERAL (OSG)
Severino wants these offices and positions combined, which would push the role of the Surgeon General, who "communicates evidence-based health information to the public," closer to the current Secretary, who advises the President (and likely vice versa).
In order to deal with sexually-transmitted diseases, Several wants to focus on "strengthening marriage" and "sexual risk avoidance." He also wants to promote discussions of the link between abortion and breast cancer (there is absolutely none) and the "emotional damage" of providing gender-affirming care to children.
To clarify, "gender affirming care" can be a haircut. It can be a choice of clothing. In more medical circumstances it can be puberty blockers, which allow a child to stave off physical bodily changes until they are mature enough to make a decision about their own gender. And yes, puberty blockers are reversable.
Severino brings up Title X, a federal grant program that began in 1970 that provides family planning and preventative health services, stating that it should be separate from all abortion-related activity because it "requires grantees to refer for abortions despite sincere moral or religious objections."
In no state are pro-life doctors referring their patients for abortions. If they choose not to perform an abortion, their patients can ask for a referral to another doctor.
ADMINISTRATION FOR STRATEGIC PREPAREDNESS AND RESPONSE (ASPR)
Severino asks that the roles of ASPR vs. FEMA (Federal Emergency Management Agency) be reviewed to avoid duplication efforts.
OFFICE OF GENERAL COUNSEL (OGC)
The OGC serves as the chief legal advisor to the department, but Severino thinks that "legal caution" often outweighs "practical necessity," slowing decision-making during a crisis such as the COVID-19 pandemic. He recommends said practical necessity, including "rescinding suspended civil rights" (i.e. not enforcing masks and vaccines) and "curtail(ing) OCR authority over religious freedom(s)."
OFFICE OF GLOBAL AFFAIRS (OGA)
Severino wants the Director of OGA to be another Assistant Secretary of HHS because "Director" might not indicate leadership. Again, he asks that this position clearly voice the pro-life and pro-family stance, and wants all members of the office to be in the same building for "better oversight."
OFFICE FOR CIVIL RIGHTS (OCR)
Severino does not expressly call out issues of civil rights such as gender and racial equity, but instead focuses on protecting "rights of conscience," including the Church, Coats-Snowe, and Weldon Amendments, and most of all, religious freedom. Any HHS officials and divisions who violate these statues will lose funding if they do not correct their behaviors. This includes any negative bias toward faith-based adoption and fostering programs where parents do not require vaccines. Severino also wants Donald Trump's original limits of statutory text that refer to a "binary biological concept of sex discrimination" to be reinstated after the Biden Administration imposed nondiscrimination rules on the basis of sexual orientation and gender identity. He claims this will "protect minors from genital mutilation."
"A new study by researchers at Harvard T.H. Chan School of Public Health found little to no utilization of gender-affirming surgeries by transgender and gender-diverse (TGD) minors in the U.S. The study also found that cisgender minors and adults had substantially higher utilization of analogous gender-affirming surgeries than their TGD counterparts." - Harvard University, 2024
Severino recommends a policy announcing plans to enforce discrimination bans only on the basis of race, sex, and disability, including not pressuring female college athletes to obtain abortions, removing all discussion of Critical Race Theory, and emphasizing protecting disabled children who were born alive after abortions.
Again, just as with the NCAA trans athlete debate (10 trans students in 500,000 total athletes) here we are talking about a very, very tiny percentage. Six states kept track of the totals over a period of time to determine how many live births occurred after a failed abortion. In the three years studied, there were no live births after abortion in the State of Texas. Nor were there any reported in Oklahoma over three years. In 2017 Minnesota reported .03% of abortions resulted in a live birth, and Arizona reported .07%. In 2018 Florida reported .008% of abortions resulted in a live birth. Michigan also reported, but the stats are not available. In all cases, a live birth was treated with life-saving measures.
References:
Project 2025
Ellie is an author, editor, and owner of Red Pencil Transcripts, and works with filmmakers, podcasts, and journalists all over the world. She lives with her family just outside of New York City, and is represented by Vicki Marsdon at High Spot Literary.
Severino is worse than Kennedy
He’s going to be responsible for more human death.