Tag: Deartment of Health and Human Services

Trump erases health care protections for transgender patients during Pride Month

Just two weeks into Pride Month — and on the anniversary of the Pulse nightclub shooting — the Trump administration announced that it is rolling back Obama-era health care protections for people who are transgender. The rule, announced Friday, will impact transgender patients’ ability to fight against discrimination by doctors, medical facilities and health insurance providers. 

Former president Barack Obama’s administration changed federal health care guidelines in 2016 to expand sex-based protections based to include protections based on gender identity, “which may be male, female, neither, or a combination of male and female.” His administration also pushed for discrimination protections for those who have had abortions. 

But the Department of Health and Human Services (HHS) released a statement on Friday saying the final rule is based on “the plain meaning of the word ‘sex’ as male or female and as determined by biology.”

“All of these are essentially legislative changes that the Department lacked the authority to make,” the administration said of the 2016 changes in the final rule. “They purported to impose additional legal requirements on covered entities that cannot be justified by the text of Title IX, and in fact are in conflict with express exemptions in Title IX.”

In the summary of the final rule, HHS responded to several comments that criticized the lack of protection for people who do not identify with the sex they were assigned at birth. In one response to the comments, HHS compared gender identity to political affiliation. 

“For example, in the unlikely event that a healthcare provider were to deny services to someone based solely on his or her political affiliation, the Department would not be able to address such denial of care under Section 1557,” HHS said. “Unlike other bases of discrimination, the categories of gender identity and sexual orientation (as well as political affiliation) are not set forth in those statutes.”

The rule summary also argued that health care based on sex assigned at birth, rather than gender identity, is necessary for health care, and insinuated that transgender health care may be confusing for providers.

“The 2016 Rule risked masking clinically relevant, and sometimes vitally important, information by requiring providers and insurers to switch from a scientifically valid and biologically based system of tracking sex to one based on subjective self-identification according to gender identity,” the summary said. “…The 2016 Rule’s mandate cannot answer, for example, how a provider is to determine whether or when a transgender individual is entitled by law to be referred to a women’s mental health support group, a men’s mental health support group, either group, or both at the same time.”

Roger Severino, director of the HHS Office for Civil Rights, maintained in the announcement that “HHS respects the dignity of every human being.”

“…and as we have shown in our response to the pandemic, we vigorously protect and enforce the civil rights of all to the fullest extent permitted by our laws as passed by Congress,” Severino said. “We are unwavering in our commitment to enforcing civil rights in healthcare.”

Transgender individuals have long faced discrimination in health care. A quarter of the 28,000 individuals who took the U.S. Transgender Survey reported that they have experienced an insurance issue because of their gender identity. Even more respondents reported that they have experienced verbal harassment, been refused treatment, or had a health care provider who did not know how to properly treat transgender individuals. 

Thousands of survey participants also reported they were denied routine health and sexual health screenings. Those who are transgender are more likely than the general U.S. population to be uninsured, according to the survey. 

The American Civil Liberties Union quickly responded to the administration’s announcement, writing on Twitter that the rule “will embolden health care discrimination against transgender people, those seeking reproductive health care, and many other individuals who need health care — all while a global pandemic is occurring.”

“Politicians have no business coming between us and our health care,” the organization added.

The announcement also came at the end of a week where two black transgender women were murdered. So far this year, at least 14 transgender or gender non-conforming individuals have been fatally shot or killed by other violent means in the U.S., according to the Human Rights Campaign. 

[CBS News]

Trump Replaces Key Watchdog Who Identified Critical Medical Shortages

Trump got rid of another career official in the Department of Health and Human Services last night. Her crime? Highlighting critical medical shortages in her report of April 6, as well as inadequate testing for the coronavirus. Since such facts aren’t allowed within this criminal enterprise known as the Trump administration, her days were numbered as soon as Trump was made aware of the report. Christi A. Grimm has been in government since the Clinton administration.

Naturally, these skulking cowards made the announcement after business hours, as they so often do with their Friday night news dumps.

Source: New York Times

WASHINGTON — President Trump moved on Friday night to replace a top official at the Department of Health and Human Services who angered him with a report last month highlighting supply shortages and testing delays at hospitals during the coronavirus pandemic.

The White House waited until after business hours to announce the nomination of a new inspector general for the department who, if confirmed, would take over for Christi A. Grimm, the principal deputy inspector general who was publicly assailed by the president at a news briefing three weeks ago.

The nomination was the latest effort by Mr. Trump against watchdog offices around his administration that have defied him. In recent weeks, he fired an inspector general involved in the inquiry that led to the president’s impeachment, nominated a White House aide to another key inspector general post overseeing virus relief spending and moved to block still another inspector general from taking over as chairman of a pandemic spending oversight panel.

[Crooks and Liars]


HHS ousts vaccine expert who pushed back on COVID-19 treatment

The former head of the office involved in developing a vaccine for COVID-19 said he was removed after he pushed to vet and to limit drug treatments often touted by President Trump. “Specifically, and contrary to misguided directives, I limited the broad use of chloroquine and hydroxychloroquine, promoted by the Administration as a panacea, but which clearly lack scientific merit,” Dr. Rick Bright said in a statement released by his lawyers Wednesday.

In tweets and public remarks, Mr. Trump has referred to hydroxychloroquine as a potential “game-changer” in treating COVID-19. The president has recommended the use of the antimalarial drug as a potential treatment for the coronavirus, despite limited evidence that the drug would be effective.

Bright was the director of the Biomedical Advanced Research and Development Authority (BARDA) and HHS deputy assistant secretary for preparedness and response by the administration.

He said that he was “involuntarily transferred to a more limited and less impactful position at the National Institutes of Health,” a transfer that he believes came in response to his “insistence that the government invest the billions of dollars allocated by Congress to address the COVID-19 pandemic into safe and scientifically vetted solutions, and not in drugs, vaccines and other technologies that lack scientific merit.”

“I am speaking out because to combat this deadly virus, science — not politics or cronyism — has to lead the way,” he said in his statement. Bright is a career official and not a political appointee. He has requested that the inspector general for the Department of Health and Human Services investigate his dismissal.

Bright said that he’s “prepared to look at all options and to think ‘outside the box’ for effective treatments,” but “I rightly resisted efforts to provide an unproven drug on demand to the American public.”

He demanded that the drugs only be used under a doctor’s supervision and only to “hospitalized patients with confirmed COVID-19” because of the “potentially serious risks associated with them, including increased mortality observed in some recent studies in patients with COVID-19.”

“Rushing blindly towards unproven drugs can be disastrous and result in countless more deaths. Science, in service to the health and safety of the American people, must always trump politics,” Bright said.

[CBS News]

White House told federal health agency to classify coronavirus deliberations

The White House has ordered federal health officials to treat top-level coronavirus meetings as classified, an unusual step that has restricted information and hampered the U.S. government’s response to the contagion, according to four Trump administration officials.

The officials said that dozens of classified discussions about such topics as the scope of infections, quarantines and travel restrictions have been held since mid-January in a high-security meeting room at the Department of Health & Human Services (HHS), a key player in the fight against the coronavirus.

Staffers without security clearances, including government experts, were excluded from the interagency meetings, which included video conference calls, the sources said.

“We had some very critical people who did not have security clearances who could not go,” one official said. “These should not be classified meetings. It was unnecessary.”

The sources said the National Security Council (NSC), which advises the president on security issues, ordered the classification.”This came directly from the White House,” one official said.

The White House insistence on secrecy at the nation’s premier public health organization, which has not been previously disclosed, has put a lid on certain information – and potentially delayed the response to the crisis. COVID19, the disease caused by the virus, has killed about 30 people in the United States and infected more than 1,000 people.

HHS oversees a broad range of health agencies, including the U.S. Centers for Disease Control and Prevention, which among other things is responsible for tracking cases and providing guidance nationally on the outbreaks.

The administration officials, who spoke to Reuters on condition of anonymity, said they could not describe the interactions in the meeting room because they were classified.

An NSC spokesman did not respond to questions about the meetings at HHS. But he defended the administration’s transparency across federal agencies and noted that meetings of the administration’s task force on the coronavirus all are unclassified. It was not immediately clear which meetings he was referring to.

“From day one of the response to the coronavirus, NSC has insisted on the principle of radical transparency,” said the spokesman, John Ullyot. He added that the administration “has cut red tape and set the global standard in protecting the American people under President Trump’s leadership.”

A spokeswoman for the HHS, Katherine McKeogh, issued a statement that did not address questions about classified meetings. Using language that echoed the NSC’s, the department said it that it agreed task-force meetings should be unclassified.

Critics have hammered the Trump administration for what they see as a delayed response to coronavirus outbreaks and a lack of transparency, including sidelining experts and providing misleading or incomplete information to the public. State and local officials also have complained of being kept in the dark about essential federal response information.

U.S. Vice-President Mike Pence, the administration’s point person on coronavirus, vowed on March 3 to offer “real-time information in a steady pace and be fully transparent.” The vice president, appointed by President Donald Trump in late February, is holding regular news briefings and also has pledged to rely on expert guidance.

The meetings at HHS were held in a secure area called a “Sensitive Compartmentalized Information Facility,” or SCIF, according to the administration officials.

SCIFs are usually reserved for intelligence and military operations. Ordinary cell phones and computers can’t be brought into the chambers. HHS has SCIFs because theoretically it would play a major role in biowarfare or chemical attacks.

A high-level former official who helped address public health outbreaks in the George W. Bush administration said “it’s not normal to classify discussions about a response to a public health crisis.”

Attendees at the meetings included HHS Secretary Alex Azar and his chief of staff Brian Harrison, the officials said. Azar and Harrison resisted the classification of the meetings, the sources said.

HHS did not make Azar or Harrison available for comment.

One of the administration officials told Reuters that when complex issues about a quarantine came up, a high-ranking HHS lawyer with expertise on the issue was not admitted because he did not have the proper security clearance. His input was delayed and offered at an unclassified meeting, the official said.

A fifth source familiar with the meetings said HHS staffers often weren’t informed about coronavirus developments because they didn’t have adequate clearance. He said he was told that the matters were classified “because it had to do with China.”

The coronavirus epidemic originated in China and the administration’s main focus to prevent spread early on was to restrict travel by non-U.S. citizens coming from China and to authorize the quarantine of people entering the United States who may have been exposed to the virus.

One of the administration officials suggested the security clearances for meetings at HHS were imposed not to protect national security but to keep the information within a tight circle, to prevent leaks.

“It seemed to be a tool for the White House – for the NSC – to keep participation in these meetings low,” the official said.

[Reuters]

Doctors Could Refuse to Treat People Based on Race and Age Under Trump’s New Rule

A new Trump administration proposal would change the civil rights rules dictating whether providers must care for patients who are transgender or have had an abortion. News stories have mainly focused on how the proposal might affect LGBTQ rights and abortion rights, but the sweeping proposal has implications for all Americans, because the Department of Health and Human Services seeks to change how far civil rights protections extend and how those protections are enforced.

Roger Severino, the director of the HHS Office for Civil Rights, has been candid about his intentions to overturn an Obama-era rule that prohibited discrimination based on gender identity and termination of a pregnancy. In 2016, while at the conservative Heritage Foundation, he co-authored a paper arguing the restrictions threaten the independence of physicians to follow their religious or moral beliefs. Supporters of the approach say it protects the freedom of conscience, but opponents say it encourages discrimination.

His office unveiled the proposed rule on May 24, when many people were focused on the start of the long Memorial Day holiday weekend.

The rule is the latest Trump administration proposal to strip protections for transgender Americans, coming the same week another directive was proposed by the Department of Housing and Urban Development that would allow homeless shelters to turn away people based on their gender identity.

The public was given 60 days to comment on the HHS proposal. Here’s a rundown of what you need to know about it.

What would this proposal do?

Fundamentally, the proposed rule would overturn a previous rule that forbids health care providers who receive federal funding from discriminating against patients on the basis of their gender identity or whether they have terminated a pregnancy.

The Trump administration proposal would eliminate those protections, enabling providers to deny these groups care or insurance coverage without having to pay a fine or suffer other federal consequences.

That may mean refusing a transgender patient mental health care or gender-confirming surgery. But it may also mean denying patients care that has nothing to do with gender identity, such as a regular office visit for a bad cold or ongoing treatment for chronic conditions like diabetes.

“What it does, from a very practical point of view, is that it empowers bad actors to be bad actors,” Mara Keisling, executive director of the National Center for Transgender Equality, told reporters.

The proposal would also eliminate protections based on sexual orientation and gender identity from several other health care regulations, like non-discrimination guidelines for the health care insurance marketplaces.

Does it affect only LGBTQ people?

The proposal goes beyond removing protections for the LGBTQ community and those who have had an abortion.

It appears to weaken other protections, such as those based on race or age, by limiting who must abide by the rules. The Trump proposal would scrap the Obama-era rule’s broad definition of which providers can be punished by federal health officials for discrimination, a complicated change critics have said could ease requirements for insurance companies, for instance, as well as the agency itself.

And the proposal erases many of the enforcement procedures outlined in the earlier rule, including its explicit ban on intimidation or retaliation. It also delegates to Severino, as the office’s director, full enforcement authority when it comes to things like opening investigations into complaints lodged under the non-discrimination rule.

Why did HHS decide to change the rule?

The Obama and Trump administrations have different opinions about whether a health care provider should be able to refuse service to patients because they are transgender or have had an abortion.

It all goes back to a section in the Affordable Care Act barring discrimination on the basis of race, color, national origin, age, disability or sex. President Barack Obama’s health officials said it is discrimination to treat someone differently based on gender identity or stereotypes.

It was the first time Americans who are transgender were protected from discrimination in health care.

But President Donald Trump’s health officials said that definition of sex discrimination misinterprets civil rights laws, particularly a religious freedom law used to shield providers who object to performing certain procedures, such as abortions, or treating certain patients because they conflict with their religious convictions.

“When Congress prohibited sex discrimination, it did so according to the plain meaning of the term, and we are making our regulations conform,” Severino said in a statement. “The American people want vigorous protection of civil rights and faithfulness to the text of the laws passed by their representatives.”

Much of what the Office for Civil Rights has done under Severino’s leadership is to emphasize and strengthen so-called conscience protections for health care providers, many of which existed well before Trump was sworn in. Last year, Severino unveiled a Conscience and Religious Freedom Division, and his office recently finalized another rule detailing those protections and their enforcement.

The office also said the proposed rule would save about $3.6 billion over five years. Most of that would come from eliminating requirements for providers to post notices about discrimination, as well as other measures that cater to those with disabilities and limited English proficiency.

The rule would also save providers money that might instead be spent handling grievances from those no longer protected.

The office “considers this a benefit of the rule,” said Katie Keith, co-founder of Out2Enroll, an organization that helps the LGBTQ community obtain health insurance. “Organizations will have lower labor costs and lower litigation costs because they will no longer have to process grievances or defend against lawsuits brought by transgender people.”

Why does this matter?

Research shows the LGBTQ community faces greater health challenges and higher rates of illness than other groups, making access to equitable treatment in health care all the more important.

Discrimination, from the misuse of pronouns to denials of care, is “commonplace” for transgender patients, according to a 2011 report by advocacy groups. The report found that 28 percent of the 6,450 transgender and gender non-conforming people interviewed said they had experienced verbal harassment in a health care setting, while 19 percent said they had been refused care due to their gender identity.

The report said 28 percent had postponed seeking medical attention when they were sick or injured because of discrimination.

Critics fear the rule would muddy the waters, giving patients less clarity on what is and is not permissible and how to get help when they have been the victims of discrimination.

Jocelyn Samuels, the Obama administration official who oversaw the implementation of the Obama-era rule, said that for now, even though the Trump administration’s HHS will not pursue complaints against those providers, Americans still have the right to challenge this treatment in court. Multiple courts have said the prohibition on sex discrimination includes gender identity.

“The administration should be in the business of expanding access to health care and health coverage,” Samuels told reporters on a conference call after the rule’s release. “And my fear is that this rule does just the opposite.”

[VICE]

The Trump administration reportedly wants the government to revoke civil rights protections from transgender people

The Trump administration is weighing making its biggest attack on transgender rights yet in a maneuver that would strip federal recognition of the gender identity of some 1.4 million Americans — and require genetic testing in some cases to match a person’s gender with the sex they were assigned at birth.

Erica Green, Katie Benner, and Robert Pear of the New York Times reported on Sunday that the Department of Health and Human Services is floating a memo that would establish the legal definition of sex under Title IX — the federal civil rights law that bans discrimination in education on the basis of gender — that would render immutable the sex of a person at birth. In other words, the government would not recognize a person’s gender other than the one based on their genitalia when they’re born.

Per the Times:

The department argued in its memo that key government agencies needed to adopt an explicit and uniform definition of gender as determined “on a biological basis that is clear, grounded in science, objective and administrable.” The agency’s proposed definition would define sex as either male or female, unchangeable, and determined by the genitals that a person is born with, according to a draft reviewed by The Times. Any dispute about one’s sex would have to be clarified using genetic testing.

According to the Times, it would “eradicate federal recognition” of some 1.4 million transgender Americans.

HHS is preparing to formally present the new definition to the Justice Department before the end of the year, and if the department decides the change is legal, it could be enforced across Title IX laws and government agencies, including the Departments of Education, Justice, Health and Human Services, and Labor.

The effects could be far-reaching — it could impact which locker rooms and bathrooms transgender students could use as well as which sports teams students join or what happens to single-sex classes, the Times points out. If enacted, it could even require some people to produce DNA tests as part of their educational experience — an unprecedented step to enforce a biological definition of gender.

The Trump administration has been terrible on transgender rights

The Obama administration worked to advance transgender rights and loosen federal regulations to allow for more gender fluidity — including defining gender identity as protected by Title IX. President Donald Trump and his administration have taken steps to reverse that.

Soon after taking office, the Trump administration sent out a letter officially revoking Obama-era guidance on protecting trans students in federally funded schools, saying it was federal overreach. Trump has sought to ban transgender people from serving in the military, rescinded a memo protecting trans workers, and stripped protections for trans prisoners. It has also worsened protections for transgender people in health care.

Trump on the campaign trail said he would embrace LGBTQ people and said he would “fight” for them while Hillary Clinton would bring in “more people that will threaten your freedoms and believes.” But as Vox’s German Lopez pointed out, he’s done quite the opposite:

As president, Trump has acted more or less how you would expect a typical anti-LGBTQ Republican to act. Maybe that reflects his own opinions. Maybe it reflects the views of the people he’s surrounded himself with in his administration, including Vice President Mike Pence and Attorney General Jeff Sessions, both of whom have very long histories of anti-LGBTQ causes.

This new assault on transgender people — and one that includes genetic testing — is just the latest chapter.

[Vox

]

Trump policy shop filters facts to fit his message

President Donald Trump’s appointees in the health department have deleted positive references to Obamacare, altered a report that undermined the administration’s positions on refugees and added anti-abortion language to the strategic plan — part of an ideological overhaul of the agency’s research office.

While every administration puts its imprint on the executive branch and promotes ideas that advance its own agenda, this one has ventured several steps further — from scrubbing links to climate change studies from an Environmental Protection Agency website to canceling an Interior Department study on coal mining risks and suppressing reports on water contaminationand the dangers of formaldehyde.

Inside the Health and Human Services policy research shop, staffers say the political pressures to tailor facts to fit Trump’s message have been unprecedented.

Several pointed to embarrassments such as PolitiFact grading a lawmaker’s statement, based on the agency’s May 2017 report on Obamacare premium hikes, as “false,” and concluding the study had serious methodological problems.

Another report suggesting that millions more people would get health coverage if Obamacare were rolled back — a finding at odds with nearly every independent analysis — was widely mocked and produced over the objections of career staff at the office of the assistant secretary for planning and evaluation, known as ASPE, say several sources.

“The heartbreaking part is that ASPE is the source of the evidence and the science for how decisions are made,” said a former senior official, who worked under both Republican and Democratic administrations. “It’s just another example of how we’re moving to a post-fact era.”

The office has been especially vulnerable to political pressure because its leadership remains in flux. The University of Minnesota health economist tapped to lead the office by Trump has been dogged by questions about his financial entanglements, leaving his nomination in limbo for more than a year. The acting head of ASPE was recently reassigned to a regional office, and the top deputy altered McKinsey-produced data to make it more favorable to the Trump administration, according to multiple sources with knowledge of the changes.

“I find the attack on the integrity and the culture of the office to be disturbing,” said Richard Frank, a Harvard health economist who ran ASPE as an Obama administration political appointee. “This is really a departure to an office that has a 50-year history to it.”

HHS officials vigorously disputed portrayals of the office as ideologically driven.

“I reject the premise of your question and allegation,” said spokeswoman Caitlin Oakley. “Secretary [Alex] Azar has made very clear that HHS is a science- and evidence-based organization and it will operate accordingly.”

Oakley said the 120-person office has been refocused to work on Trump administration priorities like drug pricing and the opioid epidemic. Two staffers say those topics are regarded as safer ground because they are not part of the health care culture wars. Under Azar, who assumed leadership of the agency about six months ago — after most of these incidents occurred — the office has produced a six-page research brief on drug pricing, which published this week, and two studies on the opioid epidemic. Oakley said more reports are coming.

But the group’s morale and role remain diminished, as key staff and teams have dwindled; there are just three staffers working on analyzing health coverage, down from about a dozen at the end of the Obama administration, said a staffer.

Republican health policy analyst Lanhee Chen, who served as an HHS senior counselor in the George W. Bush administration, scoffed at the notion that this policy shop is more partisan than the one that preceded it.

“I don’t believe the Trump administration ASPE has put out reports that are any less analytically or methodologically rigorous than those of the Obama administration ASPE,” Chen said. “Those who express concerns regarding the quality of reports ‘falling off’ are probably using that argument as a cover for the fact that they disagree with the findings of the reports.”

Chen said he regards the policy shop as a vehicle to advance administration policy, “so in that sense, methodological rigor has not necessarily been a metric I have used to evaluate their reports. That’s why we have studies from academics and analysts outside of government.”

This story is drawn from interviews with nine individuals with knowledge of ASPE operations, most of whom asked for confidentiality to speak freely, as well as with outside observers.

Shift in office’s focus

ASPE historically has been used to investigate the impact of HHS policies and help shape future strategy, and under the Obama administration, it focused closely on the expansion of health insurance coverage and the Affordable Care Act — issues on which Barack Obama had campaigned heavily and made central to his presidency. The office published 43 reports on the ACA’s effects on rural hospitals, women’s health and other discrete corners of health care between January 2015 and January 2017 alone, generally extolling the effects and sometimes overlooking the drawbacks.

For instance, one 2016 study on choosing health plans in the ACA market was criticized for slanting its findings.

[Politico]

HHS Official Called John Podesta a Pedophile and Claimed Liberals Abuse Children in Satanic Rituals

Health and Human Services official Ximena Barreto publicly apologized recently for her “heated and hyper-passionate” tweets on race and far-right conspiracies, after they were reported on by CNN.

She made her Twitter account private, and held on to her government job. But on that now-private account, she’s been unapologetic — recently calling the reports exposing her fringe views a “smear campaign.”

Mediaite conducted an extensive review of her social media posts and found that the HHS appointee pushed the baseless Pizzagate conspiracy theory even more than previously reported. Her tweets include smearing former Clinton campaign chairman John Podesta as “a pedophile,” accusing Democrats of hosting “Pedophile dinners,” and claiming liberals abuse children during satanic rituals.

The Department of Health and Human Services is tasked with implementing health and welfare-related programs. Recently, the department came under fire for losing track of more than a thousand unaccompanied immigrant children that crossed the southern border and were placed with adult sponsors.

After her apology, Barreto, who worked as a far-right media personality before joining HHS in December 2017, was allowed to keep her Trump administration job — albeit, with a demotion from her old deputy director of communications post. But her private comment attacking CNN for reporting on her controversial posts suggests she is far from repentant.

“Locked my account after CNNs smear campaign,” Barreto wrote on June 14 in response to a follower asking why they can’t retweet her posts. “[I] received too many threats and packages delivered to my home.”

Barreto did not offer evidence to followers proving her claim that she was doxxed and is receiving threats. It is also not clear how making her Twitter private would deter these supposed threats, but a locked account certainly allows her to recant her public apology to her fan base without her employers at HHS seeing.

The Department of Health and Human Services and Barreto were contacted repeatedly via email and phone for comment, but did not respond. After this reporter asked for comment, Barreto shut down her private Twitter account and deleted her tweet calling the CNN articles on her views a “smear campaign.”

In past reports on Barreto’s extreme views, the right-wing media watchdog group Media Matters found that the HHS official made racist attacks against African-Americans, called Islam a “cult,” and pushed the Pizzagate conspiracy. An investigation from CNN’s KFile team found that Barreto had shared a picture calling for the hanging of Hillary Clinton and Barack Obama for “treason,” as well as pushed the Seth Rich murder conspiracy.

Mediaite obtained screenshots of Barreto’s Twitter feed that show she pushed Pizzagate — an absurd conspiracy theory that claims the Clintons, the Podesta brothers, and other Democrats ran a child sex trafficking ring in a D.C. pizza restaurant — far more than previously reported.

She continued this claim in other tweets, writing that“@AndrewBreitbart definitely knew of #PizzaGate before passing!” and quote tweeting an old Breitbart tweet with just the hashtag “#Pizzagate.”‘

The so-called “spirit cooking” conspiracy, which alleges — without evidence — that John Podesta, his lobbyist brother Tony Podesta, and other high profile Democrats practice Satanic rituals that involve preying upon young children, was another conspiracy that Barreto frequently pushed.

“@johnpodesta why have you not tweet since nov 7th? Having too much pizza at spirit cooking parties? Or playing dominoes? #PizzaGate,” Barreto tweeted in late November 2016.

In another tweet, Barreto claimed liberals use “children… in their #SpiritCooking parties.” She pushed the same claim when someone responded to one of her posts, writing, “Are u into the pedophile satanic stuff that podesta is in?”

She also connected the Pizzagate and spirit cooking conspiracies to the rapper Jay-Z, who was a Clinton supporter, tweeting, “Didn’t jay z sold crack? And shoot his brother? #BasketOfCriminals #SpiritCooking.”

Barreto attempted to combat the spirit cooking by using spiritual warfare.

“#SpiritCooking Romans 16:20 The God of peace will soon crush Satan under your feet,” tweeted the HHS official, alongside a meme that read, “There is no election in 2016. There is only the trial of Crooked Hillary. On November 8th, vote guilty.”

The official even tied the women’s health organization Planned Parenthood to satanic rituals, tweeting, “#SpiritCooking Planned parenthood spent 38 million for democrats #AbortionsForSatan.”

Her other contributions to fighting the nonexistent pedophile ring include accusing Hillary Clinton of “trying to distract us from #PizzaGate,” invoking the supposed “Pedophile dinners” of Democrats to excuse Russian election tampering, and stating that Clinton should still be held responsible for “#PizzaGate #BillsVictims and all the things she has done wrong.”

In total, Mediaite found that Barreto tweeted about variations of the Pizzagate conspiracy at least 17 times. Additionally, she spoke at length about Pizzagate in a Periscope video, as detailed by the Media Matters report.

Her other controversial posts include Barreto saying, “Islam [is] a cult that oppresses women, kills gays and wants us all dead,” as well as claiming all Muslims “practicing Islam” are terrorists because “their religion is barbaric.” Barreto also pushed the Seth Rich conspiracy in three separate tweets, using the hashtags “#KilledByTheDNC,” “#HillaryBodyCount,” “#ClintonBodyBags,” “#SethRich,” “#Hero,” and “#RIP.”

[Mediaite]

Lawmakers banned from talking to detained migrant kids

Lawmakers are now banned from speaking with migrant children who are held at detention centers after being separated from their parents, according to a new Department of Heath and Human Services (HHS) directive sent to congressional offices on Wednesday.

The directive also states that lawmakers must give two weeks’ notice before traveling to an immigrant detention center. They will be barred from entering if they do not give the advanced notice.

HuffPost first reported on the directive.

[The Hill]

Trump challenges Native Americans’ historical standing

The Trump administration says Native Americans might need to get a job if they want to keep their health care — a policy that tribal leaders say will threaten access to care and reverse centuries-old protections.

Tribal leaders want an exemption from new Medicaid work rules being introduced in several states, and they say there are precedents for health care exceptions. Native Americans don’t have to pay penalties for not having health coverage under Obamacare’s individual mandate, for instance.

But the Trump administration contends the tribes are a race rather than separate governments, and exempting them from Medicaid work rules — which have been approved in three states and are being sought by at least 10 others — would be illegal preferential treatment. “HHS believes that such an exemption would raise constitutional and federal civil rights law concerns,” according to a review by administration lawyers.

The Health and Human Services Department confirmed it rebuffed the tribes’ request on the Medicaid rules several times. Seema Verma, administrator of the Centers for Medicare & Medicaid Services, conveyed the decision in January, and officials communicated it most recently at a meeting with the tribes this month. HHS’ ruling was driven by political appointees in the general counsel and civil rights offices, say three individuals with knowledge of the decision.

Senior HHS officials “have made it clear that HHS is open to considering other suggestions that tribes may have with respect to Medicaid community engagement demonstration projects,” spokeswoman Caitlin Oakley said, using the administration’s term for work requirements that can also be fulfilled with job training, education and similar activities.

The tribes insist that any claim of “racial preference” is moot because they’re constitutionally protected as separate governments, dating back to treaties hammered out by President George Washington and reaffirmed in recent decades under Republican and Democratic presidents alike, including the Clinton, George W. Bush and Obama administrations.

“The United States has a legal responsibility to provide health care to Native Americans,” said Mary Smith, who was acting head of the Indian Health Service during the Obama administration and is a member of the Cherokee Nation. “It’s the largest prepaid health system in the world — they’ve paid through land and massacres — and now you’re going to take away health care and add a work requirement?”

Tribal leaders and public health advocates also worry that Medicaid work rules are just the start; President Donald Trump is eyeing similar changes across the nation’s welfare programs, which many of the nearly 3 million Native Americans rely on.

“It’s very troublesome,” said Caitrin McCarron Shuy of the National Indian Health Board, noting that Native Americans suffer from the nation’s highest drug overdose death rates, among other health concerns. “There’s high unemployment in Indian country, and it’s going to create a barrier to accessing necessary Medicaid services.”

Native Americans’ unemployment rate of 12 percent in 2016 was nearly three times the U.S. average, partly because jobs are scarce on reservations. Low federal spending on the Indian Health Service has also left tribes dependent on Medicaid to fill coverage gaps.

“Without supplemental Medicaid resources, the Indian health system will not survive,” W. Ron Allen — a tribal leader who chairs CMS’ Tribal Technical Advisory Group — warned Verma in a Feb. 14 letter.

The Trump administration has allowed three states — Arkansas, Kentucky and Indiana — to begin instituting Medicaid work requirements, and at least 10 other states have submitted or are preparing applications. More than 620,000 Native Americans live in those 13 states, according to 2014 Census data. And more states could move in that direction, heightening the impact.

Some states, like Arizona, are asking HHS for permission to exempt Native Americans from their proposed work requirements. But officials at the National Indian Health Board say that may be moot, as federal officials can reject state requests.

Tribal officials say their planning process has been complicated by HHS’ refusal to produce the actual documents detailing why Native Americans can’t be exempted from Medicaid work requirements. “The agency’s official response was that they couldn’t provide that [documentation] because of ongoing, unspecified litigation,” said Devin Delrow of the National Indian Health Board. HHS did not respond to a question about why those documents have not been made available.

While the tribes say they hope to avoid a legal fight, their go-to law firm — Hobbs, Straus, Dean & Walker LLP — in February submitted a 33-page memo to the Trump administration, sternly warning officials that the health agency was violating its responsibilities.

“CMS has a duty to ensure that [Native Americans] are not subjected to state-imposed work requirements that would present a barrier to their participation in the Medicaid program,” the memo concludes. “CMS not only has ample legal authority to make such accommodations, it has a duty to require them.”

Meanwhile, tribal leaders say the Trump administration has signaled it may be seeking to renegotiate other aspects of the government’s relationship with Native Americans’ health care, pointing to a series of interactions they say break from tradition.

“This doesn’t seem to be isolated to the work requirements,” said McCarron Shuy of the National Indian Health Board.

The Trump administration also targeted the Indian Health Service for significant cuts in last year’s budget, though Congress ignored those cuts in its omnibus funding package last month, H.R. 1625 (115). The White House budget this year proposed eliminating popular initiatives like the decades-old community health representative program — even though tribal health officials say it is essential.

Tribal officials noted that both HHS Secretary Alex Azar and Deputy Secretary Eric Hargan skipped HHS’ annual budget consultation with tribal leaders in Washington, D.C., last month. The secretary’s attendance is customary; then-HHS Secretary Tom Price joined last year. However, Azar canceled at the last minute. His scheduled replacement, Hargan, fell ill, so Associate Deputy Secretary Laura Caliguri participated in his place. That aggravated tribal leaders who were already concerned about the Trump administration’s policies.

Another point of contention for the tribes is that HHS’ civil rights office — while rejecting Native Americans’ Medicaid request on grounds that they’re seeking an illegal preference — simultaneously announced new protections sought by conservative religious groups.

HHS further stressed that the administration remains committed to Native Americans’ health.

“Secretary Azar, HHS, and the Trump administration have taken aggressive action and will continue to do so to improve the health and well-being for all American Indians and Alaska Natives,” according Oakley, of HHS.

But tribal leaders and public health experts say the administration’s record hasn’t matched its rhetoric. “Work requirements will be devastating,” said Smith, the former Indian Health Service acting director. “I don’t know how you would implement it. There are not jobs to be had on the reservation.”

[Politico]

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