Category: Public Health

Utah oil drillers won pollution break from Pruitt

Utah oil and gas producers tried for years to get the EPA to exempt them from smog rules meant to prevent ailments like asthma.

They finally got their relief after Scott Pruitt took charge of the agency, newly released emails show.

To groups opposed to President Donald Trump’s policies, the records are yet another sign that Pruitt has transformed an agency created to protect the environment into a tool for granting favors to industry. They say that’s troubling even if it falls short of the overt collusion his critics have accused him of amid revelations about his ties to lobbyists who helped him arrange housing and travel.

“The public is being shut out of the decisions that affect the air we all breathe while polluters have Pruitt at their beck and call whenever they ask to throw out a life-saving protection,” said Matt Gravatt, the associate legislative director at the Sierra Club, which obtained the emails in a lawsuit over a public records request.

EPA’s aid for the oil and gas companies in Utah came after an industry lobbyist, Marc Himmelstein, a former American Petroleum Institute executive with longstandingconnectionsto top GOP fundraisers, enlisted help from another like-minded Republican, House Natural Resources Chairman Rob Bishop (R-Utah), who has pushed legislation to promote oil and gas development and ease permitting requirements.

Himmelstein coordinated a July 2017 phone call between the Utah lawmakers and Pruitt, offering specific talking points for Bishop to use, according to the records obtained in a lawsuit by the Sierra Club.

EPA was set to declare that the tribal land in the Uinta Basin in Utah was not meeting standards for smog, or ozone pollution. Once that happened, oil and gas producers wouldn’t be able to use a streamlined permitting process and would instead have to seek approval for each of the thousands of wells they aim to drill there.

“We ask the Agency to develop a streamlined permitting solution for future development of the Basin,” Himmelstein’s talking points for Bishop said.

In April, EPA proposed just that.

[Politico]

Trump rescinds Obama policy protecting oceans

President Trump is repealing a controversial executive order drafted by former President Obama that was meant to protect the Great Lakes and the oceans bordering the United States.

In his own executive order signed late Tuesday, Trump put a new emphasis on industries that use the oceans, particularly oil and natural gas drilling, while also mentioning environmental stewardship.

“Ocean industries employ millions of Americans and support a strong national economy,” the new order states, mentioning energy production, the military, freight transportation and other industries.

“This order maintains and enhances these and other benefits to the Nation through improved public access to marine data and information, efficient interagency coordination on ocean-related matters, and engagement with marine industries, the science and technology community, and other ocean stakeholders,” it states.

The order encourages more drilling and other industrial uses of the oceans and Great Lakes.

The order stands in contrast to Obama’s policy, which focused heavily on conservation and climate change. His policy was written in 2010, shortly after the deadly BP Deepwater Horizon offshore drilling explosion and 87-day oil spill.

“America’s stewardship of the ocean, our coasts, and the Great Lakes is intrinsically linked to environmental sustainability, human health and well-being, national prosperity, adaptation to climate and other environmental changes, social justice, international diplomacy, and national and homeland security,” Obama’s order stated.

[The Hill]

Why Dr. Oz’s astrology tweet was so disappointing

We’re used to Dr. Oz broadcasting outrageous, pseudoscientific ideas on his hugely popular daytime TV show, The Dr. Oz Show. The cardiac surgeon has for years devoted large amounts of airtime to peddling all sorts of suspect detoxes, diets, and other health misinformation. (He does sometimes offer good health information too.)

Now, because 2018 is weird, Oz is a member of the President’s Council on Sports, Fitness, and Nutrition — an advisory board devoted to promoting healthy lifestyles across the nation. One might wonder if he’d clean up his act. But it’s not happening.

On Wednesday, he (or someone running the Twitter account in his name) tweeted out this doozy to 4.3 million followers. (It has since been deleted.)

First off, astrology isn’t real. Repeat after me: “Astrology isn’t real.” Sing it aloud: “Astrology isn’t real!”

It’s a pseudoscientific parlor game that tends to make a big deal out of insignificant coincidences. For example, Mercury in retrograde. Every few months, from our vantage point here on Earth, it looks like the planet Mercury is drawing loop-de-loops in the sky. It’s an illusion that this occurs because the Earth and Mercury are orbiting around the sun at different rates. But yet astrologers take it to mean there’s an increased chance of miscommunication, among other maladies.

Also, do you really believe that everyone born in the same month could possibly share the same cosmic destiny? What hooey!

Oz’s tweet has since been deleted. But the webpage it linked to is still up (as is another recent tweet about astrology and health). On Oz’s website, you can still find a slideshow of content explaining things like “when an Aries feels blocked, this pent-up energy may appear in the form of migraines, sinus issues, or even jaw tension.”

This is drawn from a 2017 episode of The Dr. Oz Show in which he invites astrologer Rebecca Gordon to explain the connection between horoscope and health. Gordon has been featured on the show several times. And it seems Gordon is returning to the show this week to discuss the same topic.

In 2017, Oz asked her to explain the link between horoscope and health, and she brought up Leonardo da Vinci’s Vitruvian Man, saying the “human body is actually shaped like a 5-pointed star.” (Does she mean that because our bodies have some star-like qualities, we’re influenced by stars? Who knows!)

The tweet is silly, and so is the astrology segment on the Dr. Oz show. And largely, yes, astrology is harmless.

It’s just always disappointing to see someone with such a big audience peddle such bunk — especially because a showman like Oz is exactly the type of person who could influence a showman like President Donald Trump.

Oz often touts alternative medicines and beliefs as ways to empower his viewers and give them hope.

In 2014, he testified before a Senate subcommittee about his role promoting “green coffee extract,” which he claimed aided in weight loss. “My job, I feel on the show, is to be a cheerleader for the audience,” he said. “And when they don’t think they have hope, when they don’t think they can make it happen, I want to look … for any evidence that might be supportive to them.”

Hope can be helpful. But it’s often a lie.

[Vox]

New Trump Administration Rule Will Force Doctors to Stop Saying “Abortion”

The Trump administration is planning to instate a rule that will bar recipients of federal family planning funding from educating women about abortion options, making referrals to doctors that provide abortions, or providing abortion care. Conservatives have cheered the move as a way for the federal government to partially “defund” Planned Parenthood without requiring an act of Congress.

Reproductive-rights advocates are calling the policy a “domestic gag rule”—a U.S.-based version of the global gag rule that prevents U.S. aid dollars from going to any international organization that so much as acknowledges the existence of abortion. Every Republican president has instated the global gag rule since Ronald Reagan first implemented it; every Democratic president has rolled it back.

The domestic gag rule started with Reagan, too, in 1988. It affects money affiliated with Title X, the federal family planning grant program launched under Richard Nixon that provides subsidized contraception, gynecological care, and screenings for cancer and sexually transmitted infections. In 2016, the program served more than 4 million patients, about two-thirds of whom were living at or below the poverty line. Planned Parenthood is a disproportionately important player in the Title X ecosystem: Its health centers make up just 13 percent of Title X family planning providers in the U.S., but they serve 41 percent of all Title X patients.

Title X money is already barred from funding abortion care; grant recipients that provide abortions keep the money separate in their accounting. But the domestic gag rule would additionally require Planned Parenthood clinics and other abortion providers to enforce a physical separation between its Title X–funded services and its abortion work, with separate staff dedicated to each. Doctors providing family planning care to Title X patients would not be able to discuss abortion at all.

When Reagan first instituted the rule, Planned Parenthood and other reproductive-rights organizations immediately sued the federal government, claiming the rule violated caregivers’ rights to free speech and women’s rights to a constitutionally protected medical procedure. “The regulations will…censor communications between doctors and other health professionals and their patients on matters of vital medical significance,” read a complaint Planned Parenthood filed against then–Health and Human Services Secretary Otis Bowen. “The failure to provide complete information about pregnancy management at the earliest possible point in the pregnancy, and the failure to make necessary or appropriate referrals as early as possible, will often result in delays in, or failure of, a patient to obtain proper care.”

A federal court granted a preliminary injunction, but the Supreme Court allowed the rule to go into effect in 1991. In a 5–4 vote in Rust v. Sullivan, the court held that the rule did not constitute censorship. “This is not a case of the government ‘suppressing a dangerous idea,’ but of a prohibition on a project grantee or its employees from engaging in activities outside of its scope,” the opinion read. “The regulations do not violate the First Amendment free speech rights…since the government may make a value judgment favoring childbirth over abortion, and implement that judgment by the allocation of public funds. In so doing, the government has not discriminated on the basis of viewpoint; it has merely chosen to fund one activity to the exclusion of another.” The opinion also noted that “the government has no constitutional duty to subsidize an activity merely because it is constitutionally protected.”

[Slate]

Bill Gates: I had to explain to Trump the difference between HIV, HPV

Bill Gates discloses in newly revealed footage that President Trump twice asked him to clarify the difference between HIV and Human Papilloma Virus (HPV).

MSNBC’s “All in With Chris Hayes” aired footage Thursday night of the Microsoft founder speaking at a Gates Foundation event, telling the crowd about two meetings he had with Trump, one at Trump Tower during the presidential transition and another at the White House last year.

“Both times he wanted to know if there was a difference between HPV and HIV,” Gates said. “So I was able to explain that those were rarely confused with each other.”

Gates also said that at both meetings Trump had asked him about the negative effects of vaccines.

“In both of those two meetings, he asked me if vaccines weren’t a bad thing, because he was considering a commission to look into the ill effects of vaccines,” Gates said.

“And I said, ‘no, that’s a dead end. That would be a bad thing, don’t do that.’”

Gates said last month that Trump was “super interested” in the idea of a universal flu vaccine.

He added that Trump had asked him to be a science adviser, but that he told the president that he didn’t believe the role would be a good use of his time.

[The Hill]

Media

 

Judge rules against Trump administration in teen pregnancy prevention case

A federal judge in D.C. ruled Thursday that the Trump administration’s cuts to the Teen Pregnancy Prevention Program were unlawful.

Last summer, the administration notified 81 organizations that their five-year grants through the program would end in 2018, rather than in 2020, prompting multiple lawsuits.

Judge Ketanji Brown Jackson ruled in one of those cases Thursday, ordering the Department of Health and Human Services (HHS) to accept and process applications of four grantees as if they had not been terminated.

“We are disappointed with today’s ruling. As numerous studies have shown, the Teen Pregnancy Prevention Program is not working. Continuing the program in its current state does a disservice to the youth it serves and to the taxpayers who fund it. Communities deserve better, and we are considering our next steps,” said HHS spokesperson Caitlin Oakley in a statement. 

The Public Citizen, a consumer rights group in D.C., represented Policy and Research LLC, Project Vida Health Center, Sexual Health Initiatives for Teens and the South Carolina Campaign to Prevent Teen Pregnancy — four of 81 grantees who had their funds cut short by the administration last year.

Several other lawsuits are still playing out in court.

“The court’s decision today is a rebuke of the Trump administration’s effort to kill a program that is working effectively to lower teen pregnancy rates,” said Sean Sherman, an attorney at the Public Citizen Litigation Group. “Because of the court’s ruling, the four grantees will be able to continue to serve their local communities and to conduct important research. The court’s decision confirms that HHS must administer the Teen Pregnancy Prevention Program in accordance with the agency’s own regulations and the requirement of reasoned decision-making.”

The administration abruptly cut the grants off last year, arguing that the programs were ineffective at curbing teenage pregnancy.

The program, created in 2010 under former President Obama, funds organizations working to reduce and prevent teen pregnancy, with a focus on reaching populations with the greatest need.

But it has long been criticized by conservatives for its focus on comprehensive sex education, which can include teaching about safe sex and abstinence.

[The Hill]

Trump’s EPA quietly revamps rules for air pollution

The Trump administration has quietly reshaped enforcement of air pollution standards in recent months through a series of regulatory memos.

The memos are fulfilling the top wishes of industry, which has long called for changes to how the Environmental Protection Agency (EPA) oversees the nation’s factories, plants and other facilities. The EPA is now allowing certain facilities to be subject to less-stringent regulations and is letting companies use friendlier math in calculating their expected emissions.

Environmentalists and public health advocates say the memos could greatly increase levels of air pollutants like mercury, benzene and nitrogen oxides. They accuse the EPA of avoiding the transparency and public input requirements that regulatory changes usually go through.

“All of these, individually and taken together, will result in more air pollution and less enforcement of the Clean Air Act,” said Paul Billings, senior vice president for advocacy at the American Lung Association.

“These were radical departures of current law when they were proposed a decade ago and they’re just as radical today,” he said, referring to the Bush-era efforts, some of which were unsuccessful, to make changes to EPA air programs.

But for the EPA and its supporters, the memos simply bring the agency back to what the relevant laws and regulations are meant to be.

“They address specific concerns that people have had for years, and just make it much simpler for people to comply — especially for existing [facilities] — to make sure they can maintain their plants and replace worn-out components and those types of things, without the threat of enforcement litigation,” said Jeff Holmstead, a former head of the EPA’s air pollution office under the George W. Bush administration who now represents regulated companies at the law and lobbying firm Bracewell.

Bill Wehrum, head of the air office under EPA chief Scott Pruitt, wrote two of the three EPA memos. He recused himself from the third memo, which Pruitt wrote.

The first memo, issued in December, states that the EPA will no longer “second guess” companies’ calculations of their expected pollution output after certain big projects under what is known as New Source Review. Under that program, the EPA reviews the changes made to a facility to decide whether they need to go through the same process as if the facility were newly built.

The December memo effectively means the EPA will usually not take action against a company for its calculations if they turn out to be wrong.

The second memo, issued in January, repeals a Clinton-era policy known as “once in, always in.” Under the previous policy, facilities could never be considered “minor” sources of hazardous pollution if they were already considered “major” sources, and subject to much stricter rules.

Now, facilities can be regulated as “minor” if their emissions drop enough.

The third memo allows companies to use a procedure known as “project netting” when applying for permits for major projects under the New Source Review program. That means companies can use a more industry-friendly emissions calculation when they argue that a particular project would reduce emissions.

President Trump added to the memos last week, signing one himself that formally asks the EPA to use more industry-friendly practices in enforcing the National Ambient Air Quality Standards program, a key Clean Air Act program for air quality nationwide.

John Walke, director for clean air at the Natural Resources Defense Council, said the EPA is working to implement the policies the Bush administration failed to finish.

“I think Mr. Wehrum has decided this is likely a one-term administration and he’s going to devote his full resources to rolling back clean air, climate and public health protections in the time available to him,” Walke said.

“The most expedient and hasty way to accomplish those rollbacks is through the regular guidance documents that we have seen so far from EPA,” he said. “Rulemakings take time, they require public notice and input and hearings, and Mr. Wehrum and Mr. Pruitt plainly have no patience for those tedious fodders.”

Walke said that, taken together, the memos could allow polluting facilities to greatly increase their emissions.

The EPA didn’t respond to requests for comment.

The focus among the memos for environmental and health advocates is the one repealing the “once in, always in” policy, and letting “major” pollution sources reduce their emissions and be regulated as “minor” ones.

A coalition of environmental groups sued the EPA to stop the policy change, arguing that it should have gone through the full regulatory process, including analysis of its environmental impact and an opportunity for public comment. Democratic states joined in with their own lawsuit.

“Instead of prioritizing the health of hard-working Americans, EPA Administrator Scott Pruitt wants to let major polluters off the hook. That is unconscionable, and it is illegal,” said California Attorney General Xavier Becerra (D).

“If the ‘Once In, Always In’ policy is rescinded, children in California and around the country — particularly those who must live near the polluting plant or factory — may grow up in an environment with tons of additional hazardous pollutants in the air they breathe. California will not allow that to happen,” Becerra said.

Two environmental groups opposed to the EPA’s move have put out recent analyses of the change, focused on specific areas of the country.

The Environmental Integrity Project looked at 12 industrial plants in the Midwest and concluded they could increase their pollution to 540,000 pounds annually, a fourfold growth.

The Environmental Defense Fund looked at the Houston area, and said that 18 facilities there could increase their emissions to 900,000 pounds a year, two and a half times current levels.

Holmstead said opponents of the Trump administration’s policy are unlikely to prevail. The Supreme Court ruled in the 2015 Perez v. Mortgage Bankers Association case that federal agencies can repeal policy memos with other policy memos and don’t have to go through the full regulatory process to do so.

“I think the environmental groups are going to have a real uphill battle trying to get through court that this is somehow improper,” he said. “That really does fly in the face of the Perez decision.”

As for the increase in emissions, Holmstead said environmentalists are wrong. In many cases, the new policies will allow facilities to carry out projects that reduce emissions, or simply operate under a lower paperwork burden.

“They have yet to come up with any real-world examples of how that might happen,” Holmstead said of the scenarios in which pollution might increase. “These reforms are not going to lead to pollution increases.

“I don’t think that there will be a meaningful impact one way or another.”

[The Hill]

Trump order targets wide swath of public assistance programs

The Trump administration is seeking to completely revamp the country’s social safety net, targeting recipients of Medicaid, food stamps and housing assistance.

Trump is doing so through a sweeping executive order that was quietly issued earlier this week – and that largely flew under the radar.

It calls on the Departments of Health and Human Services, Housing and Urban Development, Agriculture and other agencies across the federal government to craft new rules requiring that beneficiaries of a host of programs work or lose their benefits.

Trump argued with the order, which has been in the works since last year, that the programs have grown too large while failing to move needy people out of government help.

“Since its inception, the welfare system has grown into a large bureaucracy that might be susceptible to measuring success by how many people are enrolled in a program rather than by how many have moved from poverty into financial independence,” it states.

The order is directed at “any program that provides means-tested assistance or other assistance that provides benefits to people, households or families that have low incomes.”

Democrats have blasted the effort, arguing the order blends the issues of welfare and broader public assistance programs in a deliberate way they say is intended to lower support for popular initiatives.

“Welfare” has historically been used to describe cash assistance programs like Temporary Assistance for Needy Families. Democrats and liberal activists say the Trump administration is seeking to expand the definition of welfare to mean food stamps, Medicaid and other programs as a way to demonize them.

“This executive order perpetuates false and racist stereotypes about certain groups supposedly taking advantage of government assistance,” House Democratic Whip Steny Hoyer (Md.) and Rep. Barbara Lee (D-Calif.) said in a joint statement reacting to the order.

President Trump “is trying to erect a smokescreen in the shape of Reagan’s ‘welfare queen’ so people don’t see he’s coming after the entire middle and working class,” said Rebecca Vallas, managing director of the Center for American Progress’s Poverty to Prosperity Program.

Welfare reform has long been a goal of GOP lawmakers, and there’s broad support in the Republican conference for changing the federal safety net to impose stricter work requirements and block grant state funding for programs like Medicaid and food stamps.

While noting that he hadn’t seen the specific text of the executive order, Rep. Tom Cole (R-Okla.) said he supports the concept.

“For able-bodied, single adults, I certainly favor work requirements,” Cole said.

With Republicans in total control of the government, conservatives have been hoping for a major legislative push to overhaul federal assistance programs.

Speaker Paul Ryan (R-Wis.) late last year said he wanted Republicans to work on entitlement reform, with a focus on promoting work and career-based education.

“We want to smooth the path from welfare to work, pull people out of poverty, pull people out of welfare,” Ryan said in December.

Robert Rector, a senior research fellow at the Heritage Institute, said the executive order is meant to signal support to congressional Republicans.

“[Administration officials] have been talking to Congress, and the executive order is designed to set the table for them,” Rector said. “Do what they can in the executive branch, and give support to similar efforts on the Hill.”

But a short legislative calendar and a slim Republican majority in the Senate mean the administration may be largely on its own.

Agencies are limited in what changes they can make to their programs, so comprehensive welfare reform may be off the table without major legislation.

Republicans have already acknowledged they won’t be able to cut spending on entitlement programs like Medicare, Medicaid and Social Security.

“I think it’s very tough to get this thing through the Senate when it requires 60 votes. I certainly don’t have any problem with the president taking initiative,” Cole said.

The executive order doesn’t set any new policy, but Center for American Progress’s Vallas said the order is important as a messaging document, and it shows that Trump is willing to act without Congress.

“This is more of President Trump not being content to wait for Congress to dismantle these programs. This is him wanting to take matters into his own hands,” Vallas said.

The order follows policy shifts already underway at various agencies.

Health and Human Services officials have encouraged states to pursue work requirements for Medicaid beneficiaries. Arkansas, Indiana and Kentucky have already been granted such waivers, and several other states have waivers pending with the administration.

Earlier this year, the Agriculture Department sought input on “innovative ideas to promote work and self-sufficiency among able-bodied adults” participating in the food stamp program.

In Congress, House Republicans unveiled a provision in the 2018 farm bill to expand mandatory work requirements in the food stamp program. The broader legislation will be marked up later this month, but it faces a long uphill battle.

The administration’s effort could also face legal challenges. Medicaid advocates in Kentucky have already sued over the work requirements, and additional safety net changes could provoke even more lawsuits.

[The Hill]

In Closed-Door UN Meetings, Trump Administration Officials Pushed Abstinence For International Women’s Health Programs

In closed-door meetings at the United Nations in March, Trump administration officials pushed socially conservative views on women’s rights issues — including abstinence-based policies over information about contraception — that were further to the right than those expressed by most other countries present, including Russia and the representative for the Arab states, UN officials who attended the meetings told BuzzFeed News.

The Trump officials’ approach at the UN meeting makes it clear that the administration intends to extend its views on abortion, contraception, and sexual education beyond US borders to an extent that is unusual even for Republican administrations.

The comments came during the annual UN Commission on the Status of Women, a two-week session described by a spokesperson for the US Mission to the United Nations as the UN’s “most important meeting on women’s empowerment.” The main event is a closed-door negotiation on language to include in an annual UN document that sets global standards and outlines potential policies pertaining to gender equality efforts in all member countries.

Early in this series of meetings, Bethany Kozma — a senior adviser for gender equality and women’s empowerment at the US Agency for International Development (USAID) and anti-transgender activist — emphasized that the US was a “pro-life nation,” sparking a strong reaction from delegates in the room, two officials in the room confirmed to BuzzFeed News.

“When she said that there was sort of a record scratch and silence,” one UN official who participated in the negotiations but asked not to be named so as to maintain a working relationship with the other member states present told BuzzFeed News. “Everyone was like, ‘are you kidding me?’”

Shannon Kowalski, the director of the International Women’s Health Coalition, said that the Trump administration’s stances on women’s health presented in the meeting were “further to the right” than they were at last year’s commission, or even under George W. Bush’s administration. While the Bush administration implemented anti-abortion policies abroad, the scope was limited to family planning programs. Trump’s policies already expand beyond those limits.

“They’re far more extreme than the US was under the Bush administration,” Kowalski told BuzzFeed News shortly after the session wrapped up. “We saw placement of ideologues within key roles who took similar positions back then, but they limited what they applied their views to.”

Throughout the two-week session, Trump administration officials discussed shifting international policy on women toward abstinence-oriented education and teaching women sexual “refusal skills.” Those views — as well as the US’s push for more conservative policies on immigration, trade and environmental regulation — ended up uniting most of the 45 CSW member states against the US on family planning issues, six sources who attended or were familiar with meetings told BuzzFeed News.

While negotiations at the UN are often political, two officials familiar with the negotiations said that they had never seen nearly all of the other membership states — many of whom have wildly different stances and priorities on family planning issues — come together against the US. The members include several countries where abortion is illegal and punishable by fines or jail time.

The Trump administration has not been shy about its stance on abortion. On his third day in office, President Donald Trump instated an expanded version of the Mexico City Policy, a rule that prevents the US from funding organizations that provide or discuss abortions with the populations they serve. While most Republican presidents have used that policy, Trump’s version applies to all US health funding abroad — not just family planning funds that prior Republican administrations regulated. This includes organizations devoted to curbing HIV/AIDS, which the Bush administration left alone, Kowalski said.

[Buzzfeed]

Notes, emails reveal Trump appointees’ war to end HHS teen pregnancy program

The Trump administration’s abrupt cancellation of a federal program to prevent teen pregnancy last year was directed by political appointees over the objections of career experts in the Department of Health and Human Services, which administers the program, according to internal notes and emails obtained by NBC News.

The trove shows three appointees with strict pro-abstinence beliefs — including Valerie Huber, the then-chief of staff for the department’s Office of the Assistant Secretary for Health — guided the process to end a program many medical professionals credit with helping to bring the nation’s teen pregnancy rate to an all-time low.

Prior to serving at HHS, Huber was the president of Ascend, an association that promotes abstinence until marriage as the best way to prevent teen pregnancy.

The $213 million Teen Pregnancy Prevention Program was aimed at helping teenagers understand how to avoid unwanted pregnancies. It had bipartisan support in Congress and trained more than 7,000 health professionals and supported 3,000 community-based organizations since its inception in 2010.

In the notes provided to NBC News, Evelyn Kappeler, who for eight years has led the Office of Adolescent Health, which administers the program, repeatedly expressed concerns about terminating the program, but appeared out of the decision-making loop and at one point was driven to tears.

In a July 17, 2017 note, she says she was admonished to “get in line” and told it was not her place to ask questions about the agency’s use of funds. In a July 28 note, Kappeler recalled she was “frustrated about the time this process is taking and the fact that (her staff) has not been part of the discussions.” She described being “so rattled” that “my reaction when I got on (sic) the phone was to cry.”

She and her staff “were not aware of the grant action until the last minute” — an apparent reference to the decision, it says.

Last month, Democracy Forward, a nonprofit law firm and advocacy group, sued the administration for unlawfully terminating the program after the agency took months to respond to its Freedom of Information Act request.

The group claims the newly obtained emails show that HHS violated the Administrative Procedure Act that bars arbitrary decision-making and that the political appointees thwarted the will of Congress.

“Now that we’ve seen these documents, there is no question to us why the Trump administration withheld” the emails, said Skye Perryman, the group’s lawyer. The decision to end the program “was made hastily, without a record of any reasoned decision making and under the influence of political appointees who have long opposed evidenced-based policy,” she said.

Parties suing over the action include the city of Baltimore and the Healthy Teen Network, which represents grantees across the country.

HHS has given different explanations about its decision to terminate the program, including claims that it was ineffective or that it did not conform to the president’s proposed budget. HHS did not respond to emails or answer questions about who was responsible for ending the program.

HHS spokesman Mark Vafiades directed NBC News to a fact sheet and announcement on the agency’s website. They state that 73 percent of the projects funded by the program “had no impact or had a negative impact on teen behavior, with some teens more likely to begin having sex, to engage in unprotected sex or to become pregnant.”

“The evidence stands in stark contrast to the promised results,” the statement says.

The story behind the program’s demise is one of a growing list of examples of the control Trump political appointees are exerting at federal agencies.

It is also part of a broader narrative about programs benefiting women and children becoming political targets under a president who insists he is an advocate for women’s rights and health. Under Trump, a mandate under the Affordable Care Act to cover contraceptive coverage has been rolled back, while Republicans in Congress have sought to defund Planned Parenthood and proposed budget cuts to Medicaid, which covers half of all births.

In July 2017, the Office of Adolescent Health notified 81 grantees including the University of New Mexico Health Sciences Center and Cuyahoga County, Ohio, that it would be discontinuing funding under the Obama-era program beginning this June, with some programs cut off immediately.

After the program’s 2010 inception, teen pregnancy and birth rates fell faster than ever. Health care experts say considerable research and money that has already been invested in the program will be wasted and the number of at-risk teens will increase.

The president of the American College of Obstetricians & Gynecologists and women’s health advocacy groups, such as Planned Parenthood, have expressed alarm.

Haywood L. Brown, president of ACOG, called the program “vital.” The administration’s decision, Brown said in a statement, is “highly unusual” and a “step backward for ensuring healthy moms and healthy babies.”

In an op-ed last year, Ron Haskins, previously a Republican co-chair of a bipartisan commission on evidence-based policy making established by House Speaker Paul Ryan, R-Wis., said that by ending the program, Trump has “exploded one of our most promising evidence-based programs.”

In a June 21 note by Kappeler, Steven Valentine, Huber’s deputy, is described as having “taken the lead” in reversing the program. Valentine directed Kappeler to halt the review process for the grants, the notes say.

Before coming to HHS, Valentine was a legislative assistant to Rep. Chris Smith, R-N.J., an outspoken abortion rights opponent. Valentine also worked for a short time at the Susan B. Anthony List, a political organization that supports candidates who oppose abortion rights.

Don Wright, a senior career official at HHS, stated in a July 28 email to Kappeler that he himself was only “tangentially” involved in the discussions about the program’s termination. But one set of notes documents him instructing skeptical career staff members on the appropriate behavior of civil servants. He later complained to Kappeler about “rolling of the eyes by some staff,” her notes say.

Weeks later, Wright was made acting secretary of the department.

Also according Kappeler’s notes, some staff “expressed concerns about being able to ask questions in this environment and the lack of engagement by policy staff directly with the program office.”

Kappeler’s memos “are quite revealing of the agency’s improper and unlawful decision making,” said Perryman, Democracy Forward’s lawyer.

“The documents also show HHS disregarded the views of experienced career employees including those of the director of the Office of Adolescent Health,” she said.

Another appointee involved in terminating the teen pregnancy program was Teresa Manning, an anti-abortion activist and Trump appointee who was in charge of the department’s family planning programs and who has publicly questioned the efficacy of several popular contraception methods. She was previously a lobbyist for the National Right to Life Committee and for the Family Research Council. In January, Manning abruptly resigned.

In November, HHS announced a $10 million research initiative to ensure “any sex education programs follow the science to improve youth health and well-being,” including “sexual risk avoidance.”

Despite their popularity in some conservative regions and school districts, abstinence-only programs have been shown not to work.

A June 2005 study conducted by Case Western Reserve University found that the sexual education programs that Huber ran in Ohio promoting abstinence-only education had “critical problems.” The study suggested the program conveyed “false and misleading information” about abortion, contraceptives and sexually transmitted infections and misrepresented “religious convictions as scientific fact.”

In King County, Washington — one of the parties in the suit challenging the program’s termination — grantees created a 15-lesson sex education curriculum known as Family Life and Sexual Health (FLASH).

The FLASH program educates students on options including abstinence, the use of birth control and the importance of consent before engaging in sexual activity. It is now used in 44 states and taught in every school district in King County, which has seen a 63 percent drop in teen pregnancies since 2008.

King County was granted $5 million to conduct the first scientific evaluation of the FLASH program, and now it is unable to complete the study. The $3 million already spent is now wasted taxpayer dollars, according to King County spokesman James Apa.

[NBC News]

Reality

Data shows clearly that abstinence-only education as a state policy is ineffective in preventing teenage pregnancy and may actually be contributing to the high teenage pregnancy rates in the U.S

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