Analysis Politics

Trump’s ‘Coordinated Effort’ to Destroy Reproductive Health Care

Ally Boguhn

The Trump administration has empowered anti-choice activists who suggest, contrary to all medical evidence, that abortion increases the risk of breast cancer.

Vice President Mike Pence praised President Trump last week for taking steps to restrict reproductive rights and access to care in the United States, pointing to how those hired to fill cabinet and agency posts oppose abortion rights.

“The president knows that personnel is policy—that’s why he has literally filled this White House and federal agencies with pro-life leaders,” Pence said during a speech at a gala for the anti-choice group Susan B. Anthony’s List. “Folks, this is the A-team. And I know everybody was proud when just last week President Trump picked the former president of Americans United for Life to be assistant secretary for public affairs at the Department of Health and Human Services. Charmaine Yoest is on the team.”

The gala crowd erupted with applause.

Yoest isn’t just a prominent anti-choice activist. Before she landed a top job at the U.S. Department of Health and Human Services (HHS), she made a name as head of Americans United for Life (AUL), a group notorious for churning out copycat legislation to restrict access to reproductive health care.

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Founded in 1971, the nonprofit anti-choice group describes itself as the “nation’s premier pro-life legal team.” Its website touts their almost unprecedented legal interference in abortion law, proclaiming that it has “been involved in every abortion-related case before the U.S. Supreme Court since Roe v. Wade.”

Yoest led the organization from 2008 to early 2016.

Under her leadership, AUL led the charge in the GOP’s relentless quest to chip away at abortion access through state-level legislation—a strategy that could pay off for anti-choice advocates should the Supreme Court overturn Roe or decide against legal abortion rights. In the 2017 legislative session alone, 431 measures to restrict abortion have been introduced, a number “about on par with past years,” according to the Guttmacher Institute.

Many of the restrictions passed in 2011 after historic Republican gains in state legislatures can be traced to AUL. That year, “24 state legislatures passed 92 abortion restrictions—more than double the total for any previous year,” the New York Times reported in a 2012 profile of Yoest. In the first half of 2012, another 40 restrictions were passed in 17 states, about a third of which could be traced back to the anti-choice organization, the Times reported. Those provisions “made it impossible for clinics to operate in some states, made the procedure harder to access in the first trimester and barred it outright later in pregnancy.”

Instead of the more confrontational attacks on reproductive freedoms undertaken by extremist groups like Operation Rescue, AUL officials prefer to do work behind the scenes.

“For us, it’s very much a military strategy,” Yoest said of AUL’s work in a 2011 interview with the National Catholic Register. “We don’t make frontal attacks. Never attack where the enemy is strongest. We don’t want to re-create Pickett’s Charge at Gettysburg. We pick our battles. What we do is very much under the radar screen and not very sexy.”

Yoest in the New York Times profile suggested she relied on science to form her positions, but in nearly the same breath spouted the discredited claim that abortion increases the risk of breast cancer. It’s a claim displayed prominently on AUL’s website, and it has found its way into the group’s copycat legislation and thus into GOP-backed laws around the country.

In a 2016 legal guide, the group points to Joel Brind, featured as one of Rewire’sFalse Witnesses” for promoting egregious myths about abortion care, as evidence for their claims. The guide pushes for more states to follow the organization’s calls for so-called informed consent restrictions, which require patients seeking an abortion to be told about “the link between abortion and breast cancer.” A similar call appears in AUL’s 2013 legal guide, which notes the organization included such a provision in its “Women’s Right to Know Act” copycat bill.

The falsehood has been refuted by medical experts—including the National Cancer Institute, the American Cancer Society, and the American College of Obstetricians and Gynecologists—but has nonetheless found support from prominent members of the Trump administration and its hires at HHS. Teresa Manning, who was appointed to run the HHS office charged with ensuring people with low incomes have access to family-planning services, has said the link between abortion and breast cancer is “undisputed.” HHS Secretary Tom Price was a member of a fringe medical association that promoted the notion.

Such disregard for settled scientific fact is typical of the legislation pushed by AUL. The organization claims to have inspired parts of the Texas Republicans’ 2013 omnibus anti-choice bill, known as HB 2, which contained many provisions with no basis in medical science or evidence. Among them were targeted regulation of abortion providers (TRAP) provisions, including requirements forcing physicians who provide abortion care to obtain admitting privileges at a local hospital, and another requiring abortion facilities to meet minimum standards adopted for ambulatory surgical centers

As Rewire reported in 2014, “the key players in Texas’ path to HB 2 were deeply connected to conservative lobby groups like ALEC and Americans United for Life (AUL).” Similar TRAP measures were introduced in Arizona, Illinois, New Hampshire, and West Virginia in 2014, as state lawmakers “copied and pasted nearly every word of AUL’s admitting privileges requirement into their proposed legislation,” according to analysis from ThinkProgress.

The TRAP measures in HB 2 were later blocked by the U.S. Supreme Court in the landmark case Whole Woman’s Health v. Hellerstedt. Justice Stephen Breyer wrote in his majority opinion that “when directly asked at oral argument whether Texas knew of a single instance in which the new requirement would have helped even one woman obtain better treatment, Texas admitted that there was no evidence in the record of such a case.”

Dr. Diane Horvath-Cosper, an ob-gyn and advocacy fellow at Physicians for Reproductive Health, told Rewire “it’s really clear that” the kind of TRAP measures pushed by Yoest and AUL “cause clinics to be closed.” Texas saw a dramatic decrease in clinics in the aftermath of HB 2.

But the Roberts Court in deciding Whole Woman’s Health “very clearly saw through the political motivations for these laws,” she said. “They’re not rooted in science, they’re not rooted in evidence, and they really do place the burden on seeking abortion care and don’t make people any safer.”

Horvath-Cosper said it was disquieting that Yoest, whose views on abortion and contraception “are not grounded in evidence,” would be appointed to a position at HHS. “This is an agency that’s tasked with protecting the health of Americans, and if the person doing the communications for HHS doesn’t even believe the best available scientific evidence—that’s deeply concerning, because what kind of information is going to get to the public?”

AUL with Yoest as its head drafted religious imposition bills it referred to as “rights of conscience” measures. AUL claims two states in 2015 considered measures at least partially based on the organization’s work that would have allowed discrimination based on religious beliefs. A 2013 primer on the copycat legislation describes AUL’s view that “certain demands of patients—usually for procedures that are life-destructive and not life-saving—must not be blindly accommodated to the detriment of the rights of healthcare providers,” seemingly referring to abortion and contraceptives.

Yoest has falsely identified the forms of contraception at issue in the Supreme Court’s Hobby Lobby case—emergency contraceptives and IUDs—as “anti-life drugs mislabeled as contraception.” In a 2014 opinion piece published on Fox News’ website, Yoest claimed the Affordable Care Act’s popular birth control benefit “cast these life-ending drugs as essential ‘health care.’”

It’s yet another false claim embraced by many of Trump’s hires, including Manning, who wrote in a 2001 press release opposing over-the-counter emergency contraception that the pills “destroy the human life already conceived.”

This language both incorrectly implies that some forms of contraception cause abortion instead of preventing pregnancy (a refrain commonly adopted by conservatives to justify restricting access), and is in line with the thinking behind radical “personhood” laws. Personhood measures “seek to classify fertilized eggs, zygotes, embryos, and fetuses as ‘persons,’ and to grant them full legal protection under the U.S. Constitution, including the right to life from the moment of conception,” as Rewire has reported. These laws could not only criminalize abortion care, but also many forms of contraception and in vitro fertilization.

These positions could have consequences, given the power held by the HHS appointees who have made no secret about their disdain for contraception access and the ACA’s birth control benefit. Yoest will be “providing executive leadership, policy direction, and management strategy” to Price, who, as Rewire has reported, could work at the agency level to weaken or roll back the birth control benefit.

Price told conservative radio host Hugh Hewitt in March that HHS was “working through the legality” of how he and the agency could use regulatory authority and the rulemaking provisions to allow for the reversal of the birth control benefit.

Then last week, Trump signed a so-called religious liberties executive order instructing HHS to “consider issuing amended regulations” on the benefit. Price followed up with a statement promising the agency “will be taking action in short order to follow the President’s instruction to safeguard the deeply held religious beliefs of Americans who provide health insurance to their employees.”

It’s difficult to imagine a scenario in which Yoest wouldn’t advise in favor of action against the birth control benefit.

“We know that access to safe, reliable, affordable contraception means that people can plan their families and decide if and when to have children,” Horvath-Cosper said when asked about the impact of rolling back the birth control benefit, “and we know that the outcomes are excellent—there is a decreased need for abortion, there is healthier families, healthier pregnancies.”

“I think that this would be devastating if it were to be rolled back,” she said. “I think that somebody who does not believe that contraception contributes to the well being of women and families has no business being in a leadership position at the HHS. I mean, the evidence is so clearly in favor of access to good contraceptive care.”

Yoest will hardly be the only HHS hire recruited along with Price to steer the agency in an anti-choice direction. Paula Stannard, a Trump “beachhead” hire listed in the employee directory as a senior advisor to the secretary, has argued a case against the birth control benefit for Criswell College. Anti-choice activist Hadley Arkes has claimed Stannard helped draft legislation that became Rep. Trent Franks’ (R-AZ) dubious 2015 “Born-Alive Abortion Survivors Protection Act.”

Such measures deploy false narratives used by abortion rights opponents to “suggest that newborn children are being murdered by abortion providers with regularity and abandon,” as Rewire has reported. Arkes claimed Stannard worked to promote these claims while working at HHS in the George W. Bush administration.

Yoest has testified in support of Colorado’s “Born-Alive Infant Protection Act,” which was based on legislation written by AUL, and for similar legislation at the federal level.

Yoest’s HHS appointment is just the latest effort by the administration to restrict access to reproductive health care.

“Seeing this in light of the executive order, and in light of the [American Health Care Act] passing, this is really a coordinated effort to take reproductive health care down, back to a time when people were not as healthy and didn’t have as much control over the ability to determine when to have a family,” Horvath-Cosper said. “So it looks bad. It’s all bad.”

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