A new U.S. Department of Health and Human Services (HHS) draft Strategic Plan for 2018 through 2022 contains verbiage defining human life as "beginning at conception" (i.e. with the fertilization of an egg), a radical departure from the language used by previous administrations. Conservatives and pro-life organizations have welcomed the change as a much-needed corrective to Obama-era policies, but women's health and pro-choice advocates see it as a harbinger of future federal efforts to restrict access to medical services such as contraceptives and abortion..
The first of five instances of the controversial phrasing appears in the document's second paragraph, which states:
HHS accomplishes its mission through programs and initiatives that cover a wide spectrum of 61 activities, serving and protecting Americans at every stage of life, beginning at conception.
For comparison, the same paragraph of the HHS strategic plan for the previous five years began:
HHS accomplishes its mission through programs and initiatives that cover a wide spectrum of activities, serving Americans at every stage of life.
The revised language represents an ideological shift in line with the pro-life stance taken by Donald Trump and the Republican Party during the 2016 presidential campaign. Anti-abortion groups such as the National Right to Life Committee (NRLC) have long relied on the "scientific" claim that that human life begins "at the moment of conception" to justify equating abortion with murder and seeking its prohibition. The NRLC endorsed Trump's appointment of Rep. Tom Price (R-Ga.), a pro-life advocate who co-sponsored legislation in 2005 proposing that "human life" be defined to "encompass all stages of life, including but not limited to the moment of fertilization or cloning," to head HHS in November 2016. (Price later resigned amid accusations that he had misused public resources.)
Observers on both the left and the right noted the political sea change evidenced in the plan. The conservative publication National Review applauded what it called the "scientific accuracy" of the new wording, adding: "We can use all the help stopping the death agenda that we can get."
And in a tweet, pro-life Sen. Ted Cruz (R-Texas) said he is "encouraged" by the plan:
— Senator Ted Cruz (@SenTedCruz) October 11, 2017
At the other end of the spectrum, pro-choice OB/GYN Dr. Jennifer Gunter wrote "This is no surprise," in a blog post highly critical of the document:
After all, these guidelines were probably drafted by Tom Price and Charmaine Yoest, a real life Aunt Lydia [a character in the dystopian novel and television series The Handmaid's Tale tasked with indoctrinating young women to accept sexual servitude], is a Trump appointee to the HHS. Before the election Trump told us he would let the Susan B. Anthony [List (a pro-life group)] get their faux feminist hands all over contraception and abortion. Remember, the Susan B. Anthony crowd thinks IUDs and emergency contraception are abortifacients. Science says they are not but hey who needs science when you have a bible?
NARAL Pro-Choice America labeled the draft plan's policy implications "extremist":
? WOW. HHS is pushing an extremist anti-choice policy that would ban abortion and some forms of birth control: https://t.co/5n6iaAjI3C
— NARAL (@NARAL) October 11, 2017
The draft contains numerous additional gifts to conservatives, including at least 40 references (as compared to three in the previous HHS strategic plan under Barack Obama) to accommodating "faith-based" organizations and health providers, and a call to implement Trump's executive order mandating that the agency "identify and remove barriers to, or burdens imposed on, the exercise of religious beliefs and/or moral convictions by persons or organizations partnering with, or served by HHS."
HHS has already acted on the latter by issuing interim rules that "provide conscience protections to Americans who have a religious or moral objection to paying for health insurance that covers contraceptive/abortifacient services." This means employers are no longer bound by an Obamacare provision requiring them to provide health insurance covering contraceptives if doing so conflicts with their religious or moral beliefs. The American Civil Liberties Union (ACLU) has filed a lawsuit challenging the decision, which they likened to "forcing women to pay for their boss’s religious beliefs."
LGBTQ advocacy group the Human Rights Campaign (HRC) issued an alert stating that the drafters of the new plan "eras[ed] all mentions of the LGBTQ population and their unique health needs," not to mention those of other minority groups, marking another departure from Obama-era HHS strategic plans:
The mission of HHS is “to enhance and protect the health and well-being of all Americans,” yet the erasure of LGBTQ people from this strategic plan suggests that for the Trump-Pence administration, helping LGBTQ people achieve better health outcomes will not be a priority. Studies show that LGBTQ people face greater health challenges than their straight and cisgender counterparts.
Concurrently, HHS withdrew a proposed rule awaiting action since 2014 which would have required Medicare and Medicaid-funded long-term care facilities to treat same-sex partners the same as opposite-sex married persons.
While conservative Christians seemed largely pleased with the draft plan, its religious thrust proved to be deeply troubling to medical professionals like Dr. Esther Choo, associate professor of emergency medicine at Oregon Health & Science University, who told us:
The strategic plan has a surprising amount of language around religion, working with religious groups, preserving religious freedom, and even assertion of fundamental beliefs that are religiously based such as the statement that life begins at conception, which concerns me as a potential starting point for denying women necessary health services. It is stunning as a document from a public health, health services, and science-focused organization. I am a scientist and public health advocate who also happens to be personally quite religious, but I found the plan as drafted to be both unusual and disturbing.