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A coalition of conservative leaders and former federal government political appointees has compiled a game plan for the next conservative president to restore the Department of Health and Human Services to a focus on health care rather than forcing a leftist agenda down Americans’ throats.
From the COVID-19 pandemic to abortion funding and transgender mandates, HHS has twisted federal law and the pursuit of public health to marginalize people of faith and promote bureaucrats and leftist activism, warns Roger Severino, former director of the HHS Office of Civil Rights under President Donald Trump. He argues that the next conservative president must reverse these abuses and return HHS to its proper role: the promotion of public health.
“Few areas of life are more important, and more subject to abuse, than public health,” Severino, vice president of Domestic Policy at The Heritage Foundation, told The Daily Signal in a statement Monday. “Unfortunately, our public health agencies have replaced science and medicine with politics and ideology, and Americans now face shorter life spans as a result. Reform can only happen if entrenched special interests, from lawless bureaucratic leaders and Big Pharma, are reined in and rooted out.” (The Daily Signal is The Heritage Foundation’s news outlet.)
Severino’s report in the book “Mandate for Leadership,” compiled by the 2025 Presidential Transition Project, notes that after the COVID-19 pandemic was over, U.S. life expectancy continued to drop precipitously. A copy of his report on HHS was provided exclusively to The Daily Signal for this article.
The Heritage Foundation helped launch the 2025 Presidential Transition Project (also known as Project 2025) to equip a potential conservative president to govern effectively from Day One.
HHS has an outsized impact on the federal government, from its role in declaring public health emergencies to its management of Medicare and Medicaid to its $1.6 trillion annual budget. Under Presidents Joe Biden and Barack Obama, HHS has also used its power over health policy to promote abortion and transgender ideology.
Severino lays out five overarching goals for a conservative president intent on reshaping HHS: (1) protecting life from conception, protecting the rights of conscience of health care workers, and defending biological reality against gender identity ideology; (2) empowering patients to make their own health care choices, enabling providers to offer more options, and unleashing markets to drive down costs and improve quality; (3) promoting stable and flourishing married families instead of LGBT activism and single motherhood; (4) correcting the errors of the COVID-19 pandemic and preparing for the next health emergency; and (5) closing the “revolving door between government and Big Pharma,” where regulators leave government and work for companies they have regulated and pharmaceutical executives move from industry into regulatory agencies.
Severino breaks down the massive bureaucracy of HHS and presents specific recommendations for each branch of the behemoth agency. This article focuses on a few of the specific issues that motivate the major changes he recommends.
Many of Severino’s critiques and recommendations for a future HHS trace back to the department’s abuses during the COVID-19 pandemic. His report notes that while the HHS secretary declared a public health emergency, “the threshold for what constitutes a public health emergency—how many cases, hospitalizations, deaths, etc.—was never defined.”
Severino recommends that Congress “restrict HHS’s ability to declare indefinite public health emergencies,” in part by establishing a set time frame for any emergency.
He also recommends that the HHS secretary “investigate, expose, and remediate any instances in which HHS violated people’s rights by” colluding with Big Tech companies to silence dissent on COVID-19.
Severino says the Centers for Disease Control and Prevention should be broken up into two separate organizations: one dedicated to gathering scientific data and one responsible for making public health recommendations—”an inescapably political function.” He notes that the CDC previously held back public health information on COVID-19 partially due to “fear that the information might be misinterpreted.”
“CDC should report on the risks and effectiveness of all infectious disease-mitigation measures dispassionately and leave the ‘should’ and ‘must’ policy calls to politically accountable parties,” he writes. “Congress should ensure that CDC’s legal authorities are clearly defined and limited to prevent” an “arbitrary and vacillating exercise of power,” as the U.S. experienced during the pandemic.
He recommends that the Food and Drug Administration, not the CDC, should regulate vaccines, and he calls for reforms to prevent the National Institutes of Health’s “inappropriate industry ties that create serious conflicts of interest.”
He notes that the National Institute of Allergy and Infectious Diseases—Anthony Fauci’s division of the NIH—”owns half of the patent for the Moderna COVID-19 vaccine, among thousands of other pharma patents.” According to NIH documents, NIH Director Francis Collins, Fauci, and Fauci’s deputy director, Clifford Lane, all received royalty payments from pharmaceutical companies between 2009 and 2014.
He faults NIH for funding “gain-of-function viral research that may have been responsible for COVID-19.”
Severino recommends HHS change many policies to protect unborn life and maternal health and to honor the religious convictions of Americans who object to the use of aborted baby body parts in medical research.
The CDC “should fund studies into the risks and complications of abortion” and require states to report abortion complications and babies born alive despite an attempted abortion, he writes. It should prohibit research on aborted baby body parts, since such research can be “easily” replaced with research on adult stem cells. And it should avoid promoting abortion as health care.
Severino condemns the CDC’s current abortion and maternal mortality reporting systems as “woefully inadequate,” since states provide those statistics on a voluntary basis. “Because liberal states have now become sanctuaries for abortion tourism, HHS should use every available tool, including the cutting of funds, to ensure that every state reports exactly how many abortions take place within its borders, at what gestational age of the child, for what reason, the mother’s state of residence, and by what method.”
The former HHS leader urges the FDA to reconsider its approval of chemical abortion drugs, an approval that currently faces a court challenge. He notes that the complication rater for chemical abortion is “four times higher” than that of surgical abortion and that the chemical abortion drug mifepristone has been associated with 26 deaths of pregnant mothers, over 1,000 hospitalizations, and thousands more adverse events. He calls the approval of this drug “politicized and illegal from the start.”
Severino also calls for the FDA to loosen its restrictions on foreign-made vaccines that were not derived through or tested on aborted baby cells, reinstituting a Trump-era waiver for Japanese-made vaccines.
He urges the Centers for Medicare and Medicaid Services to block Planned Parenthood from receiving Medicaid funds and to redirect funds to “health centers that provide real health care for women.”
Severino urges HHS to audit the Centers for Medicare and Medicaid Services for compliance to the Hyde Amendment, which prevents federal funding of abortions, and to perform a “full review” of HHS efforts to promote abortion in the wake of the Supreme Court’s overturning Roe v. Wade.
He also urges various HHS departments to rescind “ideologically motivated fearmongering” guidance that the Biden administration released in the wake of the court’s ruling, such as warnings about state governments “targeting” women for getting abortions.
3. Transgender Ideology
“Radical actors inside and outside government are promoting harmful identity politics that replaces biological sex with subjective notions of ‘gender identity,’” Severino warns. He urges a potential conservative president to reverse this trend.
Biden’s HHS has interpreted Section 1557 of the Affordable Care Act (also known as Obamacare), which prohibits discrimination on the basis of sex in health care, to forbid discrimination on the basis of “gender identity” and sexual orientation as well. Severino urges a future HHS secretary to explicitly revoke this guidance, as HHS did under Trump.
He says that the Centers for Medicare and Medicaid Services should reissue and expand upon its 2016 decision that it cannot recommend “gender reassignment surgery” for Medicare beneficiaries, citing the “growing body of evidence that such interventions are dangerous.” (Many doctors recently testified in favor of a Florida rule blocking Medicaid coverage for experimental transgender interventions.)
He also urges HHS to withdraw guidance allowing taxpayer funds to pay for cross-sex transitions.
He faults the NIH for having been “at the forefront in pushing junk gender science,” and encourages the agency to “fund studies into the short-term and long-term negative effects of [cross-sex] interventions, including ‘affirmation,’ puberty blockers, cross-sex hormones and surgeries, and the likelihood of desistence [abandoning the desire to change one’s sex] if young people are given counseling that does not include medical or social interventions.”
4. Restoring Religious Liberty
Severino notes that under liberal administrations, the office of HHS that he led, the Office for Civil Rights, “has amassed a poor record of devoting resources to conscience and religious freedom enforcement and is often complicit in approving or looking the other way at the administration’s own attacks on religious liberty.”
He encourages a prospective conservative president to direct the Office for Civil Rights to return to the Trump-era policies that “initiated robust enforcement of these conscience laws.” He urges HHS to reestablish waivers for state and child welfare agencies, especially for faith-based adoption and foster care agencies, which had previously been excluded from federal programs because they were unwilling to place children with same-sex couples.
5. Restoring Medicare and Medicaid
Severino warns that Medicare and Medicaid operate “runaway entitlements that stifle medical innovation, encourage fraud, and impede cost containment, in addition to which their fiscal future is in peril.”
He urges the Centers for Medicare and Medicaid Services to increase Medicare beneficiaries’ control over their own care; reduce regulatory burdens on doctors; ensure sustainability and value for both beneficiaries and taxpayers; and reduce fraud, waste, and abuse. He favors Medicare Advantage and urges Medicare to pay the same amount for outpatient procedures that it does for inpatient hospital services. He also encourages Medicare to reform payments along the lines of intensity and value of service, as opposed to a fee-for-service model.
Severino warns that Medicaid has a higher percentage of improper payments than any other federal program, and encourages the program to stop covering nonmedical services like air conditioning and housing. He says the Centers for Medicare and Medicaid Services should give states more flexibility to strengthen program integrity and to incentivize personal responsibility through work requirements and private insurance.
6. Medical Ethics
Severino encourages HHS to decommission the CDC and NIH Foundations, nonprofit entities “whose boards are populated with pharmaceutical company executives.”
“Private donations to these foundations—a majority of them from pharmaceutical companies—should
not be permitted to influence government decisions about research funding or public health policy,” he writes.
“We must shut and lock the revolving door between government and Big Pharma,” he adds. “Regulators should have a long ‘cooling off period’ on their contracts (15 years would not be too long) that prevents them from working for companies they have regulated. Similarly, pharmaceutical company executives should be restricted from moving from industry into positions within regulatory agencies.”
Severino recommends more changes to HHS, including a prioritization of fatherhood in the many social programs HHS controls, and the elimination of the Head Start preschool program and the NIH Office of Equity, Diversity, and Inclusion.
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