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Biden taps supporter of contraceptive mandate to HHS position

Department of Health and Human Services at the Wilbur J. Cohen Federal Building. / Mark Van Scyoc/Shutterstock

President-elect Joe Biden will nominate a supporter of the contraceptive mandate to a top position at the Department of Health and Human Services (HHS), he announced on Tuesday.

On Tuesday, Biden announced that he would nominate Dr. Rachel Levine, a biological man identifying as a transgender woman who has served as Pennsylvania's health secretary since 2017, to be HHS Assistant Secretary for Health. Before serving as Pennsylvania's health secretary, Levine served as the state's physician general.

Levine has been outspoken on social issues, supporting gender-transition surgery and the contraceptive mandate while opposing a proposed 20-week abortion ban.

Levine's nomination to HHS, along with that of Health Secretary nominee Xavier Becerra, signals that social issues could be priorities at the agency for the next several years. These might include pro-LGBTQ policies, funding of abortion providers, and religious freedom conflicts with Catholic organizations.

Regarding the Obama-era HHS contraceptive mandate, Levine in 2017 called it "immoral and unethical" to allow for religious exemptions to the mandate. Hundreds of non-profits and businesses-including the Little Sisters of the Poor-had objected to the mandate and the Obama administration's opt-out process for objecting non-profits.

After the Trump administration announced in 2017 that religious employers and other organizations morally opposed to the contraceptive mandate could receive exemptions from it, Levine issued a sharp statement in opposition.

"It is immoral and unethical to give any employer the ability to take away access to health care from an entire gender," Levine said as Pennsylvania's acting health secretary, in 2017. "We cannot allow women's health to be reduced to one issue or be jeopardized in any way."

Levine also wrote an op-ed against the Trump administration's reversal of Obama-era rules on transgender accommodation.

In Feb., 2017, the Trump administration said it would stop defending the Obama administration's transgender bathroom policy in court; the policy had directed schools to allow students to use gender-specific bathrooms according to their gender identity, and not their biological sex.

In an op-ed for the Patriot-News, Levine wrote that "[t]he decision by the Trump administration to roll back the most basic protections for transgender and gender expansive youth is heartbreaking."

"To Pennsylvania's transgender and gender expansive youth and their families who are worried or concerned, I want you to know that Governor Wolf's administration has your back," Pennsylvania's then-physician general wrote.

In 2016, Levine spoke out against a 20-week abortion ban that criminalized abortions after 20 weeks of pregnancy except in cases where the mother's life was in danger. The bill also banned the "dilation and evacuation" abortion procedure.

Levine said at the time that the bill "punishes women whose pregnancies have complications."

"Women and their families, when faced with a devastating diagnosis of a significant fetal anomaly, have the right to make the decision which is appropriate for them, in consultation with their doctors," Levine said.

Levine's family moved their mother out of a personal care home early in the COVID-19 pandemic, because of the high spread of the virus; the decision invited some media scrutiny.

Levine was also questioned for the state's policy of requiring nursing homes to accept recovering COVID patients from hospitals, although the state health secretary responded that asymptomatic staff at the homes-not patients discharged from hospitals-were the primary spreaders of the virus there.

If Levine is confirmed to HHS, along with Becerra, they together could craft policy to influence a number of issues including abortion, gender-transition surgery, and the contraceptive mandate.  

While California's attorney general, Becerra fought aggressively in favor of an abortion coverage mandate that religious employers were not exempt from, and continued the prosecution of pro-life activist David Daleiden.

If confirmed as Health Secretary, Becerra-a Catholic-could reignite a number of Obama-era policies that the U.S. Conference of Catholic Bishops and other Catholic groups were opposed to.

These might include resurrecting court battles with the Little Sisters of the Poor and other Catholic groups that opposed the Obama administration's procedure by which to "opt out" of the contraceptive mandate. The groups said that the policy still required them to provide coverage for contraceptives through their employee health plans, which they morally objected to.

Other HHS policies could include re-imposing the full transgender mandate-a requirement that doctors perform gender-transition surgery upon the referral of a mental health professional-and various requirements of religious groups that receive HHS grants, such as adoption agencies having to match children with same-sex couples.

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