Complaint: American Oversight v. HHS - Anti-Abortion Influence
Feb 21, 2019
HHS Office of Civil Rights Calendars for Senior Officials
Calendars for the Department of Health and Human Services Office of Civil Rights senior officials. These records include calendar entries for Director Roger Severino, Outreach Advisor Arina Grossu, and Advisor for Regulatory and Legislative Reform Maya Noronha.
Calendars for the Department of Health and Human Services Office of Civil Rights senior officials. These records include calendar entries for Director Roger Severino, Outreach Adviser Arina Grossu, and Adviser for Regulatory and Legislative Reform Maya Noronha. The records we received, outlined below, include a number of meetings related to Section 1557 regulations, the “conscience rule” and religious liberty.
The first production, received in September 2019, includes calendars for Arina Grossu, the outreach adviser at the Office of Civil Rights (OCR), and OCR Director Roger Severino for the period from September 2017 to May 2019.
Under Severino’s leadership, OCR has sought to revise regulations for Section 1557 of the Affordable Care Act — the law’s anti-discrimination provision — to redefine sex as “the plain meaning of the term” that OCR purports was used before HHS adopted gender identity into the definition in 2016. (In fact, several courts have ruled that the law’s prohibition on sex discrimination covers gender identity, without relying on HHS regulations.) Proposed administrative changes to Section 1557 were announced by HHS on May 24, 2019.
Prior to joining HHS, Grossu worked as director of the Family Research Council’s Center for Human Dignity, where she advocated for anti-abortion rights initiatives. Grossu’s role in OCR, evidenced by these calendar entries, was aligned with proposed changes to Section 1557.
Section 1557 Meetings
Feb. 7, 2018: Meeting regarding Section 1557 with OCR officials Louis Brown and Harold Henderson.
April 3, 2019: Grossu met with the American Association of Pro-Life OB-GYNs regarding a “1557 press package.”
March 26, 2019: Grossu and Severino held a press review regarding Section 1557.
Meetings with Religious Liberty Groups
Febr. 21, 2018: Grossu was scheduled to attend a Religious Liberties Forum hosted by the Heritage Foundation.
May 1, 2018: Phone call with Gregory Angelo, executive director of Log Cabin Republicans. Angelo requested the meeting to discuss Section 1557 of the ACA and “PATCHA” (possibly referring to PACHA, the President’s Advisory Council on HIV/AIDS).
May 17, 2018: Grossu was invited to a cocktail reception for the president of Divine Mercy University.
Aug. 23, 2018: Grossu was invited to a teleconference hosted by the Federalist Society and moderated by Judge Don Willett. Potential topics covered on the call included NIFLA v. Becerra, Trump v. Hawaii, and the HHS Conscience and Religious Freedom Division.
Oct. 29, 2018: Grossu and Severino were invited to attend a briefing hosted by the Helsinki Commission called “Beyond Tolerance: Faith in the Public Square.”
Jan. 21, 2019: Rep. Chris Smith’s officed asked Severino to speak to members of the Pro-Life Caucus on March 6, 2019. On Feb. 22, after the administration announced a final rule denying Title X family-planning funding to groups providing or referring patients for abortions, Deputy Assistant Secretary Laura Pence also asked Smith’s office whether they wanted HHS to send a someone to talk about Title X.
Jan. 23, 2019: Severino and Grossu meeting with Religious Freedom Institute executives Tom Farr and Kent Hill.
March 12, 2019: Lunch meeting with Arina Grossu and Freedom2Care Director Jonathan Imbody and fellow Anne Foster.
May 23, 2019: Severino spoke at a conference held by the National Institute of Family and Life Advocates (NIFLA). His session was entitled “Protecting Rights of Conscience and Religious Freedom in Health Care and Human Services.”
The production received in October 2019 include the calendar entries from June 2017 to December 2018 for Maya Noronha, senior advisor for regulatory and legislative reform at HHS OCR.
Section 1557 Meetings
March 12, 2018: Meeting with Sarah Albrecht, Daniel Lawyer, and March Bell regarding Section 1557 and Title IX. (Page 336) Sarah Albrecht currently serves as the associate deputy director of OCR’s Conscience and Religious Freedom Division (CRFD).
Aug. 20, 2018: Bell, OCR’s chief of staff and a longtime anti-abortion rights advocate, circulated a meeting invitation, saying, “We are initiating a new series of meeting on our reg work — this one is on 1557.”
Regulatory Reform Meetings
June 30, 2017: The Office of the Executive Secretary shared instructions for a monthly conference call with “regulatory reform officers” to begin on Oct. 12, 2017. The purpose of the meeting was “to discuss updates on deregulatory items, gain insight into Op/StaffDivs’ approach toward the deregulatory endeavor and benefit from their experience … and have a forum to exchange ideas and gain perspective that will benefit the deregulatory work at your Division.”
May 25, 2018: An email from Albrecht regarding “next steps” for the submission of a CRFD regulation for OMB review on Oct. 1, 2018.
Nov. 29, 2018: Noronha organized a regulatory reform meeting with Severino, CRFD official Justin Butterfield, and others.
Other Records
Nov. 9, 2017: Severino had a meeting with Little Sisters of the Poor, Mark Reinzi of the Becket Fund, and Martin Nussbaum, who sued HHS on behalf of the Catholic Benefits Association over the Affordable Care Act’s contraception mandate. The meeting was to discuss “the infringement against religious liberty and conscience imposed by HHS mandate,” and the meeting information notes that Severino would be contacting the Department of Justice attorney working on related cases. Staff for the meeting included Paula Stannard, Matt Bowman, Laura Trueman, and Shannon Royce.
Mar. 26, 2018: Severino received a letter from the National Association of Chain Drug Stores (NACDS) and subsequently scheduled a meeting to consider preemptive regulatory reform that would change the requirements for pharmacies to post tagline notices in the top 15 foreign languages spoken in states where pharmacies operate.
Records received in November 2019 include additional calendar entries for Maya Noronha, OCR’s senior adviser for regulatory and legislative reform, from March 2018 to early May 2019. This production includes more examples of OCR’s involvement in proposing changes to ACA Section 1557 regulations.
Section 1557 Meetings
Aug. 21, 2018: “1557 Decision Points” meeting with Noronha, Severino, March Bell, and Louis Brown.
Oct. 11, 2018: “Section 1557 Regulation Update.”
Oct. 17, 2018: An “urgent” meeting with Brown, Bell, Noronha, and OCR official Luben Montoya to discuss 1557 and Limited English Proficient discrimination enforcement.
Jan. 7, 2019: “1557 Disability Chart” meeting.
March 22, 2019: Section 1557 conference call with Noronha, March, Severino and OCR official Pamela Barron.
April 5, 2019: Meeting regarding Section 1557.
Also in the production was a comparison of three “language access” measures: 1) Title VI of the Civil Rights Act of 1964; 2) Section 1557; and 3) Executive Order 13166.
Conscience Rule Meetings
June 28, 2018: Noronha shared a list of “Conscience Reg” projects.
July 31, 2018: Meeting to discuss a conscience regulatory impact analysis. Attendees included Severino, Bell, Perez, Butterfield, Albrecht, and others.
Nov. 16, 2018: “Draft Conscience Final Rule” meeting with OCR officials and HHS Deputy Secretary Eric Hargan.
Jan. 3, 2019: “Conscience rule meeting” with Perez, Butterfield, Noronha, Albrecht and Matthew Bowman, who was then HHS general counsel.
Other Records
Sept. 12, 2018: Meeting with Joseph Bingham, then a Blackstone Fellow and now the assistant general counsel in the office of Texas Gov. Greg Abbott. The Blackstone Legal Fellowship is awarded to Christian law students and is sponsored by the Alliance Defending Freedom, a conservative advocacy group.
Jan. 23, 2019: Noronha, Brown, and Barron had a meeting with Matt Valliere, executive director of Patient’s Rights Action Fund, an organization dedicated to opposing physician-assisted suicide as a treatment option for terminally ill patients.
The fourth production, received December 2019, contain OCR leadership’s calendar entries, meeting requests, and regulatory priorities.
Section 1557 Meetings
March 5, 2019: Briefing on Section 1557 enforcement with Severino, Brown, and Barron.
March 12, 2019: Meeting about the Section 1557 regulation.
March 27, 2019: Grossu and Severino met review press related to Section 1557. Severino had been interviewed by Anna Wilde Mathews of the Wall Street Journal on March 11.
April 1, 2019: Grossu and Severino met to go over final Section 1557 press materials.
Inpatient Prospective Payment System Meetings
In August 2019, the Centers for Medicare and Medicaid Services (CMS) published a final rule revising the wage index system (the Inpatient Prospective Payment System, or IPPS) used to determine Medicare payments to hospitals. The changes increased the payments made to rural hospitals but adversely affected funding to urban hospitals. The calendars include multiple meetings regarding IPPS, including on Dec. 20, 2018, and Jan. 17, Feb. 13, and March 18, 2019.
Other Meetings
Feb. 8, 2019: CMS staff held a rollout call regarding the agency’s “Interoperability Rule” and Health Information and Management Systems Society (HIMSS) amplification. Marcus Barlow, an ally of Seema Verma and head of Integritas LLC, who had been hired to boost Verma’s media profile, was included. In April 2019, HHS suspended the contract with Barlow.
Dec. 12, 2019: Meeting with Katie Doherty, a congressional aide serving on the House “Values Action Team.”
The documents received in January 2020 include the following:
April 5, 2017: “Section 1557 Follow-Up”
April 7, 2017: Severino sent a letter to “advocates,” inviting them to a “listening session” about Section 1557. “As you know,” Severino wrote, “the current and future status of OCR’s regulations under Section 1557 of the Affordable Care Act is of major interest to the civil rights community and the public at large.”
April 24, 2017: “Meeting request re: Section 1557” from Laura Trueman, the director of the HHS Office of Intergovernmental and External Affairs.
May 30, 2017: “Section 1557 Listening Session”
March 22, 2019: Call about 1557, with Severino, Bell, Noronha, Barron.
HIPAA Meetings
The calendars contain meetings on Sept. 8, 2017 and March 18, 2019 related to the Health Insurance Portability and Accountability Act (HIPAA), which regulates privacy of patients’ health information. Another meeting on Sept. 7, 2017 discussed HIPAA and opioid policy.
Other Meetings
Sept. 25, 2017: Meeting with Bethany Christian Services, a large adoption agency linked to Education Secretary Betsy DeVos and her family.
In January 2019, HHS allowed federally funded religious foster care and adoption agencies in South Carolina to deny services to same-sex or non-Christian couples. Members of the Pennsylvania House of Representatives wrote a letter to Assistant Secretary Lynn Johnson requesting a similar exemption for Pennsylvania agencies.
