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Biden faces pressure on women’s health, LGBT issues

Becerra, Biden's pick for HHS, has been a key figure in pushing back against a number of Trump administration policies

Progressive groups are already pushing President-elect Joe Biden to reverse a number of Trump administration health policies next year, with an emphasis on those that affect low-income, minority and LGBT communities.

Biden announced a number of key health policy picks Monday, including California Attorney General Xavier Becerra, his choice to serve as Health and Human Services secretary. Becerra has been a key legal figure in pushing back against a number of Trump administration policies, including changes to federal family planning programs and efforts to undermine the 2010 health care law.

Robert Blendon, a Harvard T.H. Chan School of Public Health professor of public health and health policy and political analysis, noted that progressive groups were politically active in raising money and getting out the vote.

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“He’s going to be very supportive of the groups that really worked very hard for him,” said Blendon, noting that the president-elect ran his campaign on repealing abortion restrictions and backing supportive policies for the LGBT community.

Blendon said academic studies have shown that large Democratic donors tend to skew liberal on social issues, and Biden will need to be responsive.

“It would be very hard to look at polling results and voting results and campaign contribution results and say that the best route is to be moderate and in the middle,” Blendon said. “He’s going to have to take a stand for people who really actively supported him on those issues.”

Anita Dunn, who serves as a senior adviser to the Biden transition team, appeared Monday at a membership event hosted by Planned Parenthood Action Fund and praised the women’s health organization, saying it “played a leading role” in the 2020 presidential race and in the 2018 midterms.

“On Day One, when Joe Biden and Kamala Harris put their hands on that Bible, we all are going to be prepared to build this country back better and to work together for a better society, and Planned Parenthood has been at the center of this fight for as long as I’ve been in politics,” said Dunn, who served in the Obama White House.

She said the Biden administration will look to Planned Parenthood “to both identify policy priorities and personnel.”

“We have spent four years on defense fighting to try to protect some basic things,” Dunn said, adding, “Joe Biden and Kamala Harris are going to start the hard work of reversing what the Trump administration has done to lead us into a much better future when it comes to women’s reproductive freedom.”

Dunn did not point to specific policies but the Biden campaign has emphasized that it would defend nondiscrimination protections for LGBT individuals. The Trump administration finalized a rule in June that would roll back Obama-era nondiscrimination protections in the 2010 health law on gender identity and termination of pregnancy. Becerra led a coalition of 23 attorneys general in a lawsuit challenging that rule.

Conservative advocacy groups are complaining that Becerra is a progressive pick whose nomination undercuts the message of a moderate Biden administration. Several Senate Republicans have vowed to oppose his nomination. 

“Xavier Becerra is a disaster for religious freedom and pro-life issues,” tweeted Sen. Steve Daines, R-Mont. “He has made his career aggressively pursuing a radical pro-abortion agenda and attacking the religious freedom of Americans who believe in the sanctity of human life.”

But Becerra does have some bipartisan health care experience. As California’s attorney general, he has worked with a coalition of attorneys general from both parties in efforts to hold opioid manufacturers accountable for the rise in overdose deaths and prevent youth tobacco use.

Policy pushes

Planned Parenthood’s advocacy and political organizations, which said they spent $45 million in the 2020 election cycle, has released a laundry list of items they hope to see Biden and his administration accomplish.

“We are entering into a new era where not only do we have the ability to undo the damage of the last four years, but we have the ability and the mandate and the mission to move policy and our collective imagination forward,” Planned Parenthood Action Fund President Alexis McGill Johnson said during the event Monday.

McGill Johnson outlined that on the new administration’s first day, the group hopes to see Biden issue an executive order that would protect and expand access to reproductive health care.

She also said she hopes to see a reversal of the Trump administration rule that bars federal funding through the Title X family planning program from going to facilities that provide or give referrals for abortions. Becerra led a lawsuit challenging that rule, and in October led a coalition of state attorneys general in petitioning the Supreme Court to strike it down.

The group also wants the next administration to continue to appoint advocates of abortion rights to positions and support the end of the Hyde amendment, an annual appropriations rider that bans federal funding of abortion in most cases. Both Biden and Vice President-elect Kamala Harris support these policies, and the House Appropriations Labor-HHS-Education Subcommittee held a hearing on repealing the policy on Tuesday.

Biden has also said he plans to reverse the Mexico City policy, which blocks federal funding for global non-governmental organizations that provide abortion referrals or engage in any abortion rights advocacy. President Donald Trump reinstated the policy immediately after taking office.

The president-elect has also committed to eliminating some exceptions from a requirement under the 2010 health law that most health plans cover birth control at no cost to patients.

The Trump administration finalized two rules that would allow any employer or university insurance plan to get an exemption from covering contraception for any moral or religious reason. The Supreme Court waded into this debate and upheld Trump’s rules in July, but a Biden administration could make the decision moot if the rules are reversed.

The courts have blocked a different Trump administration rule that would expand when a person assisting in a health care service could object due to religious or moral reasons. Advocates have said this rule, if implemented, could have reduced access to reproductive and gender-affirming care.

Biden has also said that enactment of a House-passed bill that would broaden the definition of protected classes to include sex, sexual orientation and gender identity is a top priority within his first 100 days.

Democrats have pushed for this legislation, which would ensure an LGBT individual would not be denied care, including counseling, wellness exams or hormone treatment. 

But unless two Jan. 5 runoff elections lead to Democratic control of the Senate, the bill is unlikely to survive that chamber.

Biden has also spoken out about Trump administration policies that provide federal funds to adoption agencies that use religious criteria in their programming, allowing them to reject same-sex couples.

“The campaign fought hard but it’s nothing compared to the battles we will face over the next two years to actually put a progressive agenda into place and I’m excited about it in Congress and also on the state level,” Dunn said.

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