I surely don’t have to tell you that the current administration is a policymaking disaster. Some of Trump’s appointments like Betsy DeVos, Rick Perry, and Steve Mnuchin have little to no experience in the fields for which they now make federal decisions. There’s also a set of lower-level agency leadership who previously worked in the George W. Bush administration advancing conservative policies and are now positioned to return to that work – either as new appointees returning from the private sector or advancing in the federal agencies where they’ve remained. The consequences of this phenomenon can be disturbing.
The Department of Health and Human Services (HHS) has fallen especially victim to this, as conservatives view a person’s right to health and personal autonomy for themselves and their families as an increasingly political act. With the reintroduction of “religious refusal” protections by healthcare providers, more people will be denied or delayed care because their body, desire for autonomy, or identity don’t fit someone else’s religious beliefs.  Earlier this year, we saw Charmaine Yoest and Teresa Manning – anti-abortion and anti-birth control stalwarts who had no business pushing their junk science in healthcare policy – leave their leadership positions at HHS.  It’s unsurprising to see these two government outsiders couldn’t hack it, despite the lengths this administration has gone towards Manning and Yoest’s own goals. [3-5]
The nature of a bureaucracy is that it’s supposed to be relatively apolitical, serving the needs of the government in place without partisanship or personal interest, and forming to fit the needs of new administrations with the expertise cultivated from the previous government. Appointees come and go, bringing their politics with them, surely, but the ideal is that they serve the current administration to their best abilities while staffed in an agency-level position. Sometimes, staffers leave with the new administration and the appointees who served as their bosses, returning either by appointment or following an old boss when the party more in line with their political interest is back at the helm of federal government.
The “revolving door” – referring to lobbyists entering and leaving federal jobs when administrations change – is a common and often unavoidable byproduct of the two-party political system, but there’s some notable differences in the current administration’s approach. The returning hires and new promotions from the Bush administration didn’t just egress to astronomically overpaid lobbying and consulting gigs on K Street. Almost anticipating the ‘take this country back’ approach of their new president, many of these officials appear to have spent the Obama years sharpening their spears to undo all the progress that had been made under that administration and return to anti-abortion and anti-LGBTQ+ pursuits they abandoned, no matter the human cost.
Scott Lloyd, now infamous for his fixation with blocking undocumented minors from accessing abortions they want,  previously worked at HHS under Bush. He spent some of his time there coauthoring a “conscience rule” allowing healthcare providers to decline to pay for or provide abortions,  then left HHS when Obama entered office to work in policy for the Knights of Columbus, a Catholic organization that is staunchly anti-abortion. During that time, he was also a board member of an anti-abortion fake clinic in Northern Virginia. The website of this fake clinic is pretty standard among its peers, but has one nefarious trick: It tells potential clients to come to the clinic before taking emergency contraception to “confirm the pregnancy.” Problem is, emergency contraception is time-sensitive and meant to be taken as soon as possible to avoid pregnancy, so there is no pregnancy yet to confirm.  This is blatantly a tactic to stall women past the window where emergency contraception can be used effectively, and into the fake clinic’s doors so they can work their stigmatizing and dark deception. It’s not dissimilar from the repeated attempts by Lloyd and his staff to delay care for the undocumented minors in their custody.
Lloyd really likes anti-abortion fake clinics. He coerced pregnant undocumented minors to go to fake clinics instead of the abortion providers they were seeking, and directed his subordinate Maggie Wynne to create a list of fake clinics in Texas to send them to.  Wynne, an HHS official who was a member of Trump’s “Landing Team,”  was more than happy to oblige. She too worked for the Knights of Columbus before joining the Trump administration, and was staff director of the House of Representatives’ Pro-Life Caucus in the ’90s. Most of her career, though, was spent at HHS, championing anti-abortion causes within her field: anti-sex trafficking policy. She worked at HHS under Bush and Obama, and fought within the bureaucracy to strip sex trafficking victims of their right to abortion services, which was mandated under the Obama administration. 
Also a longtime official in the anti-human trafficking program at HHS is Steven Wagner, who was there under Bush and returned with Trump to lead the bureau Lloyd and Wynne work in. In that capacity, he is a defendant in the suit (along with Lloyd) that the American Civil Liberties Union filed to secure undocumented minors’ access to abortion care.  Wagner too has advocated against providing abortion care to victims of trafficking,  and railed against the Obama administration for denying a federal contract to the U.S. Conference of Catholic Bishops because they refused to offer abortion and contraception services to trafficking victims.  He has founded two non-profits in his downtime from agency work: in 2007, the now seemingly defunct Renewal Forum, whose mission was to fight child sex trafficking, and in 2013, Solidarity with the Persecuted Church, which sends money and materials to Christian churches mostly in the Middle East. [15-17]
Then there’s Paula Stannard, who led Trump’s HHS Landing Team. After working for the Bush administration from 2001 through 2009, she went on to earn big bucks fighting the Affordable Care Act’s birth control mandate in court and getting cozy with pharmaceutical companies and trade groups. She also reportedly assisted in crafting legislation aimed at severely restricting abortion that was pushed by the now-disgraced and former Arizona Congressman Trent Franks, who solicited his staffers to serve as surrogates for his children, suggesting he would impregnate at least one of them himself. [18, 19] Stannard didn’t end up landing a job at HHS, but the Trump administration’s use of ‘beachheads’ to snap their takeover into place is worth a critical look, especially when those figures have money and ties in big pharma.
You’d think the HHS Office of Civil Rights would be able to check some of these nefarious policies and wily actors, but its chief, Roger Severino, has dedicated his career to fighting reproductive and LGBTQ+ healthcare access. In his previous job at the ultra-conservative Heritage Foundation, he wrote a report supporting religious-based denial of gender-affirming care for trans people, and a doctor’s right to deny healthcare to someone who previously had an abortion.  Though new to HHS, Severino previously worked at the U.S. Department of Justice, where he worked on religious freedom issues in the Office of Civil Rights. 
A sleeper cell lies in wait for its moment to pounce into action. This group’s years of patience were rewarded by a president who faithfully listens to his Christian conservative ear-whisperers while he hides his own sexual indiscretions and violence. I’m not trying to ring alarm bells on some kind of far right “deep state.” There’s strong reason to believe, however, [22-24] that the current administration is emboldening figures with bigoted views against reproductive rights and LGBTQ+ inclusion to resurrect their crusades of hate in the name of religious freedom.