The Bush administration recently appointed a new chief of family planning programs at the Department of Health and Human Services (HHS) who opposes choice, contraception, and sexuality education. Eric Keroack—currently the “medical director” of A Woman's Concern, a Christian organization that runs six crisis pregnancy centers in Massachusetts and regards the distribution of contraceptives as “demeaning to women”1 —will become deputy assistant secretary for population affairs at HHS.
Keroack, an obstetrician-gynecologist, will advise HHS Secretary Michael Leavitt on matters such as reproductive health and adolescent pregnancy and will oversee $283 million in annual family planning grants made through the Title X program. Title X provides high-quality family planning and preventive health care services to over five million low-income individuals annually. Keroack began his appointment, which does not require Senate confirmation, the week of Thanksgiving.
Family planning advocates have raised numerous concerns about Keroack's appointment. Under Keroack's supervision, A Woman's Concern centers will not distribute, encourage the use of, or provide referrals for contraceptive drugs and devices. Moreover, A Woman's Concern disparages the use of birth control, incorrectly characterizes traditional forms of birth control as abortifacients, and wrongly claims that the use of contraception increases pregnancy.2 According to its website, “A Woman's Concern is persuaded that the crass commercialization and distribution of birth control is demeaning to women, degrading of human sexuality and adverse to human health and happiness.”3 In addition, the crisis pregnancy centers overseen by Keroack are designed to dissuade pregnant women from seeking abortions, in part through false and misleading information. By supporting such biased counseling, Keroack rejects a long-standing Title X requirement that women facing an unintended pregnancy be provided with counseling on all possible options including carrying their pregnancy to term, adoption, and abortion.
Keroack also serves on the National Abstinence Clearinghouse's medical advisory council. In this capacity, he was a member of the panel commissioned by the federal government to develop the 13 themes criteria document for the Community-Based Abstinence Education grant program. This committee expanded upon the current Title V A-H “abstinence education” definition by enumerating themes and messages that should be included in federally funded abstinence-only-until-marriage curricula.4 In addition, A Woman's Concern received close to half a million dollars for each year between Fiscal Years 2003 and 2006 to provide abstinence-only-until-marriage programming.5
“It is unconscionable that an individual with this track record would be put in charge of the very programs that are supposed to provide women with the information and services they need to prevent unintended pregnancies and protect their reproductive health,” said Joseph DiNorcia, president of SIECUS. “Once again, the administration has proven that it is more concerned with advancing a conservative social agenda than with ensuring the health of our nation's women,” DiNorcia continued.
HHS has acknowledged that Keroack is not currently certified as an obstetrician-gynecologist. While that is not a requirement for the job, HHS officials have cited Keroack's expertise in defending his selection.6
Along with family planning advocates, Congressional Democrats sent letters to Secretary Leavitt calling for him to withdraw Keroack's appointment. Fourteen Democrats signed the Senate letter, which was spearheaded by incoming Senate Majority Leader Harry Reid (D-NV) and incoming Senate Health, Education, Labor and Pensions Committee Chair Edward Kennedy (D-MA). The letter reads, “Unfortunately this appointment is another example of the administration allowing ideology to trump science, and it could jeopardize vital services on which large numbers of women and families depend.”7
The House letter was signed by seven Democratic members, including Representative Henry Waxman (D-CA), who is expected to chair the House Government Reform Committee, and Representative Louise Slaughter (D-NY), who is expected to chair the House Rules Committee, as well as other lawmakers who sit on committees that oversee HHS and its budget. The House letter reads, “We are concerned that Keroack has promoted policies—including the refusal to distribute contraception even to married women—that directly conflict with the mission of the federal program.”8
Concerns expressed in the Congressional letters are also supported by recent research. The Guttmacher Institute's new analysis of the Title X family planning program found that if the budget for the program were doubled, nearly a quarter of a million unintended pregnancies would be prevented each year and the U.S. government would save almost $800 million—a return of about $3.80 in savings for every $1 increase in Title X funding.9
However, recent heads of Title X, including Dr. Alma Golden, who served as Deputy Assistant Secretary for Population Affairs from 2002 until August of this year, seem to have been chosen specifically because they would not advocate for more funding, a strategy initiated by President Ronald Reagan. Since the Reagan administration, the only president to appoint a pro-family planning, pro-contraception head of Title X and increase its funding was President Bill Clinton. In turn, President Clinton presided over the steepest decline in abortion rates in U.S. history—from 1.5 million abortions in 1993 to 1.3 million in 2000.10
“Dr. Golden never advocated for a single additional dollar for Title X family planning during her tenure, but Keroack's appointment is a classic example of the fox in the hen house,” said William Smith, vice president for public policy at SIECUS.
- Christopher Lee, “Bush Choice for Family-Planning Post Criticized,” Washington Post, 17 November 2006, accessed 22 November 2006, <http://www.washingtonpost.com/wp-dyn/content/article/2006/11/16/AR2006111601929_pf.html>.
- Policy on Contraception and Emergency Contraception , A Woman's Concern, accessed 22 November 2006,<http://partners.awomansconcern.org/images/misc/birth_control_policy.pdf>.
- Lee, “Bush Choice for Family-Planning Post Criticized.”
- See ‘” It Gets Worse: A Revamped Federal Abstinence-Only Program Goes Extreme ” for more information.
- For more information, see SIECUS State Profiles .
- Christopher Lee, “HHS Nominee Has Prescribed Birth Control,” Washington Post, 22 November 2006, accessed 22 November 2006, <http://www.washingtonpost.com/wp-dyn/content/article/2006/11/21/AR2006112101335_pf.html>.
- U.S. Senate Committee on Health, Education, Labor, and Pensions, Ranking Member, “Senators Decry Ideological Appointment to Health Post,” Press Release published 21 November 2006, accessed 4 December 2006, <http://help.senate.gov/Min_press/2006_11_21.pdf>.
- Committee on Government Reform, “Democrats ask Leavitt to Rescind Keroack Appointment,” 20 November 2006, accessed 4 December 2006, <http://www.democrats.reform.house.gov/story.asp?ID=1137>.
- Jennifer Frost, et. al., Estimating the Impact of Serving New Clients by Expanding Funding for Title X , Occasional Report No. 33 , (New York: Guttmacher Institute, November 2006), accessed 4 December 2006, <http://www.guttmacher.org/pubs/2006/11/16/or33.pdf>.
- Cristina Page, “Guess who's at the birth-control wheel?; Bush's man overseeing contraceptives for the poor is an advocate of abstinence ,” Newsday, 3 December 2006, A59.