DEPARTMENT OF HEALTH & HUMAN SERVICES ADMINISTRATION FOR CHILDREN AND FAMILIES 330 C Street, S.W. Washington, D.C. 20201 March 14, 2019 Sent via email: Macarter@equityfwd.org Re: ACF FOIA 18-F-0152 Dear Ms. Carter: This is a partial response pertaining to Case No. 18-cv-01509 filed June 26, 2018, relating to the Freedom of Information Act (FOIA) request 18-F-0152. FOIA request 18-F-0152 requested communications to or from Scott Lloyd and numerous individuals listed in the enclosed request. The Office of Refugee Resettlement conducted a thorough search of their files and located the enclosed 53 pages. Information is being released in full on 40 pages and disclosed in part on 13 pages pursuance to FOIA Exemption b(6). Approximately 52 additional pages originated with the Department (“HHS”) and are being sent to them for consultation and returned to the ACF for final release determination. Exemption 6, 5 U.S.C. § 552(b)(6) permits a Federal agency to withhold information and records about individuals in "personnel and medical files and similar files, the disclosure of which would constitute a clearly unwanted invasion of personal privacy.” The definition of “similar files" has historically been broadly interpreted to include a wide variety of files, and the United States Supreme Court has held that Congress intended the term "similar files" to be interpreted broadly, rather than narrowly. I have analyzed these records and find they meet the threshold requirement of this exemption. In this case, the withheld information consists of predominantly cell phone number of federal employees and the personal information of civilians. Additionally, I have reviewed and weighed the public interest in disclosure of this information against the privacy interest in nondisclosure, and found that the privacy interest outweighs the public's interest in disclosure. ACF will continue to review and make partial releases of the remaining portions of this request. Sincerely yours, Carla C. Smith -S Digitally signed by Carla C. Smith -S DN: c=US, o=U.S. Government, ou=HHS, ou=ACF, ou=People, cn=Carla C. Smith -S, 0.9.2342.19200300.100.1.1=200138 0247 Date: 2019.03.14 13:46:41 -04'00' Celeste Smith Director, Freedom of Information Office Office of Communications Administration for Children and Families U.S. Department of Health and Human Services Washington, D.C. Enclosures VERSIGHT To: "Susan Yoshihara " Subject: Re: Meeting with Sisters of Life Date: 2018/04/09 19:12:59 Priority: Normal Type: Note Hi Susan, That sounds great. I will taxi up and meet you there. I will be staying across from the UN at the Hilton. See you tomorrow , Scott On: 08 Ap1il 2018 17:10, "Susan Yoshihara" wrote: Recipient: "Susan Yoshihara " Sent Date: 2018/04/09 19: 12:59 Message Flags: Unsent AMERICAN PVERSIGHT EXT-18-1509-C-000001 To: "tim.saccoccia@kofc.org " "Stromberg, Leah (HHS/OGC)"; "Dees, Karena(HHS/OGC)"; "Goldin, Arthur (HHS/OGC/ETHICS)" Subject: RE: PR Date: 2018/12/04 15:49:01 Importance: High Priority: Urgent Type: Note Tim, Forgive me-I am recused from discussing th is matter (or any official matter) with you as a former Knights employee for two years after employment. As I am settling in to my new role, I am getting used to how this works with the Partnership Center's outreach and coordination efforts, and had this wrong in my mind . I re-reviewed the relevant ethical guidel ines with our ethics department and realized the email below is out-of-bounds. Please do not respond. I will discuss with Shannon and our ethics team how t o properly coordinate situations where the Knights might be involved in something that I am working on . Until you hear from the Partnership Center on the proper channel, anything that you'd like to bring before the Department should be through Shannon or laura. Many thanks, Scott From: Lloyd, Scott (ACF) Sent: Friday, November 30, 2018 9:52 AM To: 'tim.saccoccia@kofc.org ' Subject: PR Tim, Good to see you yesterday. Shannon is heading to Puerto Rico (San Juan) next week and was looking for some recommendations for meetings . I was thinking of 1) the State Deputy and/ or 2) Archbishop Nieves and / or his staff. Do you think it would be worthwhile to try to set something up with the State Deputy? Also, apart from a cold call, do you have any suggestions for gett ing in contact w ith the Archbishop's office there? We can probably ta lk to our regional reps as well. AMERICAN PVERSIGHT EXT-18-1509-C-000002 Thanks! Scott *** E. Scott Lloyd Senior Advisor Center for Faith and Opportunity Initiatives U.S. Department of Health and Human Services ~b)(6) cell) scott.lloy d@acf.hhs .gov I( "tlm .saccoccia@kofc.org"; "Stromberg, Leah (HHS/OGC)"; Recipient: "Dees, Karena(HHS/OGC)"; "Goldin, Arthur (HHS/OGC/ETHICS)" Sent Date: 2018/12/04 15:42:40 Delivered Date: 2018/12/04 15:49:01 Message Flags: Unread Unsent AMERICAN PVERSIGHT EXT-18-1509-C-000003 Lloyd, Scott (ACF) To: "SusanYoshihara" Subject: Re: Meeting with Sisters of Life Date: 2018/04/09 19:13:00 Priority: Normal Type: Note Hi Susan , That sounds great. I will taxi up and meet you there . I will be staying across from the UN at the Hilton. See you tomorrow, Scott On: 08 April 2018 17: 10, "Susan Yoshihara" wrote: AMERICAN PVERSIGHT EXT-18-1509-C-000004 Scott, They've invited us to the convent or breakfast at 8am which will give us time to get to the UN by 9:30. The address is 320 E. 66th. Where will you be staying? I will be coming from the West Side via taxi so may be able to pick you up on the way. Otherwise we can meet there. 6:::: Motherl:= ~b =)(= l==l~s=ai:..:;-d she will definitely try to get there . We will meet with Sr. .... l(b_)(6_l__ and Sr. l(b)(6) from the 66th St. Convent. I ....(6_) ___ My cell is vb_) __. __. Best, Susan On F1i, Apr 6, 2018 at 11:50 AM , Susan wrote: AMERICAN PVERSIGHT EXT-18-1509-C-000005 Scott That's great. I let them know and also that you need to be at the UN by 0930. Will get back to you on the time and place. Susan On Apr 6, 2018 at 11:35, wrote: Hi Susan, I'd love to meet with Mother l(b)(6) ~ I will be there before the event, so that should be no problem. I am pretty flexible with place and time as I will be arriving in the city the night before. /\MERICAi\ pVERSIGHT EXT-18-1509-C-000006 Just let me know! God bless, Scott From: Susan [mailto:susan @c-fam .orgl Sent: Thursday, April 05, 2018 10:10 PM To: Lloyd , Scott (ACF) Subject: Meeting with Sisters of Life Scott, AMERICAN PVERSIGHT EXT-18-1509-C-000007 Mother l(b)( 6) lwould like to meet with you when you come Tuesday. I don 't know your travel schedule but are you able to meet before the event - at their convent or at Holy Family across the street from the UN? Thanks , Susan Yoshihara /\MERICAi\ pVERSIGHT EXT-18-1509-C-000008 Lloyd, Scott (ACF) Recipient: "Susan Yoshihara " Sent Date: 2018/04/09 19:13:00 AMERICAN PVERSIGHT EXT-18-1509-C-000009 Lloyd, Scott (ACF) To: "Lisa Correnti " Subject: RE: Event flyer Date: 2018/05/08 09:15:00 Priority: Normal Type: Note Lisa, I will not be able t o attend. I have forwarded the invite to others who are a bit closer to the trafficking issue-they will reach out to you if they are able to attend . Thank you for thinking of me. God bless, Scott From: Lisa Correnti [mailto:lisa@c-fam.org] Sent: Thursday, April 26, 2018 8:20 AM To: Lloyd, Scott (ACF) Subject: Event flyer Scott, Attached is the event flyer. Since all govt reps are pending they are not listed. As well we are hoping Sen. Lankford will make opening remarks . It is a half day event but of course we would only expect you for your panel which is scheduled for 3pm. Best regards , Lisa Lloyd, Scott (ACF) Recipient: "Lisa Correnti " Sent Date: 2018/05/08 09:15:41 Delivered Date: 2018/05/08 09:15:00 AMERICAN PVERSIGHT EXT-18-1509-C-000010 Lloyd, Scott (ACF) To: "tim.saccoccia@kofc.org" Subject: PR Date: 2018/11/30 09:51:00 Priority: Normal Type: Note Tim, Good to see you yesterday. Shannon is heading to Puerto Rico (San Juan) next week and was looking for some recommendations for meetings. I was thinking of 1) the State Deputy and/ or 2) Archbishop Nieves and / or his staff . Do you think it wou ld be worthwhile to try to set something up with the State Deputy? Also, apart from a cold call, do you have any suggestions for gett ing in contact w ith the Archbishop's office there? We can probably talk to our regional reps as well. Thanks! Scott *** E. Scott Lloyd Senior Advisor Center for Faith and Opportunity Initiatives U.S. Department of Health and Human Services l(b)(6) cell) scott.l 1oyd@acf. hhs.gov I( Lloyd, Scott (ACF) Recipient: "tim.saccoccia@kofc.o rg" Sent Date: 2018/11/30 09:51:30 Delivered Date: 2018/11/30 09:51:00 AMERICAN PVERSIGHT EXT-18-1509-C-000011 Lloyd, Scott (ACF) To: "Susan " Subject: RE: Meeting with Sisters of Life Date: 2018/04/06 11:35:00 Priority: Normal Type: Note Hi Susan, I'd love to meet with Mothe ~(b}(6} pwill be there before the event, so that should be no problem. I am pretty flexible with place and time as I will be arriving in the city the night before. Just let me know! God bless, Scott From: Susan [mailto:susan@c-fam.org] Sent: Thursday, April 05, 2018 10: 10 PM To: Lloyd, Scott (ACF) Subject: Meeting with Sisters of Life Scott, Motherl(b}(6} ~ would like to meet with you when you come Tuesday. I don't know your travel schedule but are you able to meet before the event - at their convent or at Holy Family across the street from the UN? Thanks, Susan Yoshihara Sender: Lloyd, Scott (ACF) Recipient: "Susan " Sent Date: 2018/04/06 11:35:02 Delivered Date: 2018/04/06 11:35:00 AMERICAN PVERSIGHT EXT-18-1509-C-000012 Lloyd, Scott (ACF) To: "Lisa Correnti " Subject: RE: SpeakerInvite Date: 2018/04/20 11:00:00 Priority: Normal Type: Note Hi Lisa, Thank you for the invite . I w ill see if th is is possible and get back to you. Scott From: Lisa Correnti [mai lto:lisa@c-fam.org] Sent: Thursday, April 19, 2018 10:48 AM To: Lloyd, Scott (ACF) Subject: Speaker Invite Dear Scott, Attached please find an invite letter and draft agenda for an anti-trafficking b1iefing on May 17 in Washington DC at the Russell Senate bldg. We invite you to present on the vulnerability of unaccompanied minors in falling prey to traffickers and U.S. government programs that protect these children while waiting to be united with family . Your panel will begin at 3pm. Please see attached for more information. Happy to discuss by phone. Best regards , Lisa Lisa Correnti Executive Vice President Center for Family and Human Rights (C-Fam) lisa@c-fam .org NY: (212) 754-5948 DC: (202) 393-7002 Lloyd, Scott (ACF) Recipient: "Lisa Correnti " Sent Date: 2018/04/20 11:00:41 Delivered Date: 2018/04/20 11:00:00 AMERICAN PVERSIGHT EXT-18-1509-C-000014 From: Susan Yoshihara To: "Lloyd, Scott (ACF) ' ' Subject: Re: Meeting with Sisters of Life Date: 2018/04/08 17:10:34 Priority: Normal Type: Note Scott, They've invited us to the convent or breakfast at 8am which will give us time to get to the UN by 9:30. The address is 320 E. 66th . Where will you be staying? I will be coming from the West Side via taxi so may be able to pick you up on the way . Otherwise we can meet there. Mother (b)(6) and Sr. (b)(6) said she will definitely try to get there. We will meet with Sr. l(b ...... _)(6 _) _ from the 66th St. Convent. My cell is._l (b_)(6_) ___ __. __. Best, Susan On Fri, Apr 6, 2018 at 11:50 AM, Susan wrote : Scott That 's great. I let them know and also that you need to be at the UN by 0930. Will get back to you on the time and place . Susan On Apr 6, 2018 at 11:35, wro te: Hi Susan, AMERICAN PVERSIGHT EXT-18-1509-C-000015 I'd love to meet with Mother ~ I will be there before the event, so that should be no problem. I am pretty flexible with place and time as I will be arriving in the city the night before. Just let me know! God bless, Scott From: Susan [mailto:susan@c-fam.org1 Sent: Thursday , Aptil 05, 2018 10:10 PM To: Lloyd, Scott (ACF) Subject: Meeting with Sisters of Life AMERICAN PVERSIGHT EXT-18-1509-C-000016 Scott, Mother~ would like to meet with you when you come Tuesday . I don't know your travel schedule but are you able to meet before the event - at their convent or at Holy Family across the street from the UN? Thanks , Susan Yoshihara AMERICAN PVERSIGHT EXT-18-1509-C-000017 Sender: Susan Yoshihara Recipient: "Lloyd, Scott (ACF) " Sent Date: 2018/04/08 17:10:26 Delivered Date: 2018/04/08 17:10:34 AMERICAN PVERSIGHT EXT-18-1509-C-000018 From: Lisa Correnti To: "Lloyd, Scott (ACF) '' Subject: Re: Event flyer Date: 2018/05/08 10:24:58 Priority: Normal Type: Note Scott, Thanks so much for passing it on. I appreciate your help with this. Wish you all the best with the important work you are doing. Blessings, Lisa On May 8, 2018, at 6:15 AM, Lloyd , Scott (ACF) wrote: Lisa, I will not be able to attend. I have forwarded the invite to others who are a bit closer to the trafficking issue- they will reach out to you if they are able to attend. Thank you for thinking of me. God bless, Scott From: Lisa Correnti [mai lto:lisa @c-fam .org1 Sent: Thursday, April 26, 2018 8:20 AM To: Lloyd, Scott (ACF) Subject: Event flyer Scott , Attached is the event flyer. Since all govt reps are pending they are not listed . As well we are hoping Sen. Lankford will make opening remarks. It is a half day event but of course we would only expect you for your panel which is scheduled for 3pm. Best regards , Lisa AMERICAN PVERSIGHT EXT-18-1509-C-000019 Sender: Lisa Correnti Recipient: "Lloyd, Scott (ACF) '' Sent Date: 2018/05/08 10:24:30 Delivered Date: 2018/05/08 10:24:58 AMERICAN PVERSIGHT EXT-18-1509-C-000020 From: Lisa Correnti To: "Lloyd, Scott (ACF) " Subject: Re: Event flyer Date: 2018/05/1114:16:43 Priority: Normal Type: Note Hi Scott, Just checking back in on whether you have a colleague available to pa1iicipate. We would really welcome someone's participation and can extend until Monday confirmation . Best regards , Lisa On May 8, 2018, at 6:15 AM, Lloyd, Scott (ACF) wrote: Lisa, I will not be able to attend. I have forwarded the invite to others who are a bit closer to the trafficking issue-they will reach out to you if they are able to attend. Thank you for thinking of me. God bless, Scott AMERICAN PVERSIGHT EXT-18-1509-C-000021 From: Lisa Correnti [ma ilto :lisa@c-fam .org] Sent: Thursday , April 26, 2018 8:20 AM To: Lloyd , Scott (ACF) Subject: Event flyer Scott, Attached is the event flyer . Since all govt reps are pending they are not listed. As well we are hoping Sen. Lankford will make opening remarks. It is a half day event bu t of course we would only expect you for your panel which is scheduled for 3pm. Best regards , Lisa AMERICAN PVERSIGHT EXT-18-1509-C-000022 Sender: Lisa Correnti Recipient: "Lloyd, Scott (ACF) " Sent Date: 2018/05/1114:16:11 Delivered Date: 2018/05/1114:16:43 AMERICAN PVERSIGHT EXT-18-1509-C-000023 From: Lisa Correnti To: "Lloyd, Scott (ACF) '' Subject: Speaker Invite Date: 2018/04/ 19 10:50:13 Priority: Normal Type: Note Dear Scott, Attached please find an invite letter and draft agenda for an anti-trafficking b1iefing on May 17 in Washington DC at the Russell Senate bldg. We invite you to present on the vulnerability of unaccompanied minors in falling prey to traffickers and U.S . government programs that protect these children while waiting to be united with family. Your panel will begin at 3pm. Please see attached for more information. Happy to discuss by phone. Best regards, Lisa Lisa Correnti Executive Vice President Center for Family and Human Rights (C-Fam) lisa@c-fam .org NY: (212) 754-5948 AMERICAN PVERSIGHT EXT-18-1509-C-000024 DC: (202) 393-7002 Sender: Lisa Correnti Recipient: "Lloyd, Scott (ACF) " Sent Date: 2018/04/19 10:48:25 Delivered Date: 2018/04/19 10:50:13 AMERICAN PVERSIGHT EXT-18-1509-C-000025 HALF- DAV EVENT ON THE HILL - DRAFT May 17, 201 8 12:00 - 4 :00 pm Russell Se nat e Bldg - Roo m 485 Welcome and Introduction - LUNCH OFFERED Opening Remarks - Senator James Lankford and Rep. Chris Smith Panel 1 - The Problem - Moderated by Laura Lederer, J.D. -What Does the Research Tell Us - CONFIRMED Tanya Street- Survivor, member President's Natl Advisory Council on Trafficking)- CONFIRMED Dr. Donna Harrison (Ob-Gyn, President, AAPLOG) - CONFIRMED Dr. Yara Garcia (Florida Gulf Coast University clinical psychologist) - CONFIRMED Panel 2 - Provider Perspective/Case Studies - Moderated by Hilary Chester, USCCB,{INVITED) Hope Green, Survivor and Service Provider - CONFIRMED Dean Nelson, Pastor, and Consultant, Human Coalition - CONFIRMED Cynthia Collins, Speaking Hope - CONFIRMED Panel 3 - The Way Forward: Double Panel - Moderated by Chuck Donovan, President, Charlotte Lozier Institute (INVITED) Bette McDowell, Heartbeat International, TIP Training Pregnancy Resource Centers CONFIRMED Clydette Powell, Board member, CMDA - CONFIMRED Marlene Carlson, Survivor and Service Provider- CONFIRMED Panel 3 Part 2 - Government Panel - Moderated by Valerie Huber, HHS - Preventing Trafficking by Training Teens to Avoid Sexually Risky Behavior and Predatory Relationships {INVITED) Scott Lloyd, ORR, HHS - Programs to Address Abortion and Trafficking on the Border {INVITED) William Wubbenhorst - Integrating Anti-Trafficking Programming into FYSB(Family Youth Service Bureau Programs) {INVITED) Michele Bekkering, - Bureau of Economic Growth, Education, and Environment (E3) {INVITED) Closing Remarks /\MERICAi\ pVERSIGHT EXT-18-1509-C-000026 Date: May 17th Time of Day: 12:00 - 4:00 pm Name of Event: Human Trafficking and Women's and Children 's Health Issues Point of Contact/Email/Phone: Laura J. Lederer 703 919 6828 Type of event: Briefing Food or drink: Lunch, Coffee , Tea and Dessert Number of Attendees: 100 Full Event Description: Human trafficking impacts all aspects of the vic t im's health, but especially reproductive, procreative, and other women's hea lth issues . In one study , 71.2% of females got pregnant at least once while being traff icking; 21.2% reported five or more pregnancies while being trafficked. Of those, 54.7% had at least one miscarriage ; 29.7% had mu ltip le miscarriages. Similarly, 55.2% had at least one abortion while 29.2% reported mult iple abortions while being trafficked . 67.3% contracted an STD; 63.8% reported gynecological problems such as pelvic inflammatory disease (PID), infertil ity, and other serious gynecological problems . In addition , many serious communicable diseases affect women being trafficking , including hepatitis, and tuberculosis. In one recent case, out of 125 women and children apprehended in a raid on 13 brothels owned by the same trafficker, over 75% of them tested positive for TB. Finally , studies indicate that thousands of children are born into trafficking in the U.S. today. Whi le there is little research on this problem, the negative physical, mental and emot ional repercussions for such ch ildren are considerable and deserve further attention . Co-Sponsors - All Co-Sponso rs are Pro-Lif e, Anti Trafficking NGOs (Confirmed): Global Centurion C-FAM Am erican Association of Pro -Lif e Ob-Gyns (AAPLOG) Speaking Hope The Justice Center Center Against Forced Abortion Operation Outcry The Charles and Mary Cro ssed Foundation Feminists Choosing Life of New York Identifi able Me Rahab 's Hideaway Civil Rights for the Unborn Co-Sponsors (Awaiting Confirmation) Charlotte Lozier Institute Christian Medical and Dental Association (CMDA) Heartbeat Internat ional Human Coalition USCCB Catholic Char ities /\MERICAi\ pVERSIGHT EXT-18-1509-C-000027 -Fam CENTERFORFAMlLY & HUMAN RIGHTS NEW YOR.K · WASIIINGTO • DC E. Scott Lloyd Director Office of Refugee Resettlement U.S. Department of Health and Human Services 200 Independence Avenue, S.W. Washington, D.C. 20201 April 19, 2018 Dear Scott, Together with the anti-trafficking organization Global Centurion we extend an invitation to you to participate in a briefing that examines the health consequences of women and girls who are victims of trafficking and prostitution. Additionally, panelists will present on best practices to arm and protect women and girls from being vulnerable to trafficking. The briefing is scheduled from 12:00pm to 4:00pm on May 17, 2018 in Room 485 of the Russell Senate Office building. We are grateful to Sen. Lankford for making this event possible where we hope to educate staffers and advocates. Several anti-trafficking organizations will participate both as panelists and as co-sponsoring organizations. We have reserved the fourth panel to hear from experts from the Trump administration to inform on policy and programs that assist women and girls both domestically and internationally. We invite you to present on the vulnerability of unaccompanied minors in falling prey to traffickers and U.S. government programs that protect these children while waiting to be united with family. More information on the event can be found in the accompanying draft agenda. We hope you will accept this invitation. We look forward to a fruitful discussion. Best regards, Lisa Correnti Executive Vice President AMERICAN PVERSIGHT EXT-18-1509-C-000029 From: Lisa Correnti To: "Lloyd, Scott (ACF) '' Subject: Event flyer Date: 2018/04/26 08:20: 17 Priority: Normal Type: Note Scott, Attached is the event flyer. Since all govt reps are pending they are not listed. As well we are hoping Sen. Lankford will make open ing remarks . It is a half day event but of course we would only expect you for your panel which is scheduled for 3pm . Best regards, Lisa Sender: Lisa Correnti Recipient: "Lloyd, Scott (ACF) " Sent Date: 2018/04/26 08:19:40 Delivered Date: 2018/04/26 08:20:17 AMERICAN PVERSIGHT EXT-18-1509-C-000030 Trallickinf! lllldwomen's andChildren's Health: Interven iott,Recovery andPrevention Trafficking and sexual exploitation is a gross violation of human rights inflicting great harm to women and girls. Experts will examine the health impact as well as treatment and prevention programs to safeguard at risk women and children. SPEAKERS: Tanya Street, Survivor, Member, President's National Advisory Council on Trafficking Box lunchserved at 12 PM ORGANIZERS: Dr. Donna Harrison, Ob-Gyn, President, AAPLOG Global Centurion Foundation Center for Family and Human Rights (C-Fam) Dr. Yaro Garcia, Clinical Psychologist, Florida Gulf Coast University CO-SPONSORED BY: Hope Green, Survivor and Service Provider American Association of Pro - Life Ob -Gyns (AAPLOG) Speaking Hope TI1e Justice Center Center Against Forced Abortion Operation Outcry The Char les and Mary Crossed Foundat ion Feminists Choos ing Life of New York Identifiable Me Rahab's Hideaway Civil Rights for the Unborn Frederick Douglass Leadership Institute Human Coalition Dean Nelson, Pastor, National Outreach Director, Human Coalition Cynthia Collins, Founder, Speak Hope Chuck Donovan, President, Charlotte Lozier Institute Betty McDowell, Heartbeat International, TIP Training Pregnancy Resource Centers Marlene Carlson, Survivor and Service Provider Laura Lederer, J.D., President, Global Centurion Foundation EXT-18-1509-C-000031 (SFam From: Susan To: "Lloyd, Scott (ACF) '' Subject: Meeting with Sisters of Life Date: 2018/04/05 22:10:23 Priority: Normal Type: Note Scott, Mother~ would like to meet with you when you come Tuesday. I don't know your travel schedule but are you able to meet before the event - at their convent or at Holy Family across the street from the UN? Thanks, Susan Yoshihara Sender: Susan Recipient: "Lloyd, Scott (ACF) " Sent Date: 2018/04/05 22:10:05 Delivered Date: 2018/04/05 22:10:23 AMERICAN PVERSIGHT EXT-18-1509-C-000032 From: Susan To: "Lloyd, Scott (ACF) " Subject: Re: Meeting with Sisters of Life Date: 2018/04/06 11:51:19 Priority: Normal Type: Note Scott That's great. I let them know and also that you need to be at the UN by 0930. Will get back to you on the time and place. Susan On Apr 6, 2018 at 11:35, wrote: Hi Susan, I'd love to meet with Mother problem . l(b)(6) II will be there before the event, so that should be no I am pretty flex ible with place and time as I w ill be arriv ing in the city the night before. Just let me know! God bless, AMERICAN PVERSIGHT EXT-18-1509-C-000033 Scott From: Susan [mailto:susan@c -fam.org] Sent: Thursday, April 05, 2018 10:10 PM To: Lloyd , Scott (ACF) Subject: Meeting with Sisters of Life Scott, Mother~ would like to meet with you when you come Tuesday. I don't know your travel schedule but are you able to meet before the event - at their convent or at Holy Family across the street from the UN? Thanks, AMERICAN PVERSIGHT EXT-18-1509-C-000034 Susan Yoshihara Sender: Susan Recipient: "Lloyd, Scott (ACF) " Sent Date: 2018/04/06 11:50:56 Delivered Date: 2018/04/06 11:51:19 AMERICAN PVERSIGHT EXT-18-1509-C-000035 From: Lisa Corrent i < lisa@c-fam.org> To: "Lloyd, Scott (ACF) " Subject: Re: Speaker Invite Date: 2018/04/20 12:33:36 Priority: Normal Type: Note Thank you , Scott. On Apr 20, 2018 , at 11 :00 AM , Lloyd , Scott (ACF) wrote: Hi Lisa, Thank you for the invite. I will see if this is possible and get back to you. Scott From: Lisa Correnti [ma ilto:l isa@c-fam .org] Sent: Thursday , April 19, 2018 10:48 AM To: Lloyd , Scott (ACF) Subject: S eaker Invite AMERICAN PVERSIGHT EXT-18-1509-C-000036 Dear Scott, Attached please find an invite letter and draft agenda for an anti-trafficking briefing on May 17 in Washington DC at the Russell Senate bldg. We invite you to present on the vulnerability of unaccompanied minors in falling prey to traffickers and U.S. government programs that protect these children while waiting to be united with family . Your panel will begin at 3pm. Please see attached for more information. Happy to discuss by phone . Best regards, Lisa Lisa Correnti Executive Vice President Center for Family and Human Rights (C-Fam) lisa@c-fam.o rg NY: (212) 754-5948 /\MERICAi\ pVERSIGHT EXT-18-1509-C-000037 DC: (202) 393-7002 Sender: Lisa Correnti Recipient: "Lloyd, Scott (ACF) " Sent Date: 2018/04/20 12:32:43 Delivered Date: 2018/04/20 12:33:36 AMERICAN PVERSIGHT EXT-18-1509-C-000038 From: Edward Lloyd j(b)(6) l@gmail.com> "Lloyd, Scott (ACF) '' Subject: Fwd: NVDaily - full page ad vs. PGK Scott Date: 2018/07/23 13:03:49 Priority: Normal Type: Note Sent from my iPhone Begin forwarded message: From: l(bl(6l tb)(6) lc4gmail.com> Date: July 23 , 2018 at 11:21 :01 AM EDT To: (b)(6) (b)(6) mail.co m>, (b)(B) l ix.ne tcom .com> (b)(6l (b)(6) ahoo .com>, ~ ~(b)(6) l@gmail.com>, (b)(6) (b)(6) mail.com> , (bl(6l (bl(6l a) e aiwork s.com>, rt:b:i"ii) (B:'i"i) -----i (:b) :::(6 ::; =) =:;-::::--c -o_m_c_,ast.n et> Cc: Scott Lloyd J(b)(6) 1@gmai l.co111> Subject: NVDaily - full page ad vs. PGK Scott In case you haven't heard yet , there was a full page ad in today's Northern Virginia Daily blaming PGK Scott Lloyd for the family separations at the border. I've attached a picture . The website also calls out LegalWorks , Witness Works, KofC, and the Front Royal Pregnancy Center. I pray this doesn't go further than words in the newspaper , but there are people out there listening when Maxine Waters says things like , "Let's make sure we show up wherever we have to show up. And if you see anybody from that Cabinet in a restaurant , in a department store , at a gasoline station , you get out and you create a crowd. And you push back on them. And you tell them they're not welcome anymore , anywhere . We've got to get the children connected to their parents." I don't know what we can do to help , but as Knights, neighbors , and fiiends , regardless of the politics , we should be ready to support Scott and his family . Scott, please don't hesitate to reach out and let us know what would (or wouldn't) help. AMERICAN PVERSIGHT EXT-18-1509-C-000039 Those of us who live in Happy Creek Knolls might also want to be a little extra vigilant. --Bill NVDaily.JPG Sender: (b)(6) l@gmail.com> "Lloyd, Scott (ACF) '' Sent Date: 2018/07/23 13:02:13 Delivered Date: 2018/07/23 13:03:49 AMERICAN PVERSIGHT EXT-18-1509-C-000040 Powers, Mary (ACF) "Hayes,Jonathan (ACF) "; "Lloyd, Scott (ACF) "; ( FYDIBOHF23SPDL "Wagner, Steven (ACF) "; "Marriott, Brian (ACF) "; "Wolfe, Kenneth (ACF) "; "Pilato, Anna (ACF) " FW: Afternoon Pulse, presented by PhRMA:Anti-abortion Trump appointee faces influx of Subject: migrant children - Trump reorganization would reshape HHS- Obamacarerate hikes bring headachesto GOP Date: 2018/06/21 14:24:25 Priority: Normal Type: Note Also lead story in afternoon-pulse. - - From: POLITICO Pro Health Care [mailto:politicoemail@politicopro.com] Sent: Thursday, June 21, 2018 2:08 PM To: Powers, Mary (ACF) Subject: Afternoon Pulse, presented by PhRMA: Anti-abortion Trump appointee faces influx of migrant children - Trump reorganization would reshape HHS - Obamacare rate hikes bring headaches to GOP By Adriel Bettelheim I 06/21/2018 02:06 PM EDT With help from Sarah Karlin-Smith and Paul Demko ANTI-ABORTION TRUMP APPOINTEE FACES INFLUX OF MIGRANT CHILDREN: The Trump administration's "zero-tolerance" border enforcement policy is raising fresh questions about whether HHS'Office of Refugee Resettlement has the experience or resources to care for more than 2,300 children scattered in shelters across the nation. The office's director, Scott Lloyd, has little background working with refugees and already ignited controversy for intervening to prevent undocumented minors from obtaining abortions. He's now confronted with an influx of migrant children who are quickly filling the agency's privately contracted shelters, and ORR has faced charges that it has failed to adequately vet and monitor contractors in charge of the shelters that have racked up dozens of violations. Read more from Pro's Adam Canc1yn and Renuka Rayasam here. AMERICAN PVERSIGHT EXT-18-1509-C-000041 SWEEPING TRUMP REORGANIZATION WOULD BRING CHANGES TO HHS: The 132-page proposal issued Thursday calls for shrinking federal agencies, selling assets and reorganizing the way the government delivers services. HHS would be renamed the Department of Health and Public Welfare and pick up several public assistance programs now overseen by the Department of Agriculture, including the $70 billion Supplemental Nutrition Assistance Program. The FDA would lose its food safety responsibilitie s to USDA and get a new name: the Federal Drug Administration. The plan would also trim the Public Health Service Commissioned Corps to a maximum of 4,000 officers , down from more than 6,500. More from Pro's Rachana Pradhan here. Happy Thursday and welcome to Afternoon PULSE , where we note the end of this article, in which House Agriculture Chairman Mike Conaway questions the wisdom of making HHS bigger. Send tales of "monster agencies" and turf battles to: abettelheim@politico.com (@abettel on Twitter). BIG OBAMA CARE RA TE IDKES POSE POLITICAL HEADACHES FOR GOP: Republicans in recent campaign cycles capitalized on Obamacare sticker shock to help gain complete control of Congress and the White House. Now , they're likely to be the ones feeling voters' wrath, writes Pro's Paul Demko. Obamacare premiums are once again poised to spike by double digits in 2019, and Democrats and their allies have been hammering President Donald Trump and congressional Republicans for "sabotaging" the health care markets and driving up costs. Protect Our Care has been rnnning digital ads in 13 states featuring news coverage of big rate hikes and concluding with a sound bite from Trump: "Let Obamacare implode." More here. ** A message from PhRMA: As a Medicare Part D Clifflooms for seniors, the program's successful structure is also in jeopardy. Congress can act now to protect seniors from the donut hole suddenly increasing by more than $ 1,200, and secure the program for the future by fixing changes that undermine its successful competitive structure. https://catalyst.phrm a.org ** - Avalere: Rate hikes in mid-teens for silver plans. Insurers want to hike premiums for the most popular Obamacare plans by 15 percent next year, according to a new analysis of filings in 10 states and the Dist:Iict of Columbia by A valere Health. But there are big state-by -state variations in proposals. In Maryland , insurers want jack up premiums for silver plans by more than 50 percent. Other states where Obamacare customers can expect big rate hikes: New York (16 percent), Vermont (23 percent) and Washington (19 percent). But other states are still seeing modest bumps - or even slight decreases. Insurers plans to increase silver plan rates by no more than 8 percent in Maine, Michigan and Oregon. And in Minnesota, which implemented a reinsurance program this year, insurers plan to lower rates by 5 percent on average. (One caveat: the average across the states isn't weighted by population . So New York is treated the same as Vermont in calculating silver plan increases across all 10 states.) /\MERICAi\ pVERSIGHT EXT-18-1509-C-000042 FDA PULLS BIOSIMILAR GUIDANCE: The FDA today withdrew a guidance document on how it would evaluate studies show ing how well cheaper versions of brand -name biologic s mimic the original products . The agency portrayed the decision as part of efforts to make it less cumbersome to develop biosimilars. The FDA said it is working on new guidance, which will offer "appropria te flexibility" for compani es "without compromising the agency's rigorous scientific standard s for eva luating marketing applications for biosimilars." EU COMMISSIONER HITS TRUMP FOR 'FAKE NEWS' ON DRUG PRICES: The president's assertion that Europe is freeloading on American phanna innovation by buying drugs at low price s is "absolutely fake news," European Commissioner for Health Vytenis Andriukaitis said. Medicine s are cheaper in Europe than the United States because government s negotiate or regulate drug pri ces for their entire health system, Andriukaitis told Science Business. These negotiations are mainly done between individual health insurers and drugmakers in the United States. More here. **A message from PhRMA: There's lots of talk abo ut how to change Part D to address affordability and predictability for seniors . But there are righ t ways and wrong ways to do that. The budge t change passed in Febrnary was the wrong way, removing incentives experts agree are necessa ry to drive Part D's successful market-ba sed structure, and potentially jeopardizing the program for the future. One right way is for Congress to address the loomi ng Part D Cliff. In 2020, the donut hole will increase by more than $1,200, raising out-of-pocket costs for the most vulnerable seniors with significa nt health care needs . Congress should act now on both of these issues to protect senior s from a sudden spike in out-of-pocket costs in Part D , while securing and strengthening the program for the long-term.h ttps://catalyst.ph:rma.org ** To view online: https: //subscriber. politicopro .com/newsletters /aftemoon-pulse /2018/06/anti-abortion-trumpappointee-faces-influx-of-migrant-children-260843 Stories from POLITICO Pro Meet the anti-abortion Trump appointee taking care of separated kidsBack By Adam Cancryn and Renuka Rayasam I 06/21/2018 12:23 PM EDT Pre sident Donald Trump's zero-tolerance border enforcement policy has thrust thou sands of migrant children into the care of a single health agency led by an anti-abortion crusa der with little background in refugee resettlement. The separation strategy - which Trnmp moved to reverse Wednesday amid growing furor - is raising fresh questions about whether HHS' Office of Refu gee Resettlemen t has the experie nce or resources to properly care for and reunify more than 2,300 children scattered in shelter s across the nation. /\MERICAi\ pVERSIGHT EXT-18-1509-C-000043 The office's director, Scott Lloyd, has scant experience resettling refugees in a career largely devoted to promoting Cathol ic causes, including rolling back abortion rights and protecting religious minoritie s in the Middle East from persecut ion. A former attorney at the Knigh ts of Columbus, Lloyd wrote reports to the State Department and Congress abou t the plight of relig ious mino rities in Iraq , Syria, Lebanon and Jordan. But he had little experience working with and resettling migrant s, according to a December 2017 deposition cond ucted by the American Civil Liberties Union during a comt case over the abo1t ion rights of unaccompanied minors. By contrast, his predecessor Robert Carey, who led the office during the last two years of the Obama adm inistration, had decade s of exper ience managing refugees' issues, including 15 years in resett lement and migration at the International Re scue Committee. Since Lloyd's appointment last year, he's already ignited controversy for personally stepping in to prevent unaccompanied minors from obtaining abortions - prompting a rash of lawsuits and calls for his firing from Democrats and women' s rights organizations . "What he has taken on is his own perso nal crusade, and it's an ideological crusade," said Rep. Rosa DeLauro, a Connec ticut Democrat who is his chief critic, at the height of the abortion battle in March. "I'm disappointed . More than disappointed. I think Scott Lloyd should be fired." Health and Human Services Secretary A lex Azar has steadfastly defended Lloyd , though , telling POLITICO in March that he "abso lutely" still had confidence in his ab ility to run the office. Azar contended the abort ion policy regarding unaccompanied minors in shelters was "not about Mr. Lloyd,'' but was longstanding policy - a point that women's rights organizations contest. Lloyd is now overseeing an influx of migrant ch ildren that have quickly pus hed the agency's privately contracted shelters to near capac ity. Trump 's abrupt decision Wednesday to halt the family separation policy is likely to complicat e matters, puttin g his agency on the front lines of a reunification effort that immigrat ion experts say will be severely hampered by lack of recordkeeping. "How do they find sponsors for all of these kids now if the logical person to come fo1ward is in jail , or if a family member is too nervous to come forward?" said a former HHS official. "The policy decisions that have been made over the last few months and weeks will have ongoing ramifications for kids in ORR shelters." The task of caring for and reun iting kids with family member s or sponso rs is a cha llenge even under regular circumsta nces, said Carey , the fonner ORR direc tor. Now, the influx of very young and traumati zed kids , and fast-moving directives from the White House , makes the task more daunting. Lloyd "doesn't have a par ticu lar background in these issues, but that's not unheard for political appo intees," Carey said, adding, "the job is certainly a lot easier if you know relevant laws and issues." /\MERICAi\ pVERSIGHT EXT-18-1509-C-000044 P1ior to assuming leadership at ORR, Lloyd cofounded the Witness Works Foundation for a Culture of Life - an organ izatio n dedicated to Cathol ic teachings and "guided by the principles of our faith" - and worked for years in its legal arm. At the Knights of Columbus, Lloyd described himse lf on his resume as the "architect of late-term abortion restrictions" passed by several states, while writing articles about the "Big Abortion " industry. Lloyd also served in the George W . Bush adm inistration as an attorney at HHS, co-writ ing the 2008 conscience rule allowing medical providers to refuse contraceptives, abortions and other care on moral grounds. Even prior to his official appo intment at ORR, Lloyd sought to halt abmtions among pregnant teens in the agency's care who requested the procedure. The office had previously paid for the procedure when the girl was a victim of rape or incest, but Lloyd overrode that policy by mandating that he needed to personally sign off on all abortion requests - prompting confusion among shelter ope rators. In one case early in Lloyd's tenure , a girl who had started a medication abortion by taking one of two pills needed to complete the procedure , had to undergo medical screening to see if it could be reversed , according to court documents. Other political appo intees sharing Lloyd's anti-abortion views have helped implement them in HHS' refugee work. Maggie Wynne, counselor to the HHS secretary, has worked closely with Lloyd to craft ORR's policy of blocking abortion s among migrant teens. Wynne, who first joined HHS during the George W. Bush administration, was formerly the director of the House Pro-Life caucus. Health officials have yet to lay out any plan for reun ifying children with their pa rents, emphasizing instead that the agency's main job is simply to care for those in its custody. "Immigration policy isn't really what we at HHS do," Azar said Wednesday. 'Tha t would be the Department of Homeland Secur ity working with DOJ and the White House . ... If we get kids , the unaccompanied children, we work to take care of them ." Now as thousands more children are put under ORR's watch , the office is facing increasingly intense scrutiny over its vetting of contractors in charge of shelters that in some cases racked up dozens of vio lations. Texas officials cited Southwest Key, one of ORR 's biggest contractors, for about 250 violations in the past three years - nearly 80 of which were seen as high -risk issues. Some of the problems cited related to out-of-date staff background checks, but other shelter inspections found far more serious issues. In a handful of cases, ch ildren with injuries weren't seen by doctors or given prope r medications. In September 20 17, one resident at a Brownsville shelter tested positive for a sexually /\MERICAi\ pVERSIGHT EXT-18-1509-C-000045 transmitted disease but wasn't treated until two weeks later. At another Brownsville shelter, a child susta ined a wrist fracture in August 2016 but wasn't seen by a doctor for three days. Another big contracto r, BCFS, a San Antonio-based nonprofit that runs facilities around the globe including emergency shelters and foster homes, is overseeing the construction and operation of the administration's newest shelter for unaccompanied kids - a tent city in Tomillo , about 30 miles from El Paso. Because the facility is on federal land, it's not subject to state oversight like the other facilities that BCFS operates in Texas. But according to state inspection reports, the nonprofit's sixemergency shelter facilities recorded more than 50 deficiencies in the past three years, at least 13 of which were high risk including an incident in which a careg iver used physical violence on a child and another in which a careg iver didn't provide medical assistance for a kid that had vomited twice. "There is a lot of money in the privatization of this," said Texas state Rep. Mary Gonzalez, a Democrat who toured the Torn illo facility. "But the se are kids' lives that are being cap italized on. Meanwhile we are creating trauma. I would unapologetically describe it as child torture." Carey said he hopes that Lloyd relies on career ORR staff with expertise to handle the task of reunifying parents with children and finding sponsors for others. For years, he said, the office operated without an ideological bent under both Republican and Democratic administration s. "I have no insight into [Lloyd's] ideological background other than his statement on access to family planning," said Carey. "I don't know how the reunification of children can become an ideological issue." To view online click here. Trump's government reorganization would overhaul FDA, NIHB ack By Rachana Pradhan I 06/21/2 018 01: 18 PM EDT The White House's massive governmen t reorgan ization plan released this afternoon, in addition to renaming and reshaping HHS, proposes various changes to other agency divisions , including the FDA, NIH and the U.S. Public Health Service Commissioned Corps. HHS would become the Department of Health and Publ ic Welfare, in charge of severalpub lic assistance programs now overseen by the Department of Agr iculture, includ ing the $70 billion Supplemental Nutrition Assistance Program. HHS should be renamed as a result "to more accurately reflect the mission of the agency and raise the profi le of non-health related programs," according to OMB's reorganization plan. HHS already oversees Tempora ry Assistance for Needy Fam ilies, which provides cash assistance to /\MERICAi\ pVERSIGHT EXT-18-1509-C-000046 low-income households, and Medicaid, which provides health coverage for more than 70 million low-income Americans. Under the plan, SNAP, the supplemental nutrition program for Women, Infants and Children, and other food programs would be housed within HHS' Administration for Children and Families. The plan would also trim the U.S. Public Health Service Commissioned Corps to a maximum of 4,000 officers, down from more than 6,500. FDA would also lose its food safety responsibilities and get a new name: the Federal Drug Administration. Food safety would be consolidated under a new agency at USDA. The Trump administration said this would free up FDA resources to focus on its "core responsibilities" of drugs, devices, biologics and tobacco. The administration also wants to movethree research arms of HHS - the Agency for Healthcare Research and Quality, the National Institute for Occupational Safety and Health, and the National Institute on Disability, Independent Living, and Rehabilitation Researchunder NIH's umbrella. The Strategic National Stockpile , a massive repository of drugs designated for a public health emergency, would also be moved from the CDC to the HHS Assistant Secretary for Preparedness and Response. Sarah-Karlin Smith contributed to this report. To view online click here. Trump federal reorganization plan due to arrive this week.Back By Lorraine W oelle1t and Helena Bottemiller Evich I 06/20/2018 03 :02 PM EDT The White House is expected to announce as soon as Thursday a wide-ranging government reorganization plan that will include a consolidation of safety-net programs under a rebranded Department of Health and Human Services. The proposal will recommend renaming HHS the Department of Health and Public Welfare and, as POLITICOreported earlier this month, would move the $70 billion food stamp program out of the Department of Agriculture to the new agency, according to two people with knowledge of the plan. A spokesman for Mick Mulvaney, director of the White House Office of Management and Budget, had no comment. The changes will be part of a sweeping government reorganization Mulvaney has developed since his confirmation more than a year ago. Some of the proposals will require congressional approval to take effect. /\MERICAi\ pVERSIGHT EXT-18-1509-C-000047 The Trump administration is also seeking to merge the Labor and Education departments , POLITICO report ed Wednesday . Government shakeups can be a heavy political and legislative lift, but they' re nothing new. Until a reorganization of agencies in the 1970s, federal social programs were managed by the nowdefunct Department of Health , Education and Welfare. The Department of Homeland Security , which comb ined divisions from 22 different agenc ies, was stood up after Sept. 11. Health and Human Services already ove rsees Tempo rary Assistance for Needy Fam ilies, which provides cash assistance to low-income households, and Medicaid , which offers health coverage for more than 70 million Americans. The Heritage Foundat ion, a conse rvative think tank that has deeply influenced Trump's agenda , last year recommended that USDA nutrition programs , includin g food stam ps, nutrition education and school meal programs , be transferred over to HHS. Any attempt to move departments around is sure to face serious resistance in Congress , where chairmen of commi ttees tend to fiercely oppose giving up jurisdiction over anyt hing. Moving the food stamp program from USDA to HHS, for examp le, would be a huge blow to USDA's reach and budget -- something that's not likely to go over well with farm-state lawmakers, in particular. The Supplemental Nutrition Assistance Program, as its formally known, represents roughly three quarters of USDA' s budget. House Agr iculture Chairman Mike Conaway said late Wednesday he wou ld keep an open mind when reading the White House reorganization report , but he's not wild about making HHS , which already oversees some $1 trillion in spending, even bigger. "I'll need to see the logic behind why it makes sense to make an even larger age ncy out of one that's got its issues already ," Conaway said. "My normal bias is that making monster agencies even bigger is maybe not the best thing to do,'' he added. Andrew Restuccia and Nancy Cook contributed to this report. To view online click here. Reversal of fortune : Big Obamacare rate hike causing political headaches for Republicans Back By Paul Demko I 06/21/2018 12:56 PM EDT /\MERICAi\ pVERSIGHT EXT-18-1509-C-000048 Obamacare premiums are once again poised to spike by double digits in 2019, causing heartburn for politicians as voters will head to the polls within days of learning about the looming hit to their pocketbooks. But unlike recent campaign cycles, when Republicans capitalized on Obamacare sticker shock to help propel them to complete control of Congress and the White House, they're now likely to be the ones feeling the wrath of voters. That's because Republicans are now in total control of the federal government and therefore on the hook for the health care system's chronic shortcomings. Polling data has consistently suggested that more voters will blame Republicans for future problems with Obamacare. In addition, the GO P's repeated failures to repeal Obamacare after eight years of campaign promises will make it difficult to galvanize thebase on health care. Democrats and their allies have been hammering President Donald Trump and congressional Republicans for "sabotaging" the health care markets and driving up premiums. Protect Our Care has been running digital ads in 13 states featuring news coverage of big rate hikes and concluding with a sound bite from Trump: "Let Obamacare implode." They hope that message will stick with voters come November. "The political implications go only as far as people understand that they are a direct consequence of the administration's action s," said Rep. Raul Ruiz (D-Calif.) , a medical doctor who sits on a key committee that overseeshealth care. "If they realize that, then they will be very , very upset with them." In particular , Democrats blame Republicans for eliminating the mandate penalty for failing to obtain health insurance, which was designed to be a cudgel to compel people who might otherwise go uninsured to buy coverage. They also point to the Trump administration's efforts to make it easier to buy skinnier , cheaper plans that don't meet the Affordable Care Act's coverage requirements and patient protections as an exacerbating factor. "Once they fractured the mandate, that changed the insurance pool," said Rep. Richard Neal (DMass.), the ranking member on the Ways and Means Committee. "Insurance is based upon shared risk, meaning fewer people contributing, the premiums escalate." Republicans scoff at the notion that they're to blame for Obamacare's failings. They point out that big rate hikes were a chronic condition of the exchange markets long before they took full control of the government. "The Affordable Care Act has been a total failure," said Rep. Buddy Carter (R-Ga.), a pharmacist who serves on one of the key House committees dealing with health care. "It's been a train wreck since day one. What we're trying to do is to fix it." Republicans further argue that Democrats sabotaged a bipartisan effort to pass legislation designed to stabilize the markets and reduce rate hikes. They contend that Democratic concerns over abortion language that ultimately derailed the deal were a smokescreen . /\MERICAi\ pVERSIGHT EXT-18-1509-C-000049 "They are the reason why we didn't pass the legislation that would have solved the issue," said Sen. Bill Ca ssidy (R-La.), who has been closely involved in efforts to come up with a Republican plan to replace the ACA. "I can only guess that it's politics." Democrats counter that the GOP added the abortion restrictions knowing that would be the dealbreaker. Insmance experts generally agree that the rate hikes will be more severe because of actions taken by the Republican-led Congress and the Trump administration. "If it hadn't been for the individual mandate being repealed , and the threat of short-term and other loosely regulated plans proliferating, I think we would have seen single digit premiums increases," said Cynthia Cox, an insw-ance expert at the Kaiser Family Foundation. "Insurers are performing much better on the exchange markets than they had in the early years." However, that strong financial perfonnance of the markets is also complicating Democratic talking points about sabotage. In many states, competition is increasing as insmers see opportunities to move into markets with little competition. Most notably, Oscar Health - the tech-friendly start-up that's lost hundreds of millions in the Obamacare markets - is entering or expanding its footprint in nine states. That's a stark contrast from last summer, when dozens of counties across the country were at risk of having no competing insurers due to market exits. But double-digit premium increases are still likely in many states, as evidenced by the rate filings that have been trickling out in recent weeks. Premiums for the most popular Obamacare plans are going up by 15 percent on average - about $100 per month- according to an analysis of rate filings in 10 states by Avalere Health. While rates won't be finalized until the fall, it's already clear that there will be wide discrepancies across the country that could affect the political salience of the issue. Insurers in Maryland want to raise rates on the most popular plans by an eye-popping 53 percent , while New York insurers are seeking average premium increases of 24 percent. By contrast, insurers in Pennsylvania only want to raise premiums by 5 percent on average. All four insurers selling Obamacare plans in Minnesota want to decrease premiums. One big factor affecting the severity of the rate hikes is how insurers account for the removal of the individual mandate. The Congressional Budget Office has projected it will increase premiums by 10 percent, mainly because fewer healthy people will opt to enroll, but Republicans have scoffed at that as an unrealistic assessment of the mandate's significance. "It's really kind of a crap shoot for the actuaries to say well it is or it isn't going to have an effect," said John Baackes, CEO of L.A. Care Health Plan, which has 70,000 Obamacare customers. "We will make a decision with our gut." Highmark Health , which sells Obamacare plans in Pennsylvania, West Virginia and Delaware, plans to raise premiums by 5 percent next year to account for the repeal of the mandate. The /\MERICAi\ pVERSIGHT EXT-18-1509-C-000050 insurer made money on its Obamacare customers last year after piling up big losses on that book of busines s in prior years. "The rates are catching up to the risks ," said David Holmberg , Highmark Health' s CEO. "Eve1y time you change the rules you disrupt that." The other major wild card is the Trump administration's efforts to increase the availability of cheaper plans that don't meet the ACA's coverage requirements. On Tuesday, the Labor Department finalized rules making it easier for small businesses and self-employed workers to band together to purchase association health plans. Still in the pipeline are regulations that will expand the availability of short-term plans. What it all comes down to for insurers is trying to gauge how many people will drop coverage entirely or seek options outside of the Obamacare markets due to the changes, said Jim Whisler, who leads Deloitte Consulting's health actuarial practice. "That's the real wild card," Whisler said. "It really dramatically increases the range of reasonable assumptions." Republicans are unimpres sed by asse1tions that insurers will be forced to raise rates because of changes they've made to Obamacare. "Insurers are going to cite anything as factors to increase their premiums," said Carter. "I can assure you that this is a direct result of the Affordable Care Act." Democrat s note that Republican s are hoping to at least partially insulate themselves from health care attacks by passing a barrage of bills designed to address the opioid crisis. But Ruiz points out that many individuals who enter rehab to treat opioid addiction are enrolled in Medicaid, which Republicans sought to dramatically scale back as part of their Obamacare repeal efforts. "You realize that this is a sma ll step forward, but ten steps back if they get their way," Ruiz said. To view online click here. Back EU health commissioner hits Trump for 'fake news' on foreign drug pricesB ack By Carmen Paun I 06/21/2018 11: 16 AM EDT President Donald Trump's position that Europe is freeloading on American pbanna innovation by buying drugs at low prices is "absolutely fake news ," European Commissioner for Health Vytenis Andriukaitis said. /\MERICAi\ pVERSIGHT EXT-18-1509-C-000051 Medicines are cheaper in Europe than the U.S. because government s negotiate or regulate drug prices for their entire health system , Andriukaiti s told Science Business . These negotiations are mainly done between individual health insurers and drugmakers in the U.S. Andriukaitis called Trump's analysis that the EU and other countries around the world are taking advantage of the U.S. as "a simplification of understanding ," according to Science Business. He queried how to separate individual drug development investments of multinational pharmaceu tical companies that "cover continents". Many U.S. companie s are involved in a public-private partnership with the European Commission in Europe , in which Brussels puts € 1.6 billion . The health commissioner called for more cooperation between countrie s to get drug s for diseases such as tuberculosis and malaria at "socially acceptable prices." This alert.first app eared on POLITICO.EU on June 21, 2018. To view online click here. Was this Pro content helpful? Tell us what you think in one click . Somewha t Yes, very Somewhat I Neutra l Not really Not at all You received this POLITICO Pro content because your customized settings include: Afternoon Pulse. To change your alert settings, please go to h ttps: //subscriber. politicopro.co m/settings This email was sent to mary.powers @acf.hhs.gov by: POLITICO, LLC 1000 Wilson Blvd. Arlington, VA, 22209, USA Sender: Powers, Mary (ACF) "Hayes,Jonathan (ACF) "; "Lloyd, Scott (ACF) "; "Wagner, Steven (ACF) "; AMERICAN PVERSIGHT EXT-18-1509-C-000052 "Marriott, Brian (ACF) "; "Wolfe, Kenneth (ACF) "; "Pilato, Anna (ACF) " Sent Date: 2018/06/21 14:24:24 Delivered Date: 2018/06/21 14:24:25 AMERICAN PVERSIGHT EXT-18-1509-C-000053