Has HHS really banned certain words? Apparently not.

Last week, the Washington Post claimed:

The Trump administration is prohibiting officials at the nation’s top public health agency from using a list of seven words or phrases — including “fetus” and “transgender” — in official documents being prepared for next year’s budget.

Today, the Post’s editors double down on the story in an editorial called “Seven dirty words, according to the Trump administration” (a nod to the late George Carlin). In the paper edition, the Post calls on “the misbegotten language militia of HHS” to “stand down.”

The Post’s editorial, which compares HHS language policy to China’s, Russia’s, and Saudi Arabia’s, is overwrought. However, it would be disturbing if, in fact, HHS were banning words, as the Post’s reporters claim.

But Yuval Levin, a former HHS official, has debunked the Post’s reporting. After reaching out to a number of officials at HHS and its sub-agencies for an explanation, he is “persuaded that the impression created by the Post’s story is not accurate.”

According to Yuval, two things are going on at HHS, and they do not add up to the censorship reported by the Post.

First, the budget office at HHS sent the various divisions of the department a style guide to use in their budget-proposal language and “congressional justification” documents for the coming year. That style guide, which sets out a standard style for everything from capitalization of the titles of key offices to some commonly disputed points of grammar and punctuation, also sets out some words to be avoided.

These, I am told, are avoided because they are frequently misused or regularly overused in departmental documents (make of that what you will) and they include three terms on the Post’s list: “vulnerable,” “diversity,” and “entitlement.” The style guide does not prohibit the use of these terms, but it says they should be used only when alternatives (which it proposes in some cases) cannot be.

Does it make sense to avoid using these three terms?

“Entitlement” really isn’t a term that should be used in congressional-justification documents (where “mandatory” is the technical, if actually less correct, term of art).

The common practice of substituting the term “vulnerable” for “poor” has a long history of annoying some Republicans on Capitol Hill, and presumably that accounts for the instruction to avoid it in congressional-justification documents—although this has come up more often in the work of the Centers for Medicare and Medicaid Services than in that of the Centers for Disease Control and Prevention. In public health, after all, “vulnerable” has a distinct definition, and there are some CDC programs that couldn’t really avoid using the term in justifying their budget requests (like the Social Vulnerability Index). Presumably the guidance wasn’t intended for them.

Your guess is as good as mine (and probably similar to mine) as to why HHS career officials might have thought “diversity” was not a good word to use with congressional Republicans. But these three are “avoid when possible” terms in a style guide specifically intended for budget documents. They’re not words that are banned in the department.

(Emphasis added)

The other allegedly banned terms are similarly of concern in the budget document context.

Second, these three terms to avoid [entitlement, vulnerable, and diversity] apparently came up in the course of a meeting among career officials at the CDC late last week about preparing next year’s congressional-justification documents. That discussion then led to a conversation in the meeting about other terms that might be best avoided. (To be very clear: I did not speak with anyone who was present at that meeting, though I did speak with people who later spoke with the career CDC person who was in charge of the meeting and briefed the other career people there.)

This meeting did not involve any political appointees, and apparently the conversation about terms beyond “diversity,” “entitlements,” and “vulnerable” was not about terms that anyone in the department had said should be avoided but about terms that it might be wise to avoid so as not to raise red flags among Republicans in Congress.

(Emphasis added)


[W]hat happened regarding these other terms (“transgender,” “fetus,” “evidence-based,” and “science-based”) was not that retrograde Republicans ordered career CDC officials not to use these terms but that career CDC officials assumed retrograde Republicans would be triggered by such words and, in an effort to avoid having such Republicans cut their budgets, reasoned they might be best avoided.

With regard to “evidence-based” and “science-based” in particular, I gather the reasoning was simpler than that, and that the group thought these terms are so overused in the CDC budget documents they were discussing as to become nearly meaningless and that their use should be limited to where it actually made a point.

In short, if Yuval Levin’s sources are correct, there is no ban; the desire to avoid certain terms applies only to budget documents; and it is based on assumptions of career officials about how GOP members of Congress think, not on the views of political appointees at HHS and not necessarily on the actual thinking of congressional Republicans.

Is the Post’s story “fake news”? At a minimum, it’s misleading news.


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