The prominent use of Kellyanne Conway's decade-old polling in a new federal rule is a reminder of her pre-Trump career partnering with anti-abortion groups. | Brendan Smialowksi/AFP/Getty Images white house How Kellyanne Conway influenced a new Trump rule cheered by religious conservatives Polling done a decade ago by the senior White House adviser finds its way into a new federal rule cheered by religious activists.

Kellyanne Conway was a Republican pollster when she appeared at a 2009 news conference, flanked by more than a dozen people in white doctors’ coats, to unveil surveys she conducted on religious freedom and medicine.

Conway had been hired by the Christian Medical and Dental Associations to bolster the groups’ position that doctors and nurses shouldn’t be required to perform procedures, including abortions, to which they morally objected.


“Who among us would want a medical professional to perform a technique or provide a service with which they were personally uncomfortable and to which they personally objected?” Conway asked during the news conference in a National Press Club conference room. Her data backed up that view: nearly nine out of 10 respondents said medical professionals have “almost an inalienable right” to such objections, she said.

A decade later, Conway’s polling is getting results.

Late last week, the Health and Human Services Department unveiled a regulation that empowers doctors and other health workers to decline care that violates their beliefs. The 440-page rule cites Conway’s years-old polling, including another she conducted in 2011, a dozen times. No other surveys are cited more frequently — and no other data is more central to the Trump administration’s arguments.

POLITICO Pulse newsletter Get the latest on the health care fight, every weekday morning — in your inbox. Email Sign Up By signing up you agree to receive email newsletters or alerts from POLITICO. You can unsubscribe at any time. This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Today, Conway, a senior White House adviser to the president, is known best as a cheerfully combative and steadfastly loyal defender of President Donald Trump, sparring at length with the likes of CNN’s Chris Cuomo, and famously invoking “alternative facts” in a bid to explain the administration’s false statements.

But the prominent use of her polling in a relatively obscure federal rule — albeit one that has aroused passions on the right — is a reminder of her long pre-Trump career partnering with anti-abortion and conservative groups, a legacy that is still quietly resonating as the president courts evangelical voters.

Conway told POLITICO that she didn’t work directly on the new HHS rule, and two administration officials insisted that her polling was not cited because of her role as a top Trump adviser.

Yet the regulation’s reliance on years-old polling that was conducted before the U.S. health system underwent a series of significant reforms has alarmed some public health groups and regulatory experts.

“This rule, and what [the Trump administration] does next to enforce it, will have a profound effect on vulnerable people nationwide,” said Katie Keith, a Georgetown law professor who’s tracked the health department’s regulations. “That leaves a lot riding on very old survey data — and the assumptions that HHS officials make because of it.”

The rule would expand health workers ability to decline care that conflicts with their beliefs. Religious-rights groups have insisted that the rule is necessary to protect doctors, nurses and other staff from assisting in abortions or gender-reassignment surgery. Health care organizations and patient advocates have said those fears are largely unfounded, and the new rule could lead to discrimination.

Health workers’ religious rights are “already enshrined in law and needs not be expanded,” said Rosie Phillips Davis, president of the American Psychological Association, who warned that workers could be newly empowered to turn away LGBTQ patients who seek routine care. “This so-called conscience rule is flatly unconscionable.”

Trump announced the rule in a Rose Garden ceremony on Thursday. "Together, we are building a culture that cherishes the dignity and worth of human life," he told a group of religious leaders gathered at the White House.

"Together, we are building a culture that cherishes the dignity and worth of human life," President Donald Trump said during an event in the Rose Garden. | Brendan Smialowski/AFP/Getty Images

The news was met with cheers from Christian conservatives.

“President Trump has once again demonstrated today that he keeps his promises to the pro-life community and to America,” Father Frank Pavone, national director of Priests for Life, said after Trump’s announcement.

But the praise hasn’t swayed experts worried about the heavy reliance on Conway’s 2009 and 2011 polling, noting that the surveys were done before the U.S. health system was reshaped by the Affordable Care Act, a slew of industry mergers and even new nondiscrimination protections for patients.

The Trump administration also uses the survey data to argue that health workers will quit or medical students will refuse to enter the field without its new rules. “In total, 91 percent of respondents reported that they ‘would rather stop practicing medicine altogether than be forced to violate [their] conscience,’” the administration's rule reads, drawing on one of Conway’s decade-old surveys.

Critics of the new rule say that hasn’t happened, potentially calling the validity of the new federal rule itself into question.

Most polling respondents predicted there would be fewer health workers if the Obama administration eliminated George W. Bush-era conscience protections, as it did in March 2011. But the health care profession has continued to grow since; physicians' offices have added 400,000 jobs in the interim, for instance.

Some of the doctors who threatened to quit if the Obama administration got its way — including ones who stood with Conway at her 2009 National Press Club news conference — have instead continued to practice.

The health department’s rule relies most heavily on Conway’s 2009 online survey of self-selected members of Christian medical associations. The findings are “not intended to be representative of the entire medical profession,” Conway wrote in an accompanying memo.

In an interview, Conway stressed that she wasn't involved in the crafting of the regulation. But she said, "Unquestionably, many medical professionals feel they're victims of outright discrimination," adding that some may feel reluctant to come forward to air their concerns.

Conway argued that the regulation is common sense, making the case that few patients would want their doctor to perform a procedure they weren’t comfortable with.

“I would just ask those who are against it: What’s your objection? They scream when somebody you already know hugs you,” she said.

As a Republican pollster before she joined Trump’s 2016 campaign, Conway was a close ally of anti-abortion groups in Washington who “knew her for more than 20 years as someone fiercely dedicated to the pro-life cause,” as the National Catholic Register put it in January 2017. The publication noted that she “went deeper than mainstream pollsters in addressing the issue, [and] was able to show pro-life groups that their issues enjoyed much broader support from both self-identified ‘pro-life’ and ‘pro-choice’ people.”

That has made her an asset to Trump, who has worked to overcome suspicion on the religious right about his past claims to support abortion rights.

The new HHS regulation is part of a broader effort by the Trump administration to win over evangelicals, many of whom have set aside concerns about Trump’s personal behavior and embraced his socially conservative policies — including his opposition to several state abortion laws that he says go too far.

“The president I work for is the most pro-life president in American history,” Conway said.

The Trump administration’s extensive use of Conway’s old data also reflects a polling reality: Major organizations haven’t dug into examining conscience-rights issues. Health care groups and polling firms have instead surveyed about health coverage, drug prices and other issues that voters have flagged as top priorities.

The American Medical Association hasn’t polled its members on religious-rights issues, a spokesperson said. But the doctors’ group has repeatedly warned the Trump administration that its new rule could put patients at risk.

“While we support the legitimate conscience rights of individual health care professionals, the exercise of these rights must be balanced against the fundamental obligations of the medical profession to protect the well-being of patients,” AMA President Barbara McAneny said in a statement.

Even the organization that paid for Conway’s 2009 and 2011 polls hasn’t done surveys on conscience-rights in nearly a decade, a spokesman for the Christian Medical and Dental Associations said.

The Trump administration isn’t the first to rely on findings from like-minded groups in crafting its regulations, experts say. An Obama-era rule to protect transgender patients drew on findings by the liberal-leaning Center for American Progress, for example. (A CAP official says the group's survey was far more rigorous and timely than Conway's.)

The health department defended its reliance on Conway’s years-old surveys. “HHS used the best data available on this question,” a spokesperson said.