The skit wrote itself. All “Saturday Night Live” had to do was re-up the old jokes and ad lib a bit.
It all came together after the White House announced, just before 2 o’clock on a Saturday afternoon, that Mike Pence would lead its coronavirus task force. That provided plenty of time – and material — for the writers to craft their cold open by show time that night:
The vice president, played by funnyman Beck Bennett, addresses a crowded briefing room. President Trump has just put him in charge, he announces, “even though, I don’t believe in science.” And it hasn’t been easy: the virus has been “quite the test of my faith,” Pence/Bennett says, “just like dinosaur bones.”
Life subsequently imitated sketch comedy. Rep. Alexandria Ocasio-Cortez complained that “Mike Pence literally does not believe in science,” while Sen. Bernie Sanders alleged that, as governor of Indiana, Pence “wanted to ‘pray away’ the HIV epidemic.”
The White House has decried both comments, accusing Democrats of trying “to politicize” the coronavirus and “scare people” ahead of a presidential election. But allies of Pence, both inside and outside the administration, take the criticism personally. They say it is lazy, uninformed, even evidence of possible “underlying religious bigotry.”
Not only does the vice president “believe in science,” they argue that his handling of an HIV outbreak in southern Indiana as governor displayed an executive willing to elevate facts and evidence over ideology. It was, one former staffer recalled, “a pivotal moment during his governorship.”
The crisis in question exploded in Scott County. A small town about an hour-and-a-half south of Indianapolis, Austin became ground zero in February 2015. That’s when state health officials discovered 30 new cases of HIV, up from just three infections reported in the previous decade — a deadly side effect of the opioid epidemic. The main culprit: a powerful painkiller called Opana.
The pills were manufactured with a coating meant to slow its release when swallowed and deter abuse. Drug users found a work-around: Grind the pill to a powder. Cook it down into a liquid. Inject the homebrew slurry into the bloodstream. The result was a heroine-like high. Abuse became so rampant, authorities said, that they raided properties housing three generations of addicts — grandparents, parents and children alike. HIV, spread by dirty needles, followed.
A month after the Indiana Department of Health identified the outbreak, Pence declared a public health emergency. He signed an executive order overriding a state law to allow a supervised syringe exchange program in Scott County for 30 days, the maximum amount of time allowed by the statute. He signed another order a month later to buy more time for the state legislature to debate a permanent fix. He also signed into law an expansion of Indiana’s Medicaid program.
All of this was out of the ordinary for a socially and fiscally conservative governor in a socially and fiscally conservative state. “At the end of this,” Brian Neale told RealClearPolitics, Pence had made “evidence-based policy decisions to champion a brand-new needle exchange program and expand health coverage to hundreds of thousands of individuals.”
Neale had worked as a legislative staffer for Pence on Capitol Hill before following him to Indiana to serve as director of health care policy for the new governor. Revisiting the HIV outbreak in light of coronavirus, and watching the criticism of his old boss, he bristles: “Isn’t that the kind of leadership we should be applauding, not denigrating?”
The experience was enough for Trump to promote Pence to handle the White House response to the virus. “Mike is going to be in charge, and Mike will report back to me,” the president said at a press conference. “But he has a certain talent for this.”
The surgeon general agrees. “When I was the State Health Commissioner in Indiana, I worked closely with then-Gov. Pence. That was especially true during the HIV outbreak that we saw in Scott County,” Jerome Adams told RCP in a statement.
“Working together, we helped address the outbreak by implementing comprehensive syringe services programs (SSPs) that helped change the scope of the unprecedented crisis,” the surgeon general continued, before noting that the response “became a model” for other states to emulate.
The recurring cast of characters from Indiana now makes comparison of the two health crises inevitable. Not everyone was impressed, however.
“Mike Pence made Indiana’s HIV outbreak worse,” Gregg Gonsalves wrote in Politico. “The whole idea that he did the right thing, and did it in a timely fashion, is just revisionist history and it’s wrong,” the professor of epidemiology later told RCP in an interview. “People don’t like to say this in journalism anymore but it’s a lie, an absolute lie.”
A 2018 study Yale University study he helped author concluded that the epidemic could have been prevented or significantly mitigated if Pence and other state officials had acted sooner. His co-author, Forrest Crawford, argued that “with earlier action the actual number of infections recorded in Scott County — 215 — might have been brought down to fewer than 56, if the state had acted in 2013, or to fewer than 10 infections if they had responded to the [hepatitis C] outbreak in 2010-2011.”
The study identifies two critical dates for action to be taken: April 2011 and January 2013. Pence was still a congressman in 2011. Pence wasn’t sworn in as governor until Jan. 14, 2013.
All the same, Gonsalves said, final response from the Indiana governor was “too little, too late.” The bill that Pence eventually signed into law in May 2015 did not make needle exchange programs more permanent, he noted. It only allowed counties to apply for permission with the state to set up exchanges, and even then, didn’t provide state funding.
Pence also signed legislation the same week making it a felony to possess a syringe without a prescription. “With one hand he offers needles,” Gonsalves concluded, “with the others he offers handcuffs.”
Brandt Hershman knows about both of those pieces of legislation, the one that set up a framework for needle exchange programs and the other one that made syringe possession without a prescription criminal. He was majority leader of the Indiana state Senate at the time. And he says anyone who questions Pence’s motivations in developing that legislation “is nothing more than a political hack.”
Pence bought the state legislature time with his executive orders, he told RCP, while lawmakers went to work to find a more permanent solution. What gets lost in retrospectives on how Pence responded, according to the former Senate majority leader, is that Indiana was trying to respond to a health crisis, not “drug abuse in and of itself.”
Yes, Hershman says, the governor signed a bill into law criminalizing the possession of a syringe: “The state did not want to become a supplier of the tools necessary to become a drug user.”
No, Hershman adds, the state was not withholding needed resources. Counties were, instead, allowed to apply for permission to set up their own exchanges; many didn’t because “many counties didn’t have a problem that needed to be solved.”
Throughout the entire process, Hershman remembers Pence as an executive who sought the advice of medical authorities and law enforcement at every level. What about the criticism that the administration didn’t move fast enough? Those critics, Hershman replied, seem to forget that “the governor is not an emperor.”
To date only nine of Indiana’s 92 counties have applied to open needle exchange programs, evidence of the fact that local leaders don’t want such an operation “on Main Street.” That is the assessment of Joey Fox, who was the legislative director for the Indiana Department of Health during the outbreak.
“These programs weren’t just illegal at the time, they were unwelcome,” Fox told RCP. And it is remarkable that Pence backed syringe exchange programs, he added, in a socially conservative state that, until recently, outlawed the sale of as much as a six-pack on Sunday. Some local leaders were likening the idea of creating a syringe exchange for addicts to supplying booze to alcoholics, he remembers. “They said, ‘We already have needles littering our playgrounds and parks.’”
Eventually it was other, more vocal, local leaders who helped convince Pence that a needle exchange was needed and then brought their own communities on board.
Dan McClain was sheriff of Scott County at the time. He says the now-vice president’s “quick response and decisive action to allow a needle exchange averted the infection of many more individuals.” He told RCP that he remains “grateful for his leadership on this critical issue.”
History could have been different, if not for a voice-mail. “This is Gov. Mike Pence calling. I would welcome the opportunity to get your counsel on what’s going on in Scott County,” McClain told the New York Times in 2016, recalling a March 24, 2015, message.
According to the former sheriff, the governor told him, “Don’t give me any political views; I want to know your opinion.” McClain replied, “I believe the only thing we can do to stop or slow this thing is to get clean needles out there.” Pence signed an executive order allowing syringes to be exchanged the next day, 29 days after the outbreak was announced. By then, there were 79 confirmed HIV cases.
Today, needle exchange programs are an accepted weapon in the federal government’s arsenal to fight HIV and other infectious diseases. Health and Human Services Secretary Alex Azar endorsed the policy as recently as 2019. Before the health emergency in Scott County, however, the idea was anathema in the Indiana state house. It took time for Pence to embrace the idea, leaving the governor open to criticism.
Ed Clere was a state representative who supported needle exchanges even before the HIV outbreak. The Republican backed the executive orders and helped author the final legislation, but later told the New York Times he was disappointed that “it took so much effort to bring the governor on board.”
He declined to be interviewed for this story; an aide told RCP that the statement to the Times was an “old comment.”
But did the state dawdle? Did Pence ride the fence rather than act decisively? “No, absolutely not,” Neale said. “Governor Pence would have rightly fired me or anyone else on the spot for even suggesting that he drag his feet on the response.”
Pence made his decision regarding the exchanges, but only after consulting a higher power, according to Adams, now the surgeon general. “The governor wanted to make sure if we went this route it was absolutely necessary,” he told the New York Times in 2016. “I believe he was praying on it up until the final decision.”
Hence the Sanders allegation that the vice president tried “to ‘pray away’” the problem and the enduring caricature that Pence believes more in faith than science. Again, his advisers bristle.
“The fact that he prayed doesn’t mean that he didn’t listen to the scientists around him,” Fox said. “He did. I was there.”
“If Mike Pence sought counsel from a higher power before ordering up an evidence-based needle exchange program, who are we to question his approach?” added Neale, who considers himself agnostic. “His policy decision saved lives, so maybe we should all consider a little more prayer.”
That Pence would deliberate wasn’t surprising. Instead, his allies argue, it shows that the governor was seriously considering the problem. A staunch social conservative, he had opposed needle exchanges for over a decade while serving in Congress. “When there was an emergency, though,” Fox said, “and the doctors that he hired told him this was the way to go, he changed his mind.”
The number of new HIV cases in Scott County quickly diminished after the program was put in place, and in 2018, the county reported seven new cases, down from 157 three years earlier. According to the Centers for Disease Control, there are 423 cases of coronavirus. The death toll has risen to 19.
Pence continues to pray before meetings of the coronavirus task force.
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