WASHINGTON -- Health and Human Services (HHS) Secretary Xavier Becerra got a largely warm reception during his testimony at a House committee on Thursday for the Biden administration's proposed $131.7-billion fiscal year 2022 discretionary HHS budget, although a few potential areas of disagreement also surfaced.
"The administration is once again taking the lead by submitting a fiscal year 2022 budget request for HHS with investments in health and human services that would improve the lives of millions of American families," said Rep. Rosa DeLauro (D-Conn.), chairman of the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies.
"The investments are vital. After a decade of sequestration and constraints and 2-year budget deals, we are finally beginning to address the needs of our nation's families, children, and underserved communities," added DeLauro, who is also chairman of the full Appropriations Committee.
Rep. Tom Cole (R-Okla.), the committee's ranking member, was likewise very welcoming toward Becerra, who formerly served in the House for 23 years. "We recognize that we know there will be areas we differ on, with some mentioned in my formal remarks, but I also know you're somebody we can work with and somebody that understands how we work, so I'm very delighted that the President made the decision to choose you," Cole said. "It is good to have you back."
Concerns About Abortion, Fetal Tissue Research Ban
However, Cole also made clear his displeasure with some aspects of the budget.
"I was disappointed to see no mention of the Biomedical Advanced Research Development Authority, or BARDA, in the budget released last week but I would expect perhaps to see that when we see a fuller budget," he said. "The success of Operation Warp Speed to develop, produce, and distribute multiple safe, highly effective vaccine candidates in less than a year is unprecedented in medical history.
"Now more than at any other time, we need to ensure BARDA continues its key role in countermeasure development," Cole said.
He also disagreed with a comment that DeLauro had made earlier about the Hyde Amendment, which bars taxpayer funds from being used to pay for abortions. DeLauro said she would like to see it repealed, calling it "a discriminatory policy that denies low-income women access to abortion, and that particularly hits low-income women of color."
Cole had a different take: "For more than 4 decades across multiple administrations and congresses ... language has been included in the Labor, Health and Human Services appropriations bill that restricts federal taxpayer funding for abortion under most circumstances," he said.
"This provision reflects a time-tested balance of strongly held and different perspectives on abortion in this country," Cole continued. "Our bills have been able to advance year after year with bipartisan support with this balance in place. As such, I will strongly oppose any appropriations bill that seeks to weaken prolife protections or eliminate side policies, and I expect that under your leadership HHS will continue to enforce the notice provisions of existing law."
Another politically sensitive issue came up when Rep. Mark Pocan (D-Wisc.) asked whether HHS had any plans to drop the ban on federally funded fetal tissue research that was instituted by the Trump administration.
Becerra said he thought NIH would be issuing an announcement Friday on the matter. "We believe we have to do the research that it takes to make sure that we're incorporating innovation and getting all of those types of treatments and therapies out there to the American people," he said, apparently hinting that the Biden administration would indeed reverse the ban.
Equity and Diversity Issues
Rep. Bonnie Watson Coleman (D-N.J.) said the proposed budget's allocations for mental healthcare were "very encouraging" and that she was concerned about issues related to Black youth suicide and mental health. She asked what HHS was doing to ensure greater diversity among people reviewing grant applications at NIH.
"I've made it very clear equity will permeate everything we do," Becerra replied. "And when it comes to NIH, whether it's the data, whether it's the studies and surveys, and whether it's the participation rates, we want to make sure it is done in a way that incorporates everyone; we don't want to leave anyone out. And so I welcome your input, your participation."
Rep. Andy Harris, MD (R-Md.), asked what Becerra's vision was for HHS's proposal for an Advanced Research Projects Agency for Health at NIH: "If it's a vision of merely doing advanced translational research, then NCATS [NIH's National Center for Advancing Translational Sciences] should have done that," Harris said. "That would move NIH further away from basic research, which I think is the main role of NIH."
Becerra seemed to disagree. "We're trying to move beyond just the basic research to be able to have transformational results," he said, citing the development of COVID vaccines as an example.
"We've seen how quickly the private sector working with the government sector can move, and so we want to be able to continue that basic research that has made America the place to go to when it comes to these discoveries, but we want to try to trigger transformation faster, because that's what we need to do, is be prepared," Becerra said.
Role of New Public Health Workers
Rep. Josh Harder (D-Calif.) wanted to know more about the administration's plan to deploy 100,000 new public health workers that were funded under the American Rescue Plan Act, noting that his district in California's Central Valley has a big provider shortage.
"We had 0% ICU bed capacity for many months in many parts of our state," he said. "It wasn't because we didn't have the physical bed capacity -- it was because we didn't have the doctors, the nurses, the healthcare workers that were necessary to get people to care that they desperately needed."
"Right now, the effort is to make sure that no community doesn't get the service they need when it comes to dealing with the pandemic because they have a shortage of personnel," Becerra said. "And so how those 100,000 public health workers will be distributed will be based on the needs of those various communities, and we can discuss that with you as well."
Rep. John Moolenaar (R-Mich.) asked whether Becerra favored surging additional vaccines to Michigan, which is currently a COVID-19 hotspot.
"That is something we can take a look at," said Becerra. "What we have to make sure is that we don't get off the plan of making sure the vaccine is available everywhere where it's needed. As you can imagine, if we start to focus only in certain particular regions, we'll start to have that disparate treatment of other regions, and so what we want to do is work with everyone to make [the vaccines] available."
Several committee members asked about the treatment of unaccompanied minors coming across the southern border of the U.S.
Rep. Ben Cline (R-Va.) said he thought the administration was "abdicating its responsibility" for those children and noted that a "startling" number of them tested positive for COVID-19 after being transferred out of the border stations. "I'd like to hear what this administration is planning to do to ensure that the people coming across the border -- whether legally or illegally -- do not have coronavirus," he said.
"When it comes to COVID testing, we test every one of these children," said Becerra. "Certainly, we do not release a child who is COVID-positive out into the community.
"We also provide care for kids who are really positive. We make sure that we don't have them commingling with kids who tested negative," Becerra continued. "You can see how it's become a challenge, but we're doing it, and we're doing it safely, protecting these kids and protecting the American public."
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