[House Hearing, 117 Congress]
[From the U.S. Government Publishing Office]





 
                       EXAMINING THE POLICIES AND
                   PRIORITIES OF THE U.S. DEPARTMENT
                      OF HEALTH AND HUMAN SERVICES

=======================================================================

                                HEARING

                               before the

                    COMMITTEE ON EDUCATION AND LABOR
                     U.S. HOUSE OF REPRESENTATIVES

                    ONE HUNDRED SEVENTEENTH CONGRESS

                             FIRST SESSION

                               __________

             HEARING HELD IN WASHINGTON, DC, JUNE 16, 2021

                               __________

                           Serial No. 117-20

                               __________

      Printed for the use of the Committee on Education and Labor
      
      

                                     
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] 

                                     

         Available via: edlabor.house.gov or www.govinfo.gov

                        __________
                              

             U.S. GOVERNMENT PUBLISHING OFFICE 
44-857PDF            WASHINGTON : 2022                                
                               
                               
                               
                               
                               

                    Committee ON EDUCATION AND LABOR

             ROBERT C. ``BOBBY'' SCOTT, Virginia, Chairman

RAUL M. GRIJALVA, Arizona            VIRGINIA FOXX, North Carolina,
JOE COURTNEY, Connecticut              Ranking Member
GREGORIO KILILI CAMACHO SABLAN,      JOE WILSON, South Carolina
  Northern Mariana Islands           GLENN THOMPSON, Pennsylvania
FREDERICA S. WILSON, Florida         TIM WALBERG, Michigan
SUZANNE BONAMICI, Oregon             GLENN GROTHMAN, Wisconsin
MARK TAKANO, California              ELISE M. STEFANIK, New York
ALMA S. ADAMS, North Carolina        RICK W. ALLEN, Georgia
MARK DeSAULNIER, California          JIM BANKS, Indiana
DONALD NORCROSS, New Jersey          JAMES COMER, Kentucky
PRAMILA JAYAPAL, Washington          RUSS FULCHER, Idaho
JOSEPH D. MORELLE, New York          FRED KELLER, Pennsylvania
SUSAN WILD, Pennsylvania             GREGORY F. MURPHY, North Carolina
LUCY McBATH, Georgia                 MARIANNETTE MILLER-MEEKS, Iowa
JAHANA HAYES, Connecticut            BURGESS OWENS, Utah
ANDY LEVIN, Michigan                 BOB GOOD, Virginia
ILHAN OMAR, Minnesota                LISA C. McCLAIN, Michigan
HALEY M. STEVENS, Michigan           DIANA HARSHBARGER, Tennessee
TERESA LEGER FERNANDEZ, New Mexico   MARY E. MILLER, Illinois
MONDAIRE JONES, New York             VICTORIA SPARTZ, Indiana
KATHY E. MANNING, North Carolina     SCOTT FITZGERALD, Wisconsin
FRANK J. MRVAN, Indiana              MADISON CAWTHORN, North Carolina
JAMAAL BOWMAN, New York, Vice-Chair  MICHELLE STEEL, California
MARK POCAN, Wisconsin                JULIA LETLOW, Louisiana
JOAQUIN CASTRO, Texas                Vacancy
MIKIE SHERRILL, New Jersey
JOHN A. YARMUTH, Kentucky
ADRIANO ESPAILLAT, New York
KWEISI MFUME, Maryland

                   Veronique Pluviose, Staff Director
                  Cyrus Artz, Minority Staff Director
                                 ------ 
                                 
                            C O N T E N T S

                              ----------                              
                                                                   Page

Hearing held on June 9, 2021.....................................     1

Statement of Members:
    Scott, Hon. Robert C. ``Bobby'', Chairman, Committee on 
      Education and Labor........................................     1
        Prepared statement of....................................     3
    Foxx, Hon. Virginia, Ranking Member, Committee on Education 
      and Labor..................................................     3
        Prepared statement of....................................     4

Statement of Witnesses:
    Becerra, Hon. Xavier, Secretary, U.S. Department of Health 
      and Human Services.........................................     5
        Prepared statement of....................................     8

Additional Submissions:
    Comer, Hon. James, a Representative in Congress from the 
      State of Kentucky:
        ``Biden admin reroutes billions in emergency stockpile, 
          Covid funds to border crunch,'' Politico, May 15, 2021.    93
    Good, Hon. Bob, a Representative in Congress from the State 
      of Virginia:
        ``Becerra's cautious border play rankles White House,'' 
          Politico, May 10, 2021.................................   102
    Harshbarger, Hon. Diana, a Representative in Congress from 
      the State of Tennessee:
        ``Xavier Becerra is wrong that no law addresses partial-
          birth abortion," PolitiFact, May 19, 2021..............   109
    Questions submitted for the record by:
        Chairman Scott...........................................   113
        Ranking Member Foxx......................................   117
        Sablan, Hon. Gregorio Kilili Camacho, a Delegate in 
          Congress from the Commonwealth of the Northern Mariana 
          Islands................................................   114
        Bonamici, Hon. Suzanne, a Representative in Congress from 
          the State of Oregon....................................   115
        Castro, Hon. Joaquin, a Representative in Congress from 
          the State of Texas.....................................   116
        Espillat, Hon. Adriano, a Representative in Congress from 
          the State of New York..................................   117
        .........................................................
    Comer, Hon. James, a Representative in Congress from the 
      State of Kentucky                                             123
        Owens, Hon. Burgess, a Representative in Congress from 
          the State of Utah......................................   124
        Miller-Meeks, Hon. Mariannette, a Representative in 
          Congress from the State of Iowa........................   124
    Responses to questions submitted for the record by:
        Secretary Becerra........................................   126


                       EXAMINING THE POLICIES AND

                   PRIORITIES OF THE U.S. DEPARTMENT

                      OF HEALTH AND HUMAN SERVICES

                              ----------                              


                        Wednesday, June 16, 2021

                  House of Representatives,
                          Committee on Education and Labor,
                                                    Washington, DC.
    The Committee met, pursuant to notice, at 9:01 a.m. via 
Zoom, Hon. Robert C. ``Bobby'' Scott (Chairman of the 
Committee) presiding.
    Present: Representatives Scott, Grijalva, Courtney, Sablan, 
Wilson of Florida, Bonamici, Takano, Adams, DeSaulnier, 
Norcross, Jayapal, Morelle, Wild, McBath, Hayes, Levin, Omar, 
Stevens, Leger Fernandez, Jones, Manning, Mrvan, Bowman, Pocan, 
Yarmuth, Mfume, Foxx, Wilson of South Carolina, Thompson, 
Walberg, Grothman, Stefanik, Allen, Banks, Comer, Fulcher, 
Keller, Murphy, Miller-Meeks, Owens, Good, McClain, 
Harshbarger, Miller, Spartz, Fitzgerald, Cawthorn, Steel, and 
Letlow.
    Staff present: Ilana Brunner, General Counsel; Ijeoma 
Egekeze, Professional Staff; Daniel Foster, Health and Labor 
Counsel; Rashage Green, Director of Education Policy; Christian 
Haines, General Counsel; Alison Hard, Professional Staff; 
Rasheedah Hasan, Chief Clerk; Sheila Havenner, Director of 
Information Technology; Eli Hovland, Policy Associate; Carrie 
Hughes, Director of Health and Human Services; Ariel Jona, 
Policy Associate; Andre Lindsay, Policy Associate; Yonatan 
Moskowitz, Oversight Counsel--Labor; Mariah Mowbray, Clerk/
Special Assistant to the Staff Director; Kayla Pennebecker, 
Veronique Pluviose, Staff Director; Theresa Thompson, 
Professional Staff; Banyon Vassar, Deputy Director of 
Information Technology; Cyrus Artz, Minority Staff Director; 
Rob Green, Minority Director of Workforce Policy; Taylor 
Hittle, Minority Professional Staff Member; Amy Raaf Jones, 
Minority Director of Education and Human Resources, Dean 
Johnson, Minority Legislative Assistant; Georgie Littlefair, 
Minority Legislative Assistant; John Martin, Minority Workforce 
Policy Counsel, Hannah Matesic, Minority Director of 
Operations; Maureen O'Toole, Minority Press Assistant; Alex 
Ricci, Minority Professional Staff Member; and Mandy 
Schaumburg, Minority Chief Counsel and Deputy Director of 
Education Policy.
    Chairman Scott. The Committee on Education and Labor will 
come to order. Welcome to everyone and I note that a quorum is 
present. The Committee is meeting today to hear testimony on 
``Examining the Policies and Priorities of the U.S. Department 
of Health and Human Services.''
    This is an entirely remote hearing and as such the 
Committee's hearing room is officially closed. All microphones 
will be kept muted as a general rule to avoid unnecessary 
background noise, and Members and witnesses will be responsible 
for unmuting themselves when they're recognized to speak, or 
when they wish to seek to be recognized.
    If a Member or witness experiences technical difficulties 
during the hearing please stay connected to the platform, make 
sure that you're muted and use your phone to immediately call 
the Committee's IT director whose number was provided for you 
in advance.
    Should the Chair experience technical difficulties and need 
to step away, Mr. Morelle or any other Majority Member, is 
hereby authorized to assume the gavel in the Chair's absence.
    In order to ensure that the Committee's five-minute rule is 
adhered to, the staff will be keeping track of time using the 
Committee's field timer which is designated in its own 
thumbnail picture designated 001_timer and will show a blinking 
light when the time is up.
    As a courtesy to our witness and to get to our questions as 
soon as possible, we will forego the customer roll call. 
Pursuant to Committee Rule 8(c) opening statements are limited 
to the Chair and the Ranking Member, and now I'll recognize 
myself for the purpose of making an opening statement.
    Today we are meeting to discuss the Department of Health 
and Human Services Budget Request for Fiscal Year 2022, and to 
examine the Department's policies and priorities. Secretary 
Becerra, thank you for coming today and thank you for your 
time. I fondly remember a time when we both served on this 
Committee, as well as the judiciary Committee, and I'm pleased 
to welcome you back.
    We look forward to discussing your vision to ensure all 
Americans access to high-quality healthcare. The importance of 
maintaining a strong public health system has never been more 
apparent. Regretfully, we are mourning the grim milestone of 
600,000 COVID-19 deaths in the United States. Many of these 
deaths could have been prevented by a coherent response to the 
pandemic.
    For example, last night I attended an event at the 
Philippine Embassy, and I was informed that they had suffered 
20,000 deaths. The United States is three times bigger than the 
Philippines, so at their rate we would have suffered 60,000 
deaths, not 600,000 deaths.
    Fortunately, the Biden/Harris Administration is taking an 
evidence-based approach to reinvesting in the well-being of our 
families and communities, most notably the Administration has 
worked with Congress to enact The American Rescue Plan which 
helped more than half of our Nation's adults get fully 
vaccinated, protected children from abuse and neglect, and 
expanded access to child nutrition and put us on track to 
cutting the child poverty rate about in half.
    We addressed rising rates of domestic and gender-based 
violence, strengthened support for older Americans, and 
expanded access to affordable healthcare. These investments 
have saved lives and reaffirmed that when we invest in the 
health of our communities, we provide people with the tools to 
care for themselves and their loved ones.
    However, severe challenges are still ahead. Secretary 
Becerra you inherited a department that consistently sabotaged 
the Affordable Care Act, and jeopardized access to healthcare 
for millions of Americans.
    Today we look forward to hearing how the Department's 
budget request, the American Jobs Plan, and the American 
Families Plan will finally help defeat the pandemic and extend 
access to high-quality healthcare for people across the Nation. 
Again, thank you for being with us today.
    [The statement of Chairman Scott follows:]

        Statement of Hon. Robert C. ``Bobby'' Scott, Chairman, 
                    Committee on Education and Labor

    Today, we are meeting to discuss the Department of Health and Human 
Services budget request for Fiscal Year 2022 and examine the 
Department's policies and priorities.
    Secretary Becerra, thank you for coming today and thank you for 
your time. I fondly remember our time when we both served on this 
Committee, as well as the Judiciary Committee, and I am pleased to 
welcome you back. We look forward to discussing your vision for 
ensuring all American access to high-quality health care.
    The importance of maintaining a strong public health system has 
never been more apparent. Regretfully, we are mourning the grim 
milestone of 600,000 COVID-19 deaths in the United States. Many of 
these deaths could have been prevented by a coherent response to the 
pandemic.
    For example, last night I attended an event at the Philippine 
Embassy, and I was informed that they had suffered 20,000 deaths. The 
United States is three times bigger than the Philippines, so at their 
rate, we would have suffered 60,000 deaths--not 600,000 deaths.
    Fortunately, the Biden-Harris Administration is taking an evidence-
based approach to reinvesting in the well-being of our families and 
communities.
    Most notably, the Administration has worked with Congress to enact 
the American Rescue Plan, which:

   Helped more than half of our Nation's adults get fully 
        vaccinated,

   Protected children from abuse and neglect and expanded 
        access to child nutrition,

   Put us on track to cutting the child poverty about in half,

   Addressed rising rates of domestic and gender-based 
        violence,

   Strengthened support for older Americans, and

   Expanded access to affordable health care.

    These investments have saved lives and reaffirmed that, when we 
invest in the health of our communities, we provide people with the 
tools to care for themselves and their loves ones.
    However, severe challenges are still ahead. Secretary Becerra, you 
inherited a Department that consistently sabotaged the Affordable Care 
Act and jeopardized access to health care for millions of Americans.
    Today, we look forward to hearing how the Department's budget 
request, the American Jobs Plan, and the American Families Plan would 
finally help defeat the pandemic and expand access to high-quality 
health care for people across the country.
    Again, thank you, for being with us today. I will now recognize the 
Ranking Member of the Committee, the gentlelady from North Carolina, 
Dr. Foxx.
                                 ______
                                 
    Chairman Scott. I will now recognize the Ranking Member of 
the Committee, the gentlelady from North Carolina Dr. Foxx.
    Ms. Foxx. Thank you, Mr. Chairman. There's absolutely no 
reason why this event should not be conducted in person in the 
Committee hearing room. Vaccines were taken, mask guidance was 
changed, yet Democrats are pursuing permanent pandemic policies 
to exert more control over people's lives.
    And there's absolutely no reason why we should not treat 
every witness we have with respect and not do the roll call and 
waste everybody's time. The Biden administration inherited a 
pandemic that was winding down, but the Administration now 
creating several new crises all on its own.
    There's a crisis at the border. Human traffickers and drug 
smugglers are ubiquitous and rampant. The Secretary of the 
Department recklessly packed children in the holding cells well 
beyond capacity limits. There's a crisis in our school system, 
students are most likely from 6 months to a year behind in 
their studies because the Biden administration insists on doing 
the bidding of teachers' union's leadership.
    There's a mental health crisis caused by Democrats' 
mandated, isolation policies. Our children, particularly our 
young girls, are attempting suicide at staggering and 
mortifying rates. There's an inflationary economic crisis, 
prices on consumer goods are skyrocketing because of the 
Democrats' failed stimulus policies and energy policies.
    And what did this Administration do with these self-imposed 
catastrophes it thrust upon the American people? The Biden 
administration proposed the most outrageous budget proposal in 
the history of our Nation. The Democrats' bloated budget 
panders to the Democrats' most extreme socialist allies and 
leaves working class Americans to fend for themselves.
    Furthermore, the President's radical healthcare proposals 
shatter the bedrock of America's healthcare system, employer-
sponsored health insurance, cheered on by socialist supporters 
in Congress. Obamacare 2.0 will be a disaster.
    The President's morally repugnant budget also forces the 
public to fund abortions. Secretary Becerra has much to explain 
and unpack at today's hearing, and Committee Republicans look 
forward to getting answers. With that Mr. Chairman I yield 
back.
    [The statement of Ranking Member Foxx follows:]

           Statement of Hon. Virginia Foxx, Ranking Member, 
                    Committee on Education and Labor

    There is absolutely no reason why this event should not be 
conducted in person in the Committee hearing room. Vaccines were taken, 
mask guidance has changed, yet Democrats are pursuing permanent 
pandemic policies to exert more control over people's lives.
    The Biden administration inherited a pandemic that was winding 
down, but the administration is now creating several new crises all on 
its own.
    There is a crisis at the border. Human traffickers and drug 
smugglers are ubiquitous and rampant. The Secretary's Department 
recklessly packed children into holding cells well beyond capacity 
limits.
    There is a crisis in our school systems. Students are most likely 
from 6 months to a year behind in their studies because the Biden 
administration insists on doing the bidding of teachers' union 
leadership.
    There is a mental health crisis caused by Democrats' mandated 
isolation policies. Our children, particularly our young girls, are 
attempting suicide at staggering and mortifying rates.
    There is an inflationary economic crisis. Prices on consumer goods 
are skyrocketing because of the Democrats' failed stimulus policies.
    And what does this administration do with these self-imposed 
catastrophes it thrust upon the American people? The Biden 
administration proposes the most outrageous budget proposal in the 
history of our Nation. The Democrats' bloated budget panders to the 
Democrats' most extreme socialist allies and leaves working class 
Americans to fend for themselves.
    Furthermore, the President's radical health care proposals shatter 
the bedrock of America's health care system--employer-sponsored health 
insurance--cheered on by socialist supporters in Congress. Obamacare 
2.0 will be a disaster.
    The President's morally repugnant budget also forces the public to 
fund abortions.
    Secretary Becerra has much to explain and unpack at today's hearing 
and Committee Republicans look forward to getting answers.
                                 ______
                                 
    Chairman Scott. Thank you. Without objection all other 
Members who wish to insert written statements into the record 
may do so by submitting them to the Committee Clerk 
electronically in Microsoft Word format by 5:00 p.m. on June 
23, 2021. I'll now introduce our witness.
    The Honorable Xavier Becerra is the 25th Secretary of the 
Department of Health and Human Services, and the first Latino 
to hold office in the history of that office in the history of 
the United States. Previously he served 12 terms in Congress, 
so welcome back as well as serving as Attorney General for the 
sake of California.
    We appreciate the Secretary for participating today and 
look forward to your testimony. Your written statement will 
appear in full in the hearing record. You are asked to limit 
your own presentation to about a five-minute summary. After 
your presentation as you know we'll move to Member questions.
    The witness is aware of the responsibility to provide 
accurate information to the Committee, and therefore will 
proceed directly with his testimony. Secretary Becerra, it's 
good to see you today, you're now recognized for five minutes.

STATEMENT OF HON. XAVIER BECERRA, SECRETARY, U.S. DEPARTMENT OF 
                   HEALTH AND HUMAN SERVICES

    Secretary Becerra. Chairman Scott, Ranking Member Foxx, and 
Members, thank you for the opportunity to be before you, and 
great to be with so many friends and colleagues from the past. 
The Department of Health and Human Services is at the center of 
many challenges facing our country today.
    The COVID-19 pandemic has shed light on how health 
inequities and inefficient Federal funding can leave 
communities vulnerable to crises. So, now more than ever, we 
must ensure that the Department has the resources to achieve 
its mission and build a healthier America.
    For HHS, the budget proposed $131 billion in discretionary 
budget authority, and $1.5 trillion in mandatory funding. This 
budget underscores the Administration's commitment to prepare 
the Nation for the next public health crisis, to expand access 
to affordable healthcare, to address health disparities, to 
tackle the opioid and other drug crises, and to invest in other 
priority areas like maternal health, tribal health, and early 
childhood education.
    Of course, the fight against COVID-19 is not yet over, but 
even as HHS works to beat this pandemic, we must prepare for 
the next public health crisis. To start, this budget makes 
significant investments in our preparedness and response 
capabilities, including investing in strategic national 
stockpile, and our public health workforce. It provides a new 
mandatory funding stream for the manufacturers of medical 
countermeasures here at home to protect America from future 
pandemics, and to create U.S. jobs.
    The budget also includes the largest Fiscal Year investment 
in the CDC in almost two decades. The budget reflects the 
President's commitment to expand access to quality affordable 
healthcare for all Americans, it builds on the groundbreaking 
reforms introduced in the American Rescue Plan by permanently 
extending the enhanced premium subsidies that put affordable 
healthcare coverage within reach for millions more Americans.
    The budget also expands access to home and--community-based 
services under Medicaid, critical services that allow older 
Americans and our loved ones with disabilities to live 
independently in their homes and communities.
    And the budget calls on Congress to take additional steps 
this year to lower the costs of prescription drugs, and further 
expand and improve health coverage through additional benefits 
and public coverage options. Healthcare must be a right, not a 
privilege, and we will work to ensure that families across the 
Nation are able to secure the healthcare they need.
    As we work to expand access to affordable healthcare and 
address the challenges of COVID-19 and future pandemics, we 
need to address public health crises that are already here, 
like violence in our communities, and climate change. The 
President's budget increases funding to support domestic 
violence survivors.
    It addresses gun violence by doubling funding for firearm 
violence prevention research, and it allows HHS to play a major 
role in the Administration's government-wide efforts to tackle 
the climate crisis by supporting research and programs 
identifying the human health impacts of climate change and 
establishing an office of climate change and health equity.
    To ensure that HHS is equitably serving all Americans, the 
budget invests in reducing maternal mortality and morbidity 
that disproportionately impacts women of color. It builds on 
the American Rescue Plan's State option to extend Medicaid 
postpartum coverage.
    It funds a range of rural healthcare programs and expands 
the pipeline for rural health providers. It includes a dramatic 
funding increase, and advance appropriations for the Indian 
Health Service, and it invests in improving access to vital 
reproductive and preventative care services through Title X. To 
support families and build the best possible future for our 
children, the budget makes major investments to ensure high-
quality childcare is affordable to low-and middle-income 
families, and it provides high-quality pre-K for all three- and 
four-year olds.
    I think we all know that our experiences as children shape 
the adults we've become, supported childhood leads to success 
in the future. To address COVID-19's unprecedented acceleration 
of substance use and mental health disorders, the budget makes 
historic investments in SAMSA to support research prevention, 
treatment, and recovery services.
    To support innovation and research, the budget increases 
funding for NIH by 9 billion, 6 and a half billion of which 
will go to establish the Advance Research Projects Agency for 
Health, or ARPAH with an additional focus on cancer and other 
diseases such as diabetes and Alzheimer's.
    This major investment in Federal research and development 
will leverage ambitious ideas to build transformational 
innovation through health research and the application and 
implementation of health breakthroughs.
    Finally, to ensure our funds are used appropriately, the 
budget invests in program integrity, including efforts to 
combat fraud, waste, and abuse in Medicare, Medicaid, and 
private insurance. Mr. Chairman, I'd like to close by 
recognizing the women and men at HHS for their outstanding and 
tireless work fighting COVID-19 to protect the health of their 
fellow Americans.
    To build back a prosperous America we need a healthy 
America. We've taken important steps over the past few months 
to beat back this pandemic, to expand access to quality 
affordable healthcare, to lower health insurance premiums, and 
to protect women's health at home and abroad.
    President Biden's budget requests build on that progress. 
Thank you.
    [The prepared statement of Secretary Becerra follows:]

               Prepared Statement of Hon. Xavier Becerra
               
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]


    Chairman Scott. Thank you. Thank you very much. We'll now 
get to Member questions beginning with the gentleman from 
Arizona Mr. Grijalva.
    Mr. Grijalva. Thank you very much Mr. Chairman and thank 
you for being here Secretary Becerra. It's good to see you 
again my friend, and glad to have you in this very important 
and vital role and leadership that you've earned as Secretary 
of Health and Human Services.
    As you have heard already today, and the drumbeat will 
continue that it is your fault, and by extension the fault of 
the Biden administration for any perceived or real ills that 
are affecting the American people. The attack on January 6 on 
our democracy forgotten; just a mere walk in the park.
    Four years under the previous Administration of concerted 
efforts to dismantle healthcare, aggravate the disparity that 
already exists, undercut and sabotage Obamacare, that didn't 
occur. The tax cuts to the super wealthy that have skewed and 
affected the services that the American people need and demand 
from their government, and the punitive refugee and immigration 
policies that were the hallmark of the previous administration.
    So yes, recovering from those is difficult, and it's going 
to continue to be difficult, but I'm glad to have you in that 
role Secretary to lend some leadership, some rationality and 
some empathy and compassion to those issues that the American 
people need addressed, and need addressed quickly.
    I think the efforts in your budget reflect that, and I'm 
proud to support it. Two questions that we saw during the 
pandemic responses. First, the lack of the response, but as a 
response undertook itself and certainly under the leadership of 
the Biden administration even more so, the role of public 
health departments, county based public health departments, how 
important they became in the vaccination process and the 
outreach process, in the testing process, and what role do you 
see for public health going forward in those departments in 
particular, and what in the budget do you see as reflecting 
that?
    The other issue is childcare. That is a glaring need in 
this country for working parents, and particularly for working 
moms, how do you see that in the budget being reflected, and 
with that I'll turn that back over you to Secretary, for your 
response to that thank you.
    Secretary Becerra. Congressman, great to see you, thank you 
for the question. Public health one of the most important 
lessons we've learned is how ill-prepared this country was to 
reach everyone in America who needed help when it came to 
COVID. And part of the problem was we didn't have a good 
partnership and a clear safety net where we were interconnected 
with our public health colleagues at the State and local level.
    And what we should learn from that is that we should never 
again allow those gaping holes to exist in our national public 
health safety network. We are working closely with our 
partners. We are providing guidance and support, not just 
simply mandates, and so we allow on the groundwork to be done 
by those closest to that work, but we will be there to support. 
We will not ever again I hope return to the day when we tell 
people you're on your own.
    It is time for us to work together, public health must be 
addressed. We don't want to see another pandemic, and that's 
why we're preparing with our State and local partners to be 
ready to provide everyone in America with the healthcare that 
they need, and for that you need a strong, safety net of public 
health.
    The second question was childcare.
    Mr. Grijalva. Childcare.
    Secretary Becerra. Yes. I hope that you all succeed in 
passing the American Family Plans that the President has 
introduced, because it will be a generational type of 
investment in our kids. We know that barely one in seven 
children who qualify, who is eligible to receive childcare has 
a chance to get it, and we want toto change that.
    We saw again with COVID what happens when you don't have 
adequate childcare, when you don't pay people who provide 
childcare services enough, and we can't experience that again. 
It's not just important for the health of our families, it's 
important for the health of our economy.
    Mr. Grijalva. Mr. Chairman thank you so much and I yield 
back.
    Chairman Scott. Thank you. Next will be the gentleman from 
South Carolina, Mr. Wilson.
    Mr. Wilson. Thank you, Mr. Chairman and thank you Ranking 
Member Virginia Foxx. Mr. Secretary, I agree very much with 
Ranking Member Virginia Foxx that we should be in-person. I 
think it's actually insulting that we're not in person for you 
to be able to speak to the American people, for us to be 
present with you to speak to the American people.
    We can always remember that the architect of Obamacare, 
Jonathan Gruber, said that it was built on the stupidity of the 
American people, and that means that we need to be open and 
transparent and somehow be working together in a bipartisan 
manner, but it can't be done with the level of isolation that I 
see here today.
    Mr. Secretary in light of the recent cybersecurity threats 
I was grateful to represent a Savannah River site in South 
Carolina and George to see that the HHS is taking initiative to 
increase cybersecurity for the radiation dose reconstruction 
program affecting claimants under the Energy Employees 
Occupational Illness Compensation Program Act.
    Unfortunately, as a result the National Institute for 
Occupational Safety and Health established a temporary 
moratorium of completing dose reconstructions. A key process 
for many claimants with cancer, meaning that workers from sites 
like the Savannah River site that I represent, will not be able 
to proceed with their claims.
    What if any immediate alternatives could be done to by 
NIOSH to implement, to ensure these claimants can proceed with 
their claims during the period, especially for those that are 
terminally ill?
    Secretary Becerra. NIOSH plays a very important role along 
with the Department of Labor trying to make sure we're 
protecting the health and safety of our workers. The research 
that we do is indispensable. We will continue to do that work. 
We understand that COVID has disrupted many things, and what I 
can commit to you is that if you believe that there's more that 
we can be doing, we can work with you.
    Please inform your team to reach out to my team, and we 
will work with you if you believe there's something more that 
we should be doing at NIOSH.
    Mr. Wilson. Well, thank you and in fact I've got a really 
talented young lady Emily Saleeby who will be in touch with 
your staff right away.
    Secretary Becerra. We'll be waiting for her call.
    Mr. Wilson. Well, hey, she's available 24 hours a day, 7 
days a week. It's really good. Mr. Secretary the policies 
contained in H.R. 3, Speaker Pelosi's partisan drug pricing 
scheme, will stifle the very innovation that contributed to the 
America's Wuhan virus vaccine success.
    I'm grateful to cosponsor H.R. 19, the Lower Cost More 
Cures Act, which is produced by Ranking Members Kathy Morris 
Rogers, Kevin Brady, and especially Congresswoman Virginia 
Foxx. Every provision in H.R. 19 is a bipartisan solution to 
drug pricing issues. Just last Congress we sent 15 bipartisan 
provisions of the Lower Cost More Cures Act to President Trump 
that he signed into law.
    The last thing I believe is that we need for government to 
hinder private sector investments to the ability of drug 
companies to develop treatments and vaccines, especially during 
a pandemic. With the White House Council of Economic Advisers, 
and even the Congressional Budget Office in agreement that H.R. 
3 would lead to fewer new drugs being produced over the next 
decade, do you agree that H.R. 3 will have a negative impact on 
the private sector's ability to development treatment and cures 
for patients which we encounter when we do encounter another 
pandemic?
    Secretary Becerra. I think you and I and everyone agrees 
regardless of what the legislation is that we have to reduce 
the cost of prescription medication. We have to make vaccines 
available to all, and that requires us to continue to have the 
infrastructure in this country, both public, but also 
importantly private; the private research and manufacturing 
capabilities to put out the vaccines as we've seen occur with 
COVID.
    And what I will tell you is the President has been very 
committed and he's been very public about this that he wants to 
see the price of drugs go down, and he is willing to work with 
anyone. H.R. 3 is a proposal that not only reduces the price of 
prescription medication, but it also saves the government quite 
a bit of money. But there are other proposals as you mentioned, 
and we are open to considering any proposal that reduces the 
price of prescription medication and protects the American 
people.
    Mr. Wilson. Well, thank you and indeed, I'm so grateful for 
the leadership of the Congresswoman Virginia Foxx, and I know 
she'd be happy to meet with you and explain the benefits and 
the superior status of H.R. 19 to3, and with that I yield back. 
Thank you.
    Chairman Scott. I thank both of our questioners for staying 
within time. I forgot to ask people to maintain their time 
because if everybody goes 1 minute over, we'll be almost an 
extra hour in the hearing, so we're going to try to keep 
exactly to five minutes, and I appreciate the first two who are 
complying before I gave the warning.
    And next will be the gentleman from Connecticut, Mr. 
Courtney.
    Mr. Courtney. Thank you, Mr. Chairman and Mr. Secretary 
it's very exciting to see you here today as one of our former 
colleagues. Congratulations on your confirmation, and also 
congratulations on your great work as Attorney General in 
California.
    You again, were one of the AG's that stepped forward to 
defend the Affordable Care Act, and with passage of the 
American Rescue Plan which we have now already seen in the very 
short space and time that well over a million new Americans 
have now enrolled in qualified health plans as well as there's 
an expansion on the Medicaid side, so your work was not in 
vain. It was really critical to stand up in the ACA's hour of 
need.
    I also want to thank you for your great work in terms of 
protecting defrauded student borrowers. The news yesterday that 
Secretary Cardona who hails from the State of Connecticut was 
finally going to discharge the debt of defrauded student 
borrowers from ITT Tech that's about 72,000 borrowers across 
the county who got totally ripped off by that institution in 
the last administration.
    I mean just disgracefully was refusing to provide relief 
for those students. Again, as Congresswoman Hayes can attest 
there's well over about 1,000--2,000 kids in Connecticut that 
are going to get relief from that order, so again your work as 
AG was not in vain.
    Mr. Secretary I wanted to focus for a minute on a COVID 
policy which HHS adopted, which I support, which is they 
basically suspended the 3-day hospitalization rule for Medicare 
patients to get coverage upon discharge from hospital. This has 
been a persistent problem over the years in terms of the way 
hospitals were coding patients as outpatient as opposed to 
inpatient, and we just have horror stories over the years of 
elderly patients with broken hips, ribs, who in some instances 
were in hospital for 5, 6, 7, sometimes 12 days, and then found 
out that they did not qualify for follow-on rehab care for 
their injuries because of the way they were coded as 
observation status, not inpatient.
    Again, HHS suspended that rule during the pandemic, which I 
think was a smart move. And I would like to at least flag this 
issue. There is a bipartisan bill H.R. 3650. It is supported by 
over 30 geriatric groups including ARP, the Committee to save 
social security and Medicare, and many provider groups like the 
ER docs and other to really get rid of this surprise billing on 
steroids, because that really is what happens to patients when 
they again find out that they were coded in the wrong bucket 
and lose this coverage.
    Again, it's a very specific issue. I don't want to put you 
on the stop this minute, but I want to flag it for you that you 
know as the emergency order sunsets that the system is going to 
snap back to where it was before, and we want to work with the 
Department to either enact 3650, or get some policy, and I 
don't know whether you just want to react and comment. I do 
have one other question.
    Secretary Becerra. Congressman first, great to see you 
again, and actually I'm aware of this. I look forward to 
working with you. You understand that this is a statute we have 
some constraints in what we can do, but we are absolutely 
willing to work with you. President Biden is committed to 
expand access to care, not reduce it, so definitely look 
forward to working with you.
    Mr. Courtney. Well, thank you, and you're right, we do need 
to move forward by law, but the good news is we now have some 
data during the pandemic to show that maybe some of the cost 
issues that have raised concerns in the past really in some 
ways allowing people to get the care that's medically 
prescribed that actually reduces hospital readmissions.
    And again, just really quickly on H.R. 3, I just would not 
that that bill, the savings that accumulates which you 
mentioned, a big portion of that is actually getting invested 
in the National Institute of Health. The bill also totally 
protects and preserves the R&D tax credit which pharmaceutical 
companies like Pfizer, you know, utilize and Moderna utilize.
    So, you know we are leaving a framework that still 
encourages investment in R&D, and I think frankly, the 
collaboration of Congress in the CARES Act, other COVID bills 
and the Rescue Plan working with the private sector is a great 
success story, but frankly the taxpayers and patients should 
not have to bear the brunt of unacceptable prices for 
medications like insulin that have been off patent for decades.
    Secretary Becerra. I agree with you Congressman, and we're 
definitely looking forward to working with you and your 
colleagues to get something done to reduce the cost of 
prescription medication.
    Mr. Courtney. Thank you. I look forward to it again. 
Congratulations, it's great to see you.
    Secretary Becerra. Thank you. It's great to see you as 
well.
    Chairman Scott. Thank you, the gentlemen for the minority 
side is the gentleman from Michigan, Mr. Walberg.
    Mr. Walberg. Thank you, Mr. Chairman and Secretary Becerra, 
welcome back to the people's house. I wanted to followup on a 
question that I know you've received in previous hearings, but 
now that you have had some time to talk with your team perhaps 
you have had time to learn more about the rationale.
    In reference to efforts to reduce maternal mortality in the 
Centers for Disease Control and prevent some budget 
justification the budget uses the term on page 14 of that 
document, uses the term of ``birthing people.'' Secretary 
Becerra is there a reason the agency is using the term 
``birthing people,'' and that's the only spot I've seen in the 
budget, but the term was used birthing people, rather than 
mother in this context. Is there a reason?
    Secretary Becerra. Congressman, thank you for the question 
and let me try to explain as I did the last time that use of 
the word birthing people is an effort to try to be not only 
inclusive, but accurate in the way we describe the individuals 
involved in this particular matter.
    And that would include mothers, that would income women of 
whatever walk of life, but we want to make sure we're 
inclusive, and we want to make sure we're using words that are 
accurate to convey what is going on.
    Mr. Walberg. Well, let me followup with that. At a previous 
hearing you said the goal was to be precise in the language you 
choose. Why is mother not a precise term that's totally 
inclusive in every way, shape, and form? In fact, when we've 
first began hearing that term ``birthing person'' or ``birthing 
people'', mothers and women in general all across my district 
expressed great concern that that was not a precise term, it 
was more given to agriculture, and it was pejorative in their 
mind.
    Mother is a term that is special, it's unique, it speaks 
specifically to the uniqueness of birth itself and who is 
capable of doing that thankfully. Can you provide this 
Committee with a definition of birthing person specifically?
    Secretary Becerra. And thank you for asking the question in 
a thoughtful way, as it does require a thoughtful response. 
Congressman, as you and I know, there are individuals take for 
example a surrogate who will not be the mother of that child. 
There are individuals who do not categorize themselves as being 
male or female, and what we want to make sure is that we are 
not excluding anyone when we use particular terms.
    Certainly, birthing person would include a woman who 
considers herself to be a future mother.
    Mr. Walberg. Well, again, as we see all across the course 
of your budget mother is used but one spot, birthing people is 
put in. There's a concern that there's a camel's nose under the 
tent for social change, and social engineering that goes 
against precise X and XY chromosomes and science itself.
    I express strong opposition to that on behalf of mothers 
and women all across my district, and I believe across this 
country. There's a time when we say what we really mean, and a 
mother is a mother, surrogate or otherwise. The term is 
understood Secretary, I'd encourage you to remove that term.
    Perhaps you could also clarify another issue that has come 
up regarding the Federal law on partial birth abortion. In 
response to several Members of Congress you said you will 
follow that law under Roe v. Wade however, it has not been 
clear if you recognize the law as defined in Section 1531 of 
Title 18 U.S. Code which bans specifically partial birth 
abortion.
    In your response to Representative Joyce at your May 12th 
hearing, you stated that partial birth abortion is not a 
medically recognized term. With all due respect Secretary 
Becerra were you suggesting that doctors would not have to 
follow the law because they used different terms?
    Secretary Becerra. Congressman, thank you again for the 
question and the thoughtful way it was presented. Just as I am 
required to follow the law and do, and will, every physician in 
America must follow the law, and I will repeat what I've said 
before. In this country the law of the land is Roe versus Wade.
    A woman has a right to exercise her choice when it comes to 
reproductive health. We will defend that right, and we will 
protect that right, and we recognize that we must do that 
according to the law that exists in America.
    Mr. Walberg. Well, I encourage you, even though you voted 
against the law that banned partial birth abortion, it is the 
law. Section 1531 of Title 18, Title 18 U.S. Code, with that I 
appreciate your response and I yield back.
    Chairman Scott. The gentleman yields back. Next the 
gentleman from the Northern Mariana Islands, Mr. Sablan.
    Mr. Sablan. Thank you very much Mr. Chairman for this. 
Secretary Becerra, thank you for joining us. Congratulations on 
your new job. You have to make up your mind whether you're 
going to live in the east coast or the west coast. You're 
always welcome here in Congress.
    Mr. Secretary the question
    [inaudible] address the barriers indicated in the 
territories caused by a Medicaid funding gap and an incidental 
local matching rate. Are you familiar with that section of the 
bargain; and if so, can you elaborate on the Administration's 
position on that addressing the disparities in the insular 
areas and territories please?
    Secretary Becerra. First, great to see you again, always 
wonderful to have a chance to work with you and I guess I'm 
familiar with this issue. You and I have worked on these issues 
in the past on behalf of the territories, and the President has 
also been clear where he stands on this issue.
    In his budget he makes it very clear that he supports 
eliminating the Medicaid funding caps for U.S. territories, and 
in aligning Medicaid financing for the territories with that of 
the states.
    Mr. Sablan. Thank you. And I'm going to jump to another 
issue. I have several that I will submit for the record, but 
Mr. Secretary starting in Fiscal Year 2021, HHS is required to 
set aside 75 million for the territories from the full amount 
appropriated in the childcare entitlement states program.
    We find that the 75 million is going to be allotted among 
the territories in proportion to their respective needs. What 
data or formula does HHS use to determine their respective 
needs of each territory? You can answer now or come back with 
me later.
    Secretary Becerra. Congressman let me get back to you on 
the precise data, or the formulation that was used, and I'm 
pretty sure you were asking about childcare, but it's a little 
difficult to understand your question because at least for me 
you were coming in and out, but I think it was regard to 
childcare, and how that funding would work for the territories. 
We can get back to you on that.
    Mr. Sablan. All right. And I will submit this question for 
you to review and give us some answers Mr. Secretary. Let me 
also say before I forget and get to my next question. Mr. 
Secretary I want to thank the men and women in your department, 
the men, and women in various public health agencies throughout 
the Nation, and of course to the American people sir. Just 
today my district in Northern Mariana Islands moved to the 
community vulnerability developing.
    This is great news and since we started this pandemic, I 
think 180-something infections, and of that we have had two 
deaths. In the very, very, beginning from individuals who are 
coming in and were sick before they got here. But of course, we 
couldn't have done any of this sir people say if it weren't for 
the generosity of the American people, and I thank you for all 
the help.
    But my final question Mr. Secretary, Northern Mariana has 
never been eligible for especially in our country, for 5 
percent of the funding from pandemic emergency assistance, or 
set aside for tribal pilot programs. We distributed it in the 
manner deemed appropriate by the HHS Secretary.
    [Inaudible]----funding for the Northern Marianas?
    Secretary Becerra. Congressman absolutely. Let me first say 
that I know the President believes this, and I feel it as well 
that when it comes to pandemics, or any types of crises we all 
reach out to everyone in the American family, and certainly our 
brothers and sisters from the Mariana Islands and the territory 
are part of the American family.
    And so, when it comes to something like a crisis, or where 
it comes to the distribution of funding, we will do at HHS what 
we can to make sure that those funds first go to those in need, 
and we try to do it in a way that lets us show a transparent 
allocation. And so, what we're willing to do is work with your 
office if you'd like your team, to give you a more precise 
answer as to what the Mariana Islands can expect.
    Mr. Sablan. Yes sir, thank you. It is good seeing you again 
Mr. Secretary. Mr. Chairman I yield back.
    Chairman Scott. Thank you. The next I see on the screen is 
the gentlelady from New York Ms. Stefanik.
    Ms. Stefanik. Thank you, Mr. Chairman. Secretary Becerra 
you talked about in your testimony the importance of focusing 
on access to healthcare in rural communities, and I represent a 
very rural district in northern New York.
    One of the challenges we've faced is there was a CMS 
redefinition of the term primary road, this significantly 
narrowed the eligibility criteria, and it's putting many of our 
rural hospitals at risk of losing their critical access 
hospital status. I am working with my colleague, Representative 
Delgado, across the aisle on addressing this issue which is 
particularly challenging because it pulls the rug out from 
under these hospitals, amidst a very challenging once in a 
century pandemic.
    Can you commit to working with both of us on a bipartisan 
basis to address this misguided redefinition because this is 
going to impact rural districts across America?
    Secretary Becerra. Congresswoman, thank you for the 
question. I'll make sure that the team at CMS is aware that 
you're asking this question, and absolutely would commit to 
working with you and your colleagues to see where we can head 
on this.
    Ms. Stefanik. My next question is regarding during the 
Trump administration, President Trump created the Conscious and 
Religious Freedom Division within HHS's Office of Civil Rights 
to review complaints of discrimination against healthcare 
entities that exercise their rights under the law to choose not 
to provide or pay for abortions or other healthcare procedures.
    It is unclear based upon the language in President Biden's 
budget, but do you plan on eliminating the Conscious and 
Religious Freedom Division yes or no?
    Secretary Becerra. Congresswoman, we are going to continue 
the work that it takes to protect the rights of all Americans, 
including religious freedom rights. We're going to do 
everything we can to be as aggressive as possible. My history, 
if you'll take a look at it, is one about defending 
Constitutional and civil rights of all Americans, and as a 
person of faith I can guarantee you that we will do everything 
we can to make sure people are able to exercise their rights 
under the Constitution when it comes to religion, their faith, 
and so forth.
    Ms. Stefanik. So that's a no, that you won't eliminate that 
division?
    Secretary Becerra. We're going to continue to move forward 
in protecting people's rights and having an Office of Civil 
Rights that will continue to protect those. We have a number of 
cases that are coming before us. All of those, if they deal 
with Constitutional civil rights, we under the Office of Civil 
Rights, we'll be protecting those rights.
    Ms. Stefanik. Great. It's a simple question, is it a yes or 
no that you plan on eliminating the Conscious and Religious 
Freedom Division?
    Secretary Becerra. We will do nothing that's against the 
law.
    Ms. Stefanik. So, you won't eliminate it, great. I'll take 
that. You'll do nothing to eliminate thank you. And I am 
familiar with your record while you were Attorney General of 
California, HHS found the State of California to be in 
violation of Federal law by imposing universal abortion 
coverage mandates.
    I just want to reiterate on the record do you commit to 
upholding the enforcement of Federal conscious protections and 
religious freedom laws, including the Weldon Amendment?
    Secretary Becerra. Congresswoman we will continue to 
respect and not only follow the law, but enforce the law when 
it's under our jurisdiction, including the religious rights of 
Americans.
    Ms. Stefanik. Great. So, the answers I've gotten today are 
thank you for being willing to work with us on a bipartisan 
basis on the rural healthcare issue. No, there will not be an 
elimination of the Conscious and Religious Freedom Division, 
and commitment to upholding Federal law when it comes to 
conscious protections, thank you I yield back.,
    Chairman Scott. Thank you. Next will be the gentlelady from 
Florida Ms. Wilson.
    Ms. Wilson. Good morning. I could hear you.
    Chairman Scott. I could hear you.
    Ms. Wilson. Good morning, everyone, and Secretary Becerra 
welcome home. We are so proud of you, and everything that you 
have accomplished, and you've earned it all, so God bless you 
as you assume this high position, we are so proud of you. I 
just want everyone to remember why we are holding this hearing 
remotely. Our country lost over 600,000 people in a pandemic, 
they died.
    And my district is an epicenter. And people are still 
dying, and they will continue to die until we can vaccinate 
everyone and get rid of all these conspiracy theories and 
misinformation. And Members of Congress are going to continue 
to get sick and to die until all Members of Congress are 
vaccinated.
    Now with that said I just have a couple of questions for 
the Secretary, and I think it would be best if I asked my 
questions in threes, and then you answer them. No. 1, school 
nurses. We have a police officer in every school. We tried to 
do that across the country, and I'm just wondering with what 
has happened during this pandemic do you agree that instead of 
having police officers in every school, we should focus on 
having a healthcare professional at every school?
    I have a bill that I have been filing for years, it's one 
nurse one school, and I filed it through the legislature, 
through the Senate and in Congress, and I want to know how you 
feel about that. Also, the American Rescue Plan includes a 
temporary 5 percent Federal medical assistance percentage 
increase for states to expand Medicaid.
    I'm from Florida. I wrote my Governor a letter asking him 
to expand Medicaid, and I want to know what you would say to 
Governor DeSantis to make him expand Medicaid, because I'm not 
having any luck with it. And then sickle cell anemia, what does 
HHS do to ensure that patients who are Medicaid and Medicare 
beneficiaries have equal access to all of the innovative 
therapeutics that are now available? Those are the first three.
    Secretary Becerra. Congresswoman great questions and great 
to see you. You look the same, I love those hats. First, nurses 
in school. You and I probably remember the days when we were in 
elementary school and we knew that there would be a nurse there 
for us, and what a sin that we don't do that for our children 
today right?
    Especially in our schools most in need to have access to a 
nurse. If you help us pass the American Families Plan, I 
guarantee you we will see far more nurses in our schools 
providing care to our children who really need it, because 
we'll give the resources to our local school districts to do 
that, so I hope we're able to work with you to pass the 
American Families Plan.
    Medicaid expansion, what would I tell any Governor? You got 
elected to care for all the people in your State, not just 
some. We're offering you a deal that is hard to beat. We're 
going to actually help pay for virtually almost 100 percent of 
that cost of that care for that individual who doesn't have 
access to care right now, and hopefully then you'll buy into it 
and find that it makes sense to cover someone, because they 
won't be getting their healthcare at the emergency room, the 
most expensive way to get it now.
    And so, it's a savings not just for you as Governor, it's a 
savings for us as a Federal Government when we get people good 
care, and they start getting the preventative care that keeps 
them from getting really ill and suffering from those chronic 
illnesses in the future that cost so much.
    Finally, sickle cell anemia. Congresswoman I've got to tell 
you, I think there's some bright news on the horizon when it 
comes to sickle cell. Finally, we're beginning to see far more 
investment, but this is where a program like ARPA H is so 
critical, because it lets us zero in on these really difficult 
and devastating diseases and conditions that sometimes because 
they don't hit everyone, are far more expensive to focus on.
    This lets us target some of those like sickle cell, certain 
cancers, Alzheimer's, and actually come up with a solution, so 
I hope you'll be supportive of our efforts to start ARPA H 
which will let us go and save lives.
    Ms. Wilson. Thank you. Quickly, I Chair Higher Ed, so I'd 
like to know how will the HHS budget support CDC engagement and 
technical assistance for colleges and universities in the event 
of an outbreak now that we're opening colleges and 
universities?
    Chairman Scott. If you can be very quick because the time 
has expired.
    Secretary Becerra. Congresswoman I'll simply say that as I 
said before, we can't have holes in our public health network, 
certainly our schools, whether college or K through 12 has to 
be part of that network to protect everyone in the case of a 
pandemic.
    Ms. Wilson. Thank you and I yield back.
    Chairman Scott. Thank you. The gentleman from Georgia Mr. 
Allen.
    Mr. Allen. OK can you hear me, OK?
    Secretary Becerra. Yes sir.
    Mr. Allen. Good. Mr. Secretary thank you for joining us 
this morning and obviously my constituents are concerned with 
the cost of healthcare and certainly, some of the issues 
surrounding you know surprise medical billing and that sort of 
thing. My first question, and again, I don't you know I can't 
tell you where these numbers are coming from, but I'd like to 
know what your agency can give me that will tell me because Mr. 
Scott, Chairman Scott brought up the Philippines this morning 
versus the United States.
    And I understand we pay about 10 times per capita for 
healthcare in the United States versus other nations. Is that 
correct?
    Secretary Becerra. Congressman I can't say that it's 10 
times, but I know compared to the rest of the industrialized 
world America has the most expensive per person cost of 
healthcare. Other countries that provide quality healthcare to 
all their people whether it's Canada, France, Germany, Great 
Britain, they all do it for far less than we do.
    Mr. Allen. Yes, and that might explain why they're coming 
here for healthcare. Mr. Secretary, for each premium dollar in 
taxpayer dollars that is paid into Obamacare, what percent of a 
dollar gets back to take care of a patient?
    Secretary Becerra. All right so I'll get back to you on a 
precise number. If I recall correctly at least close to 80 
percent of any dollar that's spent must be, must go into actual 
care. I know I'm probably off on that number. I remember from 
my days in helping craft the Affordable Care Act back in 2009 
and 10 that we wanted to make sure that the lion's share of any 
dollar that an American consumer puts into healthcare would be 
spent on healthcare, not on marketing, not on profits, and so 
the lion's share of that dollar in the Affordable Care Act must 
be spent on care for that patient.
    Mr. Allen. Right and exactly right now it has to run 
through Washington to get back to take care of a patient, and 
that's what I want to know is exactly what Washington is taking 
out of that dollar. We have about 8 million jobs open in this 
country 10 million people are not working. Of those 10 million 
about 3 and a half million are on enhanced unemployment because 
of the American Rescue Plan.
    Mr. Secretary strong economic growth allows more workers to 
enjoy the benefit of health insurance provided by their 
employers. Do you agree that getting people back to work would 
help decrease the number of uninsured individuals in the United 
States?
    Secretary Becerra. Any time you have a job Congressman, as 
you know, if you're far more capable of affording the 
healthcare that your family needs, but to have a healthy 
economy we need a healthy America, and that's why it's so 
important that we continue to expand healthcare and get people 
back to work.
    If they can get everyone vaccinated, get everyone to be 
safe. I think what we're going to do is see a prosperous 
America moving forward.
    Mr. Allen. We've you know gotten about as I said, about 25 
million work capable Americans trapped on welfare and why does 
the Biden administration budget propose to continue COBRA 
subsidies and expand ACA subsidies which make it more appealing 
not to seek employment?
    Secretary Becerra. Congressman COBRA is a program that's 
been a lifeline for a lot of Americans who lose their job and 
as a result their health insurance attained with the job.
    Mr. Allen. I understand the purpose.
    Secretary Becerra. Well, it gives people a bridge until 
they're able to find other insurance, whether through their new 
employer, or through some other means, whether it's on the 
Affordable Care Act or elsewhere, and what you want to do is 
make sure that you don't have these gaps.
    COVID exposed the gaps that we have in our healthcare 
system. The result of this pandemic is that because of these 
gaps many Americans not only got sick but died. And what we 
want to do is keep Americans alive, and the best way to do that 
is to make sure they have access to good care from the start.
    Mr. Allen. Right. And we want to give those folks an 
incentive to go to work, and then I got two more quick 
questions because I'm about out of time. Do you agree or 
disagree that Americans staying out of the workforce is bad for 
their mental, physical, and economic health?
    Secretary Becerra. Well, certainly we want to make sure 
everyone is ready to go back to work mentally, physically, and 
we want to make sure it's safe, that they've been vaccinated, 
they're not going to infect others, and I don't know many 
Americans. My dad, I don't remember a day when my dad didn't 
work, even though often times he wouldn't be able to do the 
construction job he did because the rain, he always found work.
    And so, I think many Americans are out there looking for 
every good job they can, but let's make sure they're safe, and 
they're vaccinated, and ready to go back to work.,
    Mr. Allen. Well, I'm out of time, but the other question I 
had is surprise medical billing and where we are with that 
rule, and if you could cover that at some point in time in this 
hearing that would be much appreciated. Thank you very much and 
I yield back.,
    Chairman Scott. Thank you. The gentleman's time has 
expired, and I'm sure the surprise billing will come up. I'll 
make sure of that. The gentlelady from Oregon Ms. Bonamici?
    Ms. Bonamici. Thank you, Mr. Chairman. Secretary Becerra 
it's so great to see you, and I'm very grateful that President 
Biden selected you. Congratulations on your confirmation as our 
Secretary of Health and Human Services.
    There are so many important issues within HHS, but I want 
to focus on two because of time limits. The Older Americans Act 
of PBD Services block grant program. The last years have been 
particularly difficult for seniors as they disproportionately 
faced threats to their health and well-being.
    The President's budget proposes 1.1 billion dollars to 
strengthen critical programs for older adults under the Older 
Americans Act and the Elder Justice Act, and this includes 
significant fund for nutrition assistance, vaccination efforts, 
caregivers, so I proud to see the reauthorization of the Older 
Americans Act of 2016 and again in the last Congress, and I 
hope to make similar progress with the Elder Justice issues.
    So, these programs are extremely important to not only my 
constituents in northwest Oregon, but to everyone. In the early 
parts of the pandemic CMS issued guidance on visitation in 
long-term care facilities, and unfortunately there was some 
confusion about the ability of the State long-term care on this 
to maintain access to residents in a pandemic.
    So, in response when Congress passed the CARES Act, which 
included a provision I offered to clarify that the continued 
direct access of other access through the use of technology to 
residents of long-term care facilities for health emergencies. 
Now CMS eventually clarified your guidance, but I'm concerned 
with the early confusion they have denied resident's critical 
protections and oversight.
    So, I am hoping that CMS makes access to this vital 
program, these services for long-term care residents a priority 
going forward. So, what can your department do to make sure 
that these mostly voluntary but very important advocates have 
access to the support that they need to carry out their 
important work.
    Secretary Becerra. Congresswoman, thank you for the 
question, and thanks for pointing out how critical it is that 
we have accurate data, and that we're communicating it well 
because in a pandemic a minute could make the difference 
between someone getting too ill or surviving or not.
    And so, I think at CMS what we're going to try to do is 
recognize that we are the possessors of very valuable data. We 
try to work with our local communities as best we can. Please 
let us know if you think that we're not doing that, but we are 
learning as well. I think CMS learned many important lessons as 
a result of COVID, and how we can try to get information out 
faster.
    But I look forward to working with your team.
    Ms. Bonamici. Thank you, thank you, Mr. Secretary. The 
long-term care Ombudsman program is so important because it 
really provides a voice for residents of long-term care 
facilities. So, I Chair the Civil Rights and Human Services 
Subcommittee, and one of my top priorities this year is to 
advance the long overdue reauthorization of the community 
services block grant program. So, I'm working with Congressman 
G.T. Thompson toward a comprehensive update of CSBG.
    And I know others on the Committee, the public working with 
us to strengthen these vital anti-poverty programs, so I 
particularly just want to thank you for the support for CSBG, 
especially the Administration's budget, I understand since one 
of the few Presidential budgets to propose an increase in 
funding since the program began.
    The nation's community action agencies (or CAAs) are funded 
by the community service block grants, and they have served an 
essential role during the pandemic. So, the CARES Act invested 
a billion dollars to help CAA's standard services, and the 
legislation also raised the CSBG eligibility criteria 200 
percent above poverty line, which provided greater flexibility, 
and I support that increase.
    But what is your view on the role of community service 
block grants as an anti-poverty? Would you commit to working 
with us to provide communities with the flexibilities to 
provide updates to the program that can strengthen the 
abilities of the action agencies to better serve those in need?
    Secretary Becerra. Congresswoman, indispensable. You've 
described why these services are indispensable. Thank you for 
the support and the CARES Act to give us that extra funding. 
The President makes commitment to continue that forward, and if 
you are able to pass the American Families Plan, we can make 
truly generational changing investments in making sure we're 
taking care of our folks.
    Ms. Bonamici. Thank you. And again, the community service 
block grant program has been an essential anti-poverty program, 
and I look forward to working with you and the Administration 
and again committed to this bipartisan approach to make sure 
that we can continue the great work of our community action 
agencies, so thank you, Mr. Secretary, again it's wonderful to 
see you. Thank you for your work and I yield back. Thank you, 
Mr. Chairman.
    Chairman Scott. Thank you. Next is the gentleman from 
Kentucky, Mr. Comer.
    Mr. Comer. Thank you, Mr. Chairman, Secretary Becerra. I 
was able to lead a group of our colleagues on the House 
Oversight Committee down to our southern border in April, this 
to New Mexico and Texas. We spoke to border patrol agents in 
DHS facilities housing unaccompanied children.
    Since then, Vice President Harris is yet to see this crisis 
in person and is honestly blatantly avoiding the realities of 
the crisis situation we have at the southern border. Mr. 
Secretary, isn't it correct that under current law 
unaccompanied minor children who cross the border from 
countries other than Canada and Mexico, are turned over to the 
custody of HHS?
    Secretary Becerra. That's correct Congressman.
    Mr. Comer. Given the sheer number of children who have been 
coming in recent months, isn't it true that HHS stood up a 
dozen emergency intake sites to be able to care for the influx 
of children who were arriving?
    Secretary Becerra. Congressman, we did what we were 
obligated by law to do, and that is to care for these kids, and 
so if we couldn't find a State license facility where you 
typically would send a child for such care, we did what we 
needed to do, establishing, standing up as you said, some of 
these sites to be able to provide those care and the basic 
services that we expect for any child.
    Mr. Comer. And isn't it true as Politico was reporting that 
HHS reallocated 850 million dollars that Congress originally 
allocated to rebuild the Nation's strategic national stockpile 
of medical equipment?
    Secretary Becerra. Congressman we did use the dollars that 
are available to us within our budget to try to pay for these 
services. We could, you know we have a choice, either find the 
money to pay for these, or don't provide the services. By law 
we have to provide the services, and I think our moral 
conscious would tell us that we have to provide the services 
for these children as well.
    Mr. Comer. I know it's a crisis situation. Given the surges 
we've seen do you believe it was prudent for President Biden to 
reverse many Trump policies that were deterring minors from 
making the dangerous journey at the hands of smugglers into our 
country without any plans to replace those policies?
    Secretary Becerra. Congressman I won't weigh into the 
discussion of immigration policy other than to say the 
President made it very clear, whether it's your child, my 
child, or any other child is not going to face harm in this 
country.
    We can't decide the fate of that child. That child may end 
up having to return to the home country. That's an immigration 
process, but what I can tell you at HHS our obligations to make 
sure that while they're here, even if only temporarily, we're 
going to make sure they're cared for.
    Mr. Comer. I don't want any child in harm's way either but 
with all due respect Mr. Secretary, the Biden lack of border 
policy is inviting more and more unaccompanied migrants to make 
that dangerous journey, and I strongly encourage you to 
encourage the President, or the Vice President, if she's still 
in charge of border security, to come up with a plan and take 
this seriously so we can deter the record numbers of 
unaccompanied minors and illegals who will cross that border 
every day.
    Mr. Chairman I'd ask that the political article I 
referenced be entered into the record.
    Chairman Scott. Without objection.
    Mr. Comer. Switching gears Mr. Secretary, I'm also 
concerned with the Administration's waiver of patent 
protections for successful COVID vaccines. I'm afraid that as 
our country begins recovering, we are learning more about the 
lingering effects of COVID on public health. These waivers 
would mean this outlook for the development of boosters and set 
a dangerous precedent for future vaccine developments.
    Mr. Secretary, can you provide some insight into how we 
should prepare for future pandemics if we cannot ensure the 
Federal Government is not devaluing the R and D they worked so 
hard to recover?
    Secretary Becerra. All right, so thanks for the question. 
And as I mentioned in my opening statement, we are already in 
the works preparing for the next pandemic, or next healthcare 
crisis. We don't want to wait.
    We can take the lessons learned from COVID to help protect 
the American people, but I do want to caution that what the 
President said with regard to the TRIPS treaty that we have 
that deals with pharmaceuticals and how those can be 
distributed across the world, he made a commitment to work with 
the WTO to see if there was a way to make those vaccines 
available to the rest of the world quicker.
    He did not waive any authorities. Those are all part of any 
negotiation with regard to those treaties and the treatment of 
the patents and protections that those medications have.
    Mr. Comer. Thank you. Mr. Chair I just want to close with 
this one concern. I'm concerned regarding the inequities and 
the distribution of the provider relief fund. In my 
congressional district of Kentucky, assisted living providers 
who care for over 2,000 elderly individuals across 37 
communities.
    The population that was most vulnerable to COVID were 
allocated less than 1 percent of the provider relief fund, 
that's about 3 billion dollars, and have only received about a 
third of that. The average age of a resident in assisted living 
is 85. These vulnerable individuals need assistance with daily 
activities such as eating, using the restroom, taking 
medication, dressing, et cetera.
    Over 40 percent of assisted living.
    Chairman Scott. The gentleman's time has expired.
    Mr. Comer. Residents have Alzheimer's or some form of 
dementia due to PPE needs, workforce needs, and occupancy 
declines, assisted living, caregivers have suffered over 15 
billion dollars in losses in 2020.
    Chairman Scott. The gentleman's time has expired.
    Mr. Comer. And 230 million in Kentucky alone. I just wanted 
to throw that in there Mr. Chairman. Thank you for Mr. 
Secretary for being here, and I yield back.
    Chairman Scott. Thank you. The gentleman from California 
Mr. Takano.
    Mr. Takano. Thank you, Mr. Chairman. Good to see you Mr. 
Secretary. Congratulations. I'm going to go right into it. Mr. 
Secretary, I want to give you a moment to maybe share with the 
American people, how the President's budget included in the 
American Families Plan calls for an investment of 250 billion 
dollars for childcare expansion. And 200 billion dollars to 
provide high quality universal pre-care over 10 years. How that 
would provide relief to parents and ensure that children are 
cared for in environments that support their learning and 
development.
    Secretary Becerra. Congressman great to see you and thank 
you for the question. I think it's pretty obvious after COVID 
what happened in America when we found parents unable to find 
quality safe childcare for their kids. It disrupts the work 
efforts. It disrupts the child's education.
    I don't think any of us want to experience that again. 
We're still seeing the effects of COVID on families as they try 
to get back to normal. We have to start paying our caregivers 
decent salaries so that we can attract good people to care for 
our kids. It's kind of strange that we are willing to pay a 
scientist or a merchant a great deal of money, but the people 
who train these children to become that successful scientist or 
merchant, we're not willing to pay them good money.
    And so, I think we've learned the investment that the 
President wants to make is so that every child has access to 
decent childcare. We want to make sure every three-and 4-year-
old has access to pre-K. Those are the kinds of things that are 
good for America, not just for that family or that child.
    So, we look forward to working with you to passing the 
American Families Plan.
    Mr. Takano. I'll work with you. I commit to that sir. 
Secretary Professor Taryn Morrissey of American University has 
said that on average the early care and education settings 
attended by many young children, particularly low-income 
children, or children of color, provide quality at levels too 
low to adequately promote children's learning and development.
    How would the Administration proposals ensure that low-
income children of color are not left to low quality childcare 
options?
    Secretary Becerra. Well, as you know President Biden has 
made it a commitment. One of the principals of this 
Administration will be equity. And you cannot have equity if 
you're not giving kids access to good quality care regardless 
of where they live.
    Your zip code should not determine the quality of your 
care, and this Administration is committed, and I can tell you 
that not just as Secretary, but as who I am as a person and 
what I have fought for all my life, that, at HHS, we're going 
to make sure that if someone is going to get funding for 
childcare, we're going to make sure that they're held 
accountable to make sure it's good quality care for that child 
and that family.
    Mr. Takano. Thank you for that Mr. Secretary. Secretary, as 
you know, I Chair the Veteran Affairs Committee, and I'm happy 
to report that during the pandemic we had very low infection 
rates, and very low death rates due to the pandemic at our 
community living centers which are a long-term care facilities.
    Similarly, in California Secretary Imbasciani at Cal Vets 
saw that we had veterans homes in California that have 
virtually no infections compared to other settings across the 
country. And as you know 40 percent of our COVID facilities are 
attributed to congregate living centers.
    And I note that under the Trump administration there was a 
relaxation of regulation and oversight through CMS of the for-
profit facilities across our country. Do you intend to revisit 
the regulatory environment and the oversight environment of 
these facilities? And you know, most importantly the Trump 
administration amazingly you know relieved these facilities of 
their climate to retain infection control expertise. Do you 
have a comment on that?
    Secretary Becerra. Congressman, I may no longer be the 
Attorney General for the State of California, but I take with 
me much of the work that I did to the oversight and 
accountability to make sure that those who receive taxpayer 
dollars to provide services to the American people fulfill 
their commitment, and I can guarantee you, and I mentioned it 
in my opening statement, that program integrity is going to be 
one of the hallmarks of the work that we do to make sure that 
no one is taking advantage of taxpayer dollars, and that people 
receive the care that they're entitled to.
    Mr. Takano. Well, Mr. Secretary, I believe we need to 
really learn the lessons of the pandemic, and just how these 
facilities across the country long-term care facilities could 
see such devastating death rates and infection rates. I'll try 
and talk very quickly. I note that in the territories that 
there's a lack of portability for Medicaid benefits. Is that 
something that we can count on your help to address?
    Secretary Becerra. Congressman absolutely. I addressed that 
earlier, absolutely.
    Mr. Takano. All right. I yield back Mr. Chairman, I kept 
within my five minutes.
    Secretary Becerra. Thank you. Exactly. The gentleman from 
Idaho Mr. Fulcher?
    Mr. Fulcher. Thank you, Mr. Chairman. Mr. Secretary, thank 
you for spending some time with us today. I represent the great 
State of Idaho, and I would like to talk to you about enhanced 
short-term plans (or ESTPs), for a moment. Idaho's ESTPs have 
been a critical option for people in my State who may be 
changing jobs, in temporary employment, or starting a new job 
and awaiting health insurance.
    These plans are comprehensive covering the essential health 
benefits required under the Affordable Care Act. In many cases 
Idaho's ESTPs have higher actuarial values than those offered 
by the Affordable Care Act. Unlike the ACA plans, they can be 
offered anytime throughout the year and have up to a 3-year 
renewal.
    Finally, our State insurance codes consumer protections 
apply to all of our ESTPs. These plans are needed for people 
who don't qualify for an ACAAC subsidy. As people get back to 
work, they will need that kind of flexibility and health 
insurance. The alternative for them is to wait for coverage 
having none if something happens.
    Mr. Secretary, will you commit to working with our State 
officials to ensure there is a workable option with the ESTPs, 
given their success, and given the need to encourage people how 
to have formal access to health insurance as you view short-
term health plans?
    Secretary Becerra. Congressman, thank you for the question. 
This one's important because we want everyone to be able to 
afford their health insurance coverage. We want everyone to 
have comprehensive plans. You all passed legislation on 
surprise billing because often times people thought they had 
certain levels of coverage and found out when the bill came 
that they didn't.
    We don't want Americans to be duped. And so, what we want 
to make sure is that they get strong affordable coverage that 
they can afford, and I'm sorry that they know they can count 
on. And the ACA provides protections against junk plans that 
don't really provide real services that leave people in the 
lurch holding on to a very expensive bill.
    And so, any plan that can provide quality care guaranteed 
at a good price. we'll be supportive of.
    Mr. Fulcher. Including the enhanced short-term plans?
    Secretary Becerra. Well, if they provide those levels of 
coverage at a good price and don't shock people with bills that 
won't be covered by the insurance company, we are willing to 
look at that. So, what we don't want is for these junk plans to 
proliferate.
    Mr. Fulcher. So, then you will consider ESTPs as an option 
for those people who can't qualify for the subsidy?
    Secretary Becerra. We certainly will take a look at any 
plan that offers high standards for all Americans at affordable 
prices.
    Mr. Fulcher. We as families, certainly in my State. I'm 
sure this applies elsewhere. Many family Members, whether 
schoolteachers or other public servants face what we call the 
family glitch problem, where employees are covered for health 
insurance, but not their spouse or their family. And does HHS 
have a plan to address the cost of coverage for those families, 
and if they make too much to qualify for an ACA subsidy?
    Secretary Becerra. Congressman we are willing to work with 
you. As you know we're going to need Congress to come up with a 
solution for some of these issues because it's in statute, and 
so we are absolutely willing to work with you to make sure that 
everyone has access to that affordable coverage.
    Mr. Fulcher. OK. All right Thank you, Mr. Secretary. I'm 
going to shift gears to a different top really quick before my 
time is up. Secretary on April 15 of 2021, HHS proposed a rule 
change to Title 10 of the Public Health Service Act that would 
revise the family program regulations and require all 
recipients and Title 10 funds to counsel and refer women for 
abortions.
    Not only would this rule violate the conscious right of 
healthcare providers but will also undermine Title 10 which 
protects taxpayers from being forced to fund abortions. Mr. 
Secretary, what will your department do to ensure that it does 
not exceed its constitutional power by implementing broad and 
coercive mandates such as that?
    Secretary Becerra. Congressman, thank you for the question. 
This one's important because we want all our families to know 
they have access to good quality care, and Title 10 has been so 
important for families who need family planning services. We 
will, as I've always said, make sure that we give everyone, 
including women access to the kind of coverage they need. We 
will protect their rights for that, and we'll make sure that we 
follow the law as we do so.
    We believe that in the program that we have on Title 10, 
not only are we expanding access to care for mostly women, but 
families all together, we're going to do it in a way that 
conforms with the law.
    Mr. Fulcher. Mr. Secretary thank you for the answer. I'm 
just about out of time. But that rule change does violate the 
conscious right of our healthcare providers, and so, please 
consider that as you move forward. Mr. Chairman I yield back.
    Chairman Scott. Thank you. The next one I see is the 
gentleman from New Jersey, are you still on the screen Mr. 
Norcross? The gentlelady from Washington Ms. Jayapal?
    Ms. Jayapal. Thank you, Mr. Chairman and Secretary Becerra, 
it is so wonderful to see you here today, and to say that 
shortly after your visit to Seattle, we were so proud to become 
the first city, major city in the country to reach a 70 percent 
vaccination rate that's fully vaccinated.
    We're actually I think at 78 percent for first-round 
vaccinations, so, we're proud to lead the country, Mr. 
Secretary, it's because of the Administration, because of the 
American Rescue Plan, and we thank you. You know, I think that 
we are still seeing so many of the catastrophic effects of the 
COVID-19 pandemic, and I wanted to ask you about three specific 
things.
    One is about the global pandemic. In the American Rescue 
Plan, 6 billion dollars was allocated to Health and Human 
Services for COVID-19 vaccine development, manufacturing, 
distribution, and supply chains. Could you provide an account 
of how much of that money has been spent, and how much is left 
that we can immediately put toward really improving our 
domestic production investing 25 billion into production of 
vaccines that we can send to places around the world so we 
could combat this pandemic globally?
    Secretary Becerra. Congresswoman, first congratulations on 
the work that your city has done. It is phenomenal, and it was 
a great visit that we had, and I could see why you got to 70 
percent so quickly because I could see how well everyone was 
working together as a team.
    On the question of the dollars, and if I get these wrong, 
my team will make sure that we correct them, and so, let me 
just break down the 6 billion. 2 billion of the funding has 
been going to operations. Another 3 billion is being used for 
antivirals. Thanks as well to the American Rescue Plan.
    The President is working on the 10 billion dollars that 
were approved for domestic manufacture capabilities for PPE and 
pharmaceuticals, and we're going to be investing in this budget 
that we present 21 and a half million or so, in new funding for 
the resilient supply chain and shortages program.
    So, we're doing what we can to prepare. We're doing what we 
can to make sure that we recoup what we have to use, and we're 
going to try to be ready for anything coming at us in the 
future.
    Ms. Jayapal. Thank you, Mr. Secretary. So, you're saying 
there's nothing left of the 16 billion, is that correct?
    Secretary Becerra. Well, I don't know; and a lot of it has 
been earmarked. We probably still have some there and we could 
try to give you the precise numbers when we followup with 
everything if you'd like.
    Ms. Jayapal. Great. Well, you know I think we're trying to 
work very hard to make sure that we invest 25 billion into 
addressing and getting vaccines to countries around the world 
because as you know low-income countries have received just .4 
percent of vaccines, and we're not going to defeat this crisis 
unless we defeat it globally.
    In addition to the need for greater global vaccine access, 
COVID-19 has shown us why insuring healthcare for all is 
critical. Right now, there are critical improvements to 
Medicare that President Biden has committed to.
    Can you speak to the importance of lowering the Medicare 
eligibility age to 60, so that we include 23 million additional 
Americans, including nearly 2 million uninsured individuals, 
and improving Medicare benefits to include dental, vision and 
hearing, and will you work with us Mr. Secretary to make that a 
reality for Americans?
    Secretary Becerra. And before I give the answer to that, 
can I just add that the 580 million vaccines that President 
Biden has committed to the world, to the co-vac program, but 
globally to make sure they're out there. Those surplus vaccines 
that we can make available will help tremendously in our 
commitment to be a partner in trying to help the world get 
vaccinated, and that's part of our ongoing work.
    And we've been able to do that because we've been able to 
get so far along as you've mentioned with your city in 
vaccinating Americans. So those surplus vaccines will be made 
available to the world. In regard to the benefits of lowering 
the age of eligibility for Medicare, or expanding services like 
hearing, vision, dental to seniors on Medicare, let me tell you 
it's due. We need to move forward. The President is supportive. 
He'd like to support anything that you all do in Congress.
    There is a number of ways to get there. But what we're 
hoping to do is to continue the work that has increased the 
number of Americans who have affordable care, whether it's 
through the ACA, or its through Medicare, we want to see more 
Americans get covered until every American has that right to 
say I have access to healthcare.
    Ms. Jayapal. Fantastic. And I have just a few seconds left, 
but I do want to give you a chance to address the consequences 
of Donald Trump's zero humanity policy to separate children 
from their parents, which has a conspicuous silence from many 
of my Republican colleagues.
    3,900 children were separated by this policy, and we cannot 
yet reconfirm re-unification for 2,100 families. Secretary 
Becerra, just tell us how your Administration has been tackling 
this terrible problem created by the former Administration.
    Secretary Becerra. Congressman, I know the time is expired 
so I will be very brief and simply say I have three daughters. 
Don't let anyone try to separate me from my daughters. I think 
every parent thinks the same way. We must think of that just 
with our own personal children, but with all the children that 
we have in this country.
    And we're going to do everything we can at least under this 
Administration to keep families together, not to break them 
apart.
    Ms. Jayapal. Thank you, Secretary. I wish we could hear 
more from you because you've done so much, but I'm respecting 
that my time has expired Mr. Chairman thank you.
    Chairman Scott. Thank you. The gentleman from Indiana Mr. 
Banks.
    Mr. Banks. Thank you, Mr. Chairman. Mr. Secretary I'm 
deeply concerned. I can't hear, can you hear me now. OK. I 
don't know what I'm doing wrong. Mr. Chairman I'll have to 
pass.
    Chairman Scott. We'll come back to you. The gentleman from 
Pennsylvania Mr. Keller.
    Mr. Keller. Thank you, Mr. Chairman, and I would like to 
thank the Secretary for being here today. Retroactive and 
direct, and indirect renumeration or DR fees are a huge problem 
for community pharmacies across north center and northeastern 
Pennsylvania.
    These fees are applied by pharmacy benefit managers on 
community pharmacies after the point of sale, sometimes months 
afterwards. It's hard to think of another industry that deals 
with such unfair treatment. According to the Fiscal Year 2022 
budget justification, DR fees increased by more than 91,500 
percent between 2010 and 2019.
    Earlier data showed that DR fees grew by 45,000 percent 
between 2010 and 2017, meaning this increase more than doubled 
between 2017 and 2019. According to the National Community 
Pharmacy Association the average community pharmacy pays more 
than 80,000 per year in DR fees. This is simply unsustainable 
and unacceptable.
    Mr. Secretary, DR fees are clearly creating problems, 
driving pharmacies out of business, and increasing drug costs 
for those who rely on prescription drugs, particularly seniors. 
Do you support action to prevent pharmacy benefit managers from 
imposing such crippling retroactive fees on community 
pharmacies?
    Secretary Becerra. Congressman you've touched on something 
that is part of this dilemma that we have with pharmaceutical 
costs, the costs of prescription medication. And the reason why 
I think so many of us, and I know you probably as well, want to 
get to a solution that reduces the cost.
    I am willing to work with you to try to see what we can 
address in these areas, but I will tell you that I think some 
of the solutions are going to have to come from Congress 
because much of the dilemma that you're raising is a statutory 
problem that you face.
    But we're willing to work with you, provide the technical 
assistance because what we cannot do is find that the person 
who loses at the end of the day because of those difficulties, 
bureaucratic or otherwise, are consumers who need those drugs.
    Mr. Keller. And a long time our senior citizens with their 
Medicare. In 2018, HHS and CMS included DIR reform language in 
a proposed rule, but ultimately it was not included in the 
final rule. Would you support reviving that proposed rule?
    Secretary Becerra. Congressman I commit to work with you 
and our team at CMS to review that again and see where we can 
go.
    Mr. Keller. Yes, but the rule we're talking about was HHS 
and CMS, so if this is rulemaking, and we can do something that 
is quicker in Congress, would you willing to take a look at 
that and do that?
    Secretary Becerra. Absolutely committed to taking a look at 
that, and we could stay in touch and your team could followup 
with our folks at CMS and here at HHS.
    Mr. Keller. We'll most definitely do that. The DIR Reform 
to Reduce Senior Drug Costs Act will require that price 
concessions be included in the negotiated price at the point of 
sale to a Medicare beneficiary. This would obviously require 
HHS involvement to be implemented.
    How do you feel the implementation of ideas like this might 
be at the agency level?
    Secretary Becerra. So, there we will do what we do with all 
of these proposals where we have to do regulation. We'll take a 
thorough look, a deep dive into them. What we'll do is input 
out any proposed regulation out for comment by you, by 
stakeholders, by the public, get the feedback, and then if we 
think we have something that's been pretty well baked, then 
we'll put it out there and roll it out and hopefully it can 
take effect, but we'd have to first work with you and 
stakeholders in the community to make sure that this is an idea 
that actually has good legs.
    Mr. Keller. We need to make sure that we look at the cost 
of prescriptions drugs because the increases are negatively 
impacting not just the pharmacies that have to pay these DIR 
fees, but also the constituents with access to them.
    Secretary Becerra. Absolutely agree.
    Mr. Keller. As you see it how can Congress and the 
Department of Health and Human Services work together to find 
additional solutions to this issue?
    Secretary Becerra. We're ready to provide whatever 
technical assistance you might have if you all propose 
legislation to deal with this. We are prepared to work with you 
if there's some regs that you all think we should be proposing. 
We'll work with you as we get ready to promulgate them.
    So, what we could do is put them on the ground as quickly 
as possible and let them go live.
    Mr. Keller. I appreciate the willingness to be able to work 
with the department on finding solutions to these problems that 
are affecting so many of all of our constituents, and really 
get at the root cause. We need to get at the root cause why 
these costs are happening and help our constituents with access 
because we want to make sure that our pharmacies succeed, so 
that our constituents can have the choice and the access to the 
necessary drugs, so I do appreciate this, you know, the 
prescription medicines are so important to many people's well-
being. So, thank you and I yield back.
    Secretary Becerra. Thank you.
    Chairman Scott. Thank you. The gentlelady from North 
Carolina, Ms. Adams.
    Ms. Adams. Thank you, Mr. Chairman. Thank you, Ranking 
Member, Secretary Becerra, thank you for your time today, 
particularly given since you've testified thrice last week. You 
explained various priorities in your opening highlighting all 
America's workforce continuing to face challenging 
circumstances.
    For instance, the pandemic has brought severe impacts on 
essential workers, particularly women of color in America. The 
COVID-19 vaccine workforce, vaccination workforce, has been 
expanded through the PREP Act, and efforts across North 
Carolina to donate freezers for the storage of vaccines.
    Let me ask you although the CDC's budget was increased by 
21 percent, the National Institute of Occupational Safety and 
Health was level funding for 2022, and NIOSH is the only agency 
in government with occupational health and safety research. And 
during a prior Workforce Protection Subcommittee, we learned 
that there was literally no workplace tracking of the COVID 
outbreaks during the pandemic.
    So, what does this suggest about the priority that the 
Administration is placing on the worker's health and safety 
inside CDC?
    Secretary Becerra. Congresswoman, first great to see you 
again and looking forward to working with you closely on this 
and other issues, but I can tell you, if you want to help us 
with this budget, getting it the largest increase in funding in 
two decades, we will make sure that we're investing in all the 
research that has to happen.
    NIOSH remember, does the research side of this. We don't do 
OSHA's side which is the actual enforcement side that's done 
through the Department of Labor, but I commit to you that we're 
not going to let any research lapse or go undone that helps us 
understand how we better protect our workforce because we saw 
what happens when we don't protect those essential workers, 
many of whom are people of color.
    Ms. Adams. Absolutely. Expectant mothers who experience 
discrimination in medical settings, have limited awareness 
about other maternal healthcare providers included in their 
health plans provider network. So how can HHS increase patient 
access to appropriate in-network providers?
    Secretary Becerra. Congresswoman, thank you for asking 
this, and my wife thanks you as a high-risk OB-GYN thanks you 
for not just asking it, but for being a fighter on this issue. 
Listen it is incredible to believe that in this country the 
richest nation, the democracy in the world, we have some of the 
worst outcomes for women when it comes to being pregnant. And 
the maternal mortality rate for some in our country, especially 
for women of color it's devastating.
    And so, President Biden made a commitment, and we're going 
to have resources here that tackle this to provide women with 
better care to avoid that mortality that might occur, the bad 
morbidity results, and by the way we're challenging states to 
accept an increase in Medicaid funding so that we can keep a 
woman receiving postpartum care, not just for 60 days, but for 
a full year.
    And what we hope is that the states will take us up on that 
job, while we're paying for most of it, so that women can 
continue to receive the care they need after delivery.
    Ms. Adams. Well, increasing workforce diversity in the 
field of maternal health requires additional support for 
allies, health professionals which includes lactation 
consultants, nutritionists, dieticians, laboratory sciences, 
mental health counselors, and speech language pathologists.
    So how will the Fiscal Year 202022 budget expand job 
opportunities for these critical healthcare providers who are 
underrepresented in the maternal health sector?
    Secretary Becerra. Congresswoman if you all help us with 
our budget and passing the American Families Plan, we will have 
an additional 3 billion dollars that we'll be able to make 
available to improve maternal health. We have a 200-million-
dollar program called the Maternal Mortality Review Committee's 
program where we help those at the local level know where they 
have to put the resources to help women have good outcomes and 
stay healthy.
    And so, there are a number of ideas that we're working on, 
but we're going to need your help to make sure this budget gets 
through.
    Ms. Adams. Great, great, thank you so much. You have my 
support. Thank you for all the great work that you're doing. 
Mr. Chairman I yield back.
    Chairman Scott. Thank you. It looks like Mr. Banks is 
available now, the gentleman from Indiana Mr. Banks.
    Mr. Banks. Yes Mr. Chairman we'll try this again.
    Chairman Scott. Good, very well, very well.
    Mr. Banks. Mr. Secretary your budget proposal is the first 
budget proposal in 45 years that doesn't include the Hyde 
Amendment and Hyde Amendment protections preventing taxpayer 
funds to go toward paying for abortions. If that's true, if 
that is the case as it appears to be, that would make your and 
the Biden administration the most pro-abortion Administration 
in the history of this country.
    So, what I want to know right now, and I wonder if you 
would commit to is if you will commit to never directing 
taxpayer funds to go toward funding partial birth abortion.
    Secretary Becerra. Congressman what I can try to make sure 
I do is guarantee to you that we're going to follow the law, 
and as I just finished saying to Congresswoman Adams, we want 
to make sure we're helping women be healthy and stay healthy if 
they're going through pregnancy.
    Mr. Banks. Mr. Secretary can we expect you to commit to not 
funneling money toward paying for partial birth abortions, it's 
a simple question.
    Secretary Becerra. We will not send money anywhere we're 
not allowed to by law Congressman. We will make sure that we 
enforce the law and provide the health protections and services 
that Americans are entitled to, including women.
    Mr. Banks. Mr. Secretary I'll ask you again, will you 
commit to not sending our taxpayer dollars to go toward funding 
partial birth abortion?
    Secretary Becerra. Congressman, you're asking a question 
and what I must say to you is that there are scores of low-
income women in America who are not receiving the care that 
they need and are entitled to. We're going to make sure that we 
leave no one behind, but we're going to do that by following 
the law, and so if you're a woman in America we want to make 
sure you have access to reproductive services that you're 
entitled to under the law.
    Mr. Banks. Mr. Secretary, the HHS Office for Civil Rights 
contains a conscience and religious freedom division that 
enforces nearly two dozen Federal laws protecting conscience in 
healthcare and human services, including protections against 
coerced participation in abortion and assisted suicide. That 
division is currently being overseen by a political appointee 
named Laura Durso, with a long history of--left-wing activism. 
Here is a sampling of some of the outrageous things that Laura 
Durso has publicly said about the conscience and religious 
freedom division.
    In a tweet she said the division, `Sends shivers down my 
spine.' And that, `Any policies that come from it will only 
enable discrimination and pain.' In an interview she called for 
a nation of the division, `Insulting at best.' And falsely said 
that the division only represents, `Christian beliefs,' and is 
`Trying to impose them on the country, and that they don't care 
about the vulnerable, and shield people who object to 
transgender people even existing.'
    In the same interview she enthusiastically agreed with the 
host who said that the division was, `An office that makes 
people feel like crap, and is the most immoral thing that we 
can think of.'
    Finally, in another tweet she said that the work of the 
division was like those who `stood with rapists over 
survivors.' Mr. Secretary, do you disavow any of these 
outrageous statements and attacks on career professionals of 
the division made by Ms. Durso?
    Secretary Becerra. Congressman, you're presenting me 
something that I've never seen, and I can certainly take a look 
at that, but what I will tell you is that each and every person 
in the Department of Health and Human Services, especially in 
the Office of Civil Rights has an obligation to protect the 
constitutional civil rights of all Americans, and we're going 
to do that.
    We're going to make sure.
    Mr. Banks. Mr. Secretary will you commit to removing a 
biased ideologue like Ms. Durso from any decisionmaking 
relating to the conscious and religious freedom division since 
she obviously has a bias against what the division does?
    Secretary Becerra. So, Congressman, I look forward to 
working with you to take a look at some of these issues. You're 
presenting me something I have not heard of and having been an 
Attorney General for the State of California, I don't proceed 
based on something that I'm not aware of.
    We're going to make sure everyone in our department does 
the work that's required, and I guarantee you that the people 
that are right now at the Office of Civil Rights understand 
their obligations to protect the people's civil and 
constitutional rights, including their conscience rights, 
religious freedom rights, and I think that everybody in our 
division at civil rights, and within our department does 
exactly that.
    And if there isn't someone who does that, we'll get to the 
bottom of it.
    Mr. Banks. Thank you. I yield back.
    Chairman Scott. Thank you. Next is the gentleman from New 
York, Mr. Morelle.
    Mr. Morelle. Thank you very much Mr. Chairman for holding 
this important hearing, and Mr. Secretary thank you for your 
service and for being here this morning. Mr. Secretary I do 
want to come back to the question of surprise billing. I was 
one of a number of Members very active in congressional efforts 
to pass the surprise medical billing legislation.
    And as the Administration proceeds with implementing the 
law, I believe it's paramount that public comment be under 
consideration during the rulemaking process. And I understand 
the first rule, as I understand OMB is looking at their own 
review of the No Surprise Act, as your department works on 
implementing.
    I urge you first of all to remember congressional intent. 
I'm sure that's something you're going to do. I want to make 
sure that we have an independent dispute resolution process 
that captures the unique circumstance of each billing dispute, 
and not honing in on a single piece of information or use that 
as a default which the law did not foresee.
    But in addition, there has been some concern that the rules 
pertaining to the law will proceed through an expedited 
rulemaking process as opposed to a standard rulemaking process 
which allows ample public comment. Can you give us some 
assurance that you will actually work on the standard 
rulemaking that includes public comment?
    Secretary Becerra. All right, so we're committed to 
transparency when we do these rules. That's something that I 
said during my confirmation hearings. I've said it during this 
testimony on our budget, that transparency is critical as we 
try to move through some of these rules, but we're going to 
work as quickly as we can because we understand how important 
the surprise billing law is, not just to you all, but to 
Americans, so we'll be there to work on it, and we're going to 
make sure at the end of the day regardless of where the regs 
come down, that a patient is no longer on the hook for that 
surprise bill.
    Mr. Morelle. Yes. So just to be clear does that mean that 
you intend to use a standard rulemaking with public comment?
    Secretary Becerra. I'll have to make sure I go back to CMS 
to find out exactly where they are, and I know we've already 
moved some of the proposal rules through the process here, and 
I'll get back to you on that.
    Mr. Morelle. OK. That would be great I'd appreciate it. I 
just wanted to shift for a moment to a question about long-term 
sustainability of Medicare. I grow increasingly concerned about 
the number of people particularly my age who are part of the 
baby boomer generation aging into the Medicare program.
    Early years when people enter Medicare, they tend to be 
lower in utilization, health relatively good. As they begin to 
age utilization goes up, costs go up. And it seems to be 10-15 
years from now baby boomers will not only represent a 
significant number of people in the company on Medicare, 
probably the greatest number that we've ever had, that will 
also be at the point where utilization is higher.
    At the same time if you pair that with some of the labor 
shortages, and some of the demographics, there will be fewer 
people in the workforce paying into the Medicare through their 
participation in the Medicare rates as it relates to being paid 
through wages.
    So, I wonder if you could just share with me what HHS is 
looking at or thinking about relative to the long-term 
sustainability of Medicare?
    Secretary Becerra. Congressman, great question, and I'll 
look forward to working with you all because the long-term 
sustainability of Medicare will be dependent on Congress 
passing something with the support of the Administration. And 
there are a number of long-term solutions.
    What I will tell you is this: No one wants to see us damage 
what Medicare has meant for tens of millions of seniors who 
paid into the system as you just mentioned. It has a been a 
lifesaving program for so many Americans before 1965-67, when 
Lyndon Baines Johnson helped pass Medicare.
    There were too many seniors who were living in poverty, so 
we're going to make sure that we work with you toward solvency. 
That will be something we can tackle. There are any number of 
great ideas, and what we can do is also make sure we expand 
coverage under Medicare for more Americans who are reaching 
their senior years.
    Mr. Morelle. Well, I do appreciate it, and I would love to 
work with your team on some innovative ideas around that. 
Quickly, and I know I'm running out of time, and I don't want 
to impose. The 340B Drug Pricing Program allows hospitals, 
including the 100 hospitals in my State of New York, that 
allows them to purchase outpatient pharmaceuticals from drug 
companies at a discounted rate.
    And they use those to provide greater access to needed 
drugs and more comprehensive services. Last year I led a letter 
signed by the entire New York delegation, bipartisan based, 
asking for flexibility for these hospitals during the pandemic.
    I don't know that that issue has been resolved, and I don't 
believe it's too late, and so can we have your commitment to 
work with HHS to leverage its authority to protect the 340B 
program, including using the 1135 waiver authority to 
temporarily waive the Medicare disproportionate share?
    Secretary Becerra. We look forward to working with you 
Congressman.
    Mr. Morelle. Terrific. Thank you so much. Mr. Chairman I 
yield back.
    Chairman Scott. Thank you. The gentleman from Wisconsin, 
Mr. Grothman.
    Mr. Grothman. Thank you. Just a few questions. In your 
testimony you talked about how it would be a priority, or at 
least you wanted to do something to stop sexual abuse, gun 
violence, racial inequities, drug abuse. I know we recently hit 
a point in which 90,000 people in a 12-month period died of 
illegal drug overdose.
    When I read about all these topics, and of course we've had 
hearings here for this when I was in the State legislature on 
all of these topics, whenever we deal with these topics, I 
think part of the issue in the background is value structure. 
There are absolutely wonderful children raised by families and 
wonderful people in all family structure.
    Nevertheless, there's sometimes are correlations. Would you 
in addressing these issues, be willing to look at family 
structure, or see if there are correlations there that ought to 
be publicized.
    Secretary Becerra. Congressman, we have too many of our 
kids dying of these substance use disorders. I'm willing to 
look at anything with you and others that we think helps us get 
to a solution to keep our families alive.
    Mr. Grothman. If we gather information and we find out that 
some family structures are more beneficial than others, would 
you be willing to publicize that?
    Secretary Becerra. We're willing to look into anything 
Congressman that helps keep our families alive.
    Mr. Grothman. OK. Next question. I have a bill out there in 
which we're trying to legalize by assemblers as insulin 
substitutes. Obviously, I'm being fought by the drug companies 
that gets me to the hundreds of thousands of families who are 
right now having to pay for insulin. Depending upon the quality 
of their insurance some get off relatively cheaper, but some 
are paying you know $800.00 or $900.00 a month. Would you be 
willing to champion the legalization by assemblers in order to 
result in a cheaper substitute to insulin products?
    Secretary Becerra. Congressman, I think everyone agrees 
that the price of insulin is just outrageous the way it's gone 
up, and we have to do something.
    Mr. Grothman. No. The question for you is because I know 
some companies are making money on the current system, and I'm 
going to need a champion to get this thing through, would you 
be willing to meet with me, or other representatives of the 
bio's similar group, and if it can be shown it would probably 
reduce costs for these families, would you be willing to take 
on Congress and push a bill like that through?
    Secretary Becerra. I've got my team here. They've taken 
notes. So, we'll look forward to hearing from, or we'll be in 
touch with you to followup.
    Mr. Grothman. OK. Well, I hope you have the guts to stand 
up to the special interests. Next question I have for you, you 
know inflation is just out of control. We see it on so many 
different commodities right now, and you're proposing a 23.5 
percent increase in discretionary spending for HHS.
    Even apart from the pandemic, Congress has not exactly been 
frugal over the last 3 years, right? But you're proposing a 
massive increase one more time. Could you comment on that, and 
does it ever concern you when you propose these big increases? 
And your department is one of the biggest of the bunch, that it 
can lead to inflation and permanently damage America 
economically?
    Secretary Becerra. Thanks Congressman, and a very important 
question, something that the President is also having to 
tackle. And that is what we hope we can do is make sure that 
we're making investments through this budget, not just spending 
dollars because they have to be wise allocations.
    We are seeing now, the recovery from COVID because we made 
the right investments. We are beginning to see more Americans 
get health insurance coverage because we made the right 
investments in the Affordable Care Act.
    And we're going to continue to try and do that, whether 
it's on childcare because we see how many families are in 
desperate need of good childcare, or whether it's trying to 
protect the life of a woman as she's getting ready to deliver a 
baby by providing better maternal healthcare.
    These are all good in investments that will ultimately save 
us money versus just being an expenditure that goes without 
notice.
    Mr. Grothman. Well, I think there are a lot of lines in the 
budget when you go for 24 percent of good RBI investments, and 
I would argue that during the entire massive increase in the 
Federal Government, most people claim Federal Government is 
spending this really because investments in our approaching the 
30 trillion-dollar deficit. Is there anywhere in that budget 
that you feel 23.5 percent was a tight budget? That's the 
lowest increase you can get away with?
    Secretary Becerra. Congressman, we're trying to get out of 
this hole created by COVID. It's not done free. And but I'm 
willing to work with you if you think as I mentioned in my 
opening testimony, we're going to be very aggressive when it 
comes to program integrity, making sure we root out any 
misspending, any fraud, and so look forward to working with 
you.
    You can point out a program to me that you believe is not 
being well run or is making a good investment. I'm more than 
willing to look at it.
    Mr. Grothman. Thank you very much.
    Chairman Scott. Thank you. The gentlelady from Pennsylvania 
Ms. Wild.
    Ms. Wild. Thank you, Mr. Chairman, and Thank you, Mr. 
Secretary for being with us today. I want to personally thank 
you, in addition to all of the ways you've served this country, 
to thank you for your commitment to mental health matters which 
dates back to the very earliest days of your career I know.
    And before I get to my question, I just want to take an 
opportunity to remind folks out there who are watching, that 
there are many resources available for people who are in 
distress, or contemplating suicide. The National Suicide 
Prevention Hotline is currently always available at 800-273-
8255.
    And I really look forward to the implementation of 9-8-8 as 
the new suicide prevention hotline in July 2022. I know it's 
been an indescribably difficult year for people in my community 
and across the country this past year. And our kids are 
hurting, people are hurting.
    A new study just confirmed that suicide attempts among 
girls have increased dramatically with emergency rooms now 
reporting 39 percent more suicide attempts for girls aged 12 to 
17 in the winter of 2021, compared to 2019. Your department is 
a very important piece of the suicide prevention safety net, 
but it's only one piece.
    Some partners who we would expect to be helping are our 
large companies, including YouTube. You will see behind me this 
rather large poster of a YouTube that is a screenshot from 
YouTube that we took that represents believe it or not, in the 
beginning of a video on how to tie a noose.
    And we've been in contact with YouTube. I've been pushing 
them for months to step up their suicide prevention work and 
finally remove instructional videos on how to tie a noose. I 
hope you can see it; it says how to tie a noose. These affects 
to the perfect hangman's noose. It's got 3.1 million views and 
then it goes on multiple pages of how to perfect a noose 
imagine that.
    We need to meet and find people where they are, and all too 
often our young people are for better or worse, looking for 
answers on places like YouTube. Secretary Becerra, my question 
to you is are you willing to work with me to convene a meeting 
with YouTube and experts in suicide prevention to get this 
addressed?
    Secretary Becerra. Congressman, first thank you for the 
work that you're doing on this crucial subject because I mean 
it's tough to lose any life, but a young life worse. And so, I 
would look forward to working with you and your staff any ways 
that you think we can try to address this suicide issue with 
teems, and just with the mental health issues that we know are 
cropping up as a result of COVID-19, so please count us in any 
of the efforts you're looking to undertake to help address 
this.
    We have resources. Thank you by the way for what you did 
with the American Rescue Plan. We're going to do what we can, 
and we look forward to working with you.
    Ms. Wild. Thank you so much and believe me, we will be 
reaching out. We've made some progress with YouTube, but not 
nearly enough, and I think it's going to take the weight of 
your office to get us to where we need to be with them.
    Now I want to just take a step back in my remaining time 
and ask you do you believe that your department has sufficient 
resources to prioritize suicide prevention? What's been 
promising? What needs scaling up? And how can we help here in 
Congress?
    Secretary Becerra. Well, that's a mouthful of a question 
Congressman because we actually have more resources now than we 
have had in quite some time because of the work you did on the 
American Rescue Plan. If you help us get that American Families 
Plan that the President has proposed through, we'll have more 
resources as well.
    But as you know, we've been so far behind. Even on 9-8-8, 
the resources that we have that we're putting into it. This has 
to be a nationwide effort, and it's going to be tough to scale 
up to make sure that 9-8-8 is available to anyone who needs to 
call. And so, it's great that we have more resources.
    Going back to the previous conversation I had with the 
Congressman about how we're investing our money, and can we do 
with less? You know we don't have enough right now, and you 
know this, to deal with the mental health issues that we're 
confronting, the substance abuse disorder issues that we're 
confronting.
    We need those dollars, and the budget reflects the 
President's commitment to invest to keep Americans safe and 
healthy.
    Ms. Wild. Thank you so much Mr. Secretary. I look forward 
to working with you on this very important issue, and I do 
believe it should be a bipartisan priority, so thank you.
    Chairman Scott. Thank you. Next Mr. Secretary our next 
questioner is a surgeon from North Carolina, Dr. Murphy.
    Mr. Murphy. Thank you, Mr. Chairman, and Thank you, Mr. 
Secretary for appearing before the Committee. I'm going to 
start a theme that others have spoken about. I'm a physician, 
we've done a great job of vaccinating. We're now meeting in the 
chambers without masks. This particular venue on how to conduct 
Committee business, and I know it's going on in other 
Committees too is simply ridiculous, and it's not doing the 
work of the people appropriately.
    So, I am hopeful that we'll actually get back to seeing 
people in person and doing the work in the manner that we 
should do that's most effective. Mr. Secretary, the use of 
telehealth I will tell you, I worked on telehealth for quite a 
while when I was working in our state's general assembly, and 
unfortunately got blocked by a lot of insurance companies.
    And one of the great things that the Trump administration 
did was release the regulations on telehealth. It makes a 
difference to practice. I actually still practice in a very 
rural part of eastern North Carolina, and telehealth has made a 
game changing difference of people being able to access 
healthcare.
    I'd just like to ask for your support in making the 
telehealth accepted by benefit permanent, so I'd like you to 
comment just on that, that you'll continue what was a silver 
lining in this pandemic and allow the American people to be 
able to access telehealth.
    Secretary Becerra. Congressman thanks for the question. 
Crucial. We learned a lot from COVID. Telehealth has been 
indispensable. Look forward to working with you. We'll do what 
we can through regulations with the discretion we have, but 
we'll probably need your help to make sure we can fully 
implement moving forward, the new opportunities that telehealth 
is making available.
    We have to make sure as well that we provide broadband to 
all communities so that no one is left out but look forward to 
working with you because Congress and the Administration can 
make a great deal of moving forward on telehealth.
    Mr. Murphy. Great, great. Also, Bobby noted that I'm a 
surgeon. I'm a urologist. I deal with diseases in the male and 
female genital urinary tract, so I've done a lot with fertility 
and those types of things.
    And so, I still to be very honest with you, I have to 
scratch my head, and I'm losing more hair as we go about this 
mother/father thing. Can you give me an instance where I should 
call someone a birthing person who is not a mother? In other 
words, should I now call my mom my birthing person? What is 
this nonsense?
    Give me an instance where this is appropriate.
    Secretary Becerra. Congressman, thanks for letting me 
respond. And you know I'm not going to make a mountain out of a 
mole hill. What we're talking about is making sure we use 
language that's inclusive, that is accurate, and if you wish to 
call your mom, mom as I call my mom, mom, go right to it.
    But for some people they like to make sure that they are 
accurately represented when we refer to them. And we just want 
to be inclusive, that's all it is. People can make more of it, 
but there's nothing more. You can send your Mother's Day card 
to your mother as I send to my mother, nothing changes
    Mr. Murphy. Yes, I just don't get it. I know a lot of 
genealogy. I work with X and Y chromosomes and all these other 
things. I just don't understand that. I mean what should I call 
my dad?
    Secretary Becerra. Well, let me put it to you this way. 
There was a time when my dad saw language that said, ``No dogs 
or Mexicans allowed.'' And so, he couldn't walk into an 
establishment when he was a young man, even though he was a 
U.S. citizen.
    Words have meaning and we try to be accurate, and we want 
to be sure just as we allow anyone to walk into an 
establishment, we want people to understand that when we talk 
about a program, it refers to everybody, and if you prefer to 
be referred to as a birthing individual, so be it. We're not 
harming anybody.
    Mr. Murphy. Yes, well, all right thank you. That baffles 
me. It just makes no sense to me. It's been 84 days since Vice 
President Kamala Harris was appointed as the border czar. 84 
days and she's not visited the border. Do you brief her on 
what's going on at the border, or have you asked her to visit 
the border?
    Secretary Becerra. We are fortunate to have an opportunity 
to brief the Administration, the White House, the President, 
and the Vice President periodically. Certainly, on the affairs 
that deal with Health and Human Services. And we know that the 
President and the Vice President are very engaged on this.
    The Vice President just came back from a trip to Central 
America and Mexico where she was trying to help us address 
these immigration challenges, and I know that they are on a 
day-to-day basis receiving briefings, not just from us, but 
from the Department of Homeland Security and others when it 
comes to these issues involving immigration.
    Mr. Murphy. All right. Let me just throw one other thing. 
We were just talking about overdoses and drugs as subjects that 
are very dear to my heart. I worked a lot on the opioid 
epidemic. Because of the crisis that the Biden and Harris 
Administration has created with the flood of drugs, illicit 
drugs are now coming into our border, how do you see us being 
able to push that backward, since we're going to see a massive 
increase in the number of overdoses?
    Secretary Becerra. Congressman, first it's not going to 
surprise you that I don't agree with either characterization, 
and two, I think this Administration is doing more to keep 
drugs out of the hands of individuals, and for those who 
already are drug addicted, to try to help them recover.
    And so, I hope that we're able to with your support 
continue in that course.
    Mr. Murphy. Thank you, Mr. Chairman I'll yield back.
    Chairman Scott. Thank you. The gentlelady from Georgia Mrs. 
McBath.
    Mrs. McBath. Thank you, Mr. Chairman for convening this 
hearing today, and thank you so much Secretary Becerra for your 
continued service to our country, and just your commitment is 
just definitely without reason. We definitely know that you 
truly care about the health and welfare of Americans.
    But during this pandemic you know with many families 
sheltering at home, you know we've seen an unfortunate rise in 
cases of domestic and family violence. It's now time more than 
ever I believe to really work on securing the funding for 
protecting these survivors and their children.
    I've seen too many families in my own home State of Georgia 
which I represent. They're suffering at the hands of domestic 
and family violence. And I just know we've got to protect these 
families and families all across the Nation. That's why I'm 
proud to have reintroduced the bipartisan legislation that 
reauthorizes and expands the necessary funding of programs 
focused on helping survivors of domestic and family violence, 
FIPSA, and this legislation we know would provide survivors the 
resources that they need to rebuild again, and to keep their 
children safe, and mind you this was legislation that was even 
before I came to Congress in 2018.
    But as you know the Committee recently held a hearing on 
FIPSA and is currently working on tweaking the reauthorizing of 
this legislation. And we're also providing, you know we've also 
provided 450 million in the emergency supplemental fund and in 
the American Rescue Plan to support the survivors of intimate 
partner violence, especially under COVID-19.
    But Secretary Becerra, can you provide an update for us on 
the distribution of these American Rescue Plan Act funds to 
communities, and also are people getting the help that's been 
mandated by this legislation that we passed?
    Secretary Becerra. Congresswoman, thank you for the 
question. Can I just say thank you Congresswoman McBath for 
your commitment to this, and you're just tenacious dogged 
persistence on this because it is worse than people think. We 
just don't see it because it's taking place at home, right?
    And so, thank you for protecting those family Members who 
are victims of some of the worst violence we can ever 
experience, and having it done by someone you thought you 
loved, or loves you. We are making a commitment to try to spend 
that money locally the way the locals believe it could best be 
spent, and so the more than 200 million dollars that we put 
into FIPSA in this budget would help locals make those 
decisions building on what we've learned since COVID.
    At the same time, you're probably familiar with the program 
that we're calling for under CDC, the community-based violence 
intervention initiative. That's to help prevent these things 
from ever occurring. And so, working with champions like you 
and folks back home who understand this issue, what we hope is 
that we can make a dent in this and make a big difference in 
the lives of some of these family Members, and get them the 
help they need to prevent it from occurring.
    The most important thing is to keep family units together 
as possible, one way or the other, protect Members in a family.
    Mrs. McBath. Right. Well, thank you for that. You know as 
we're moving forward with this reauthorization, and as you said 
absolutely, I am doggedly pursuing this because I've been 
watching under COVID just the percentages and the statistics go 
up with women that have been abused by their domestic partners 
through the use of guns.
    You know what are your top priorities for this legislation?
    Secretary Becerra. Well, we'd like to do our part on gun 
violence prevention. The research that we can do because this 
is a health crisis, it's not just a gun violence crisis, it's a 
health crisis. And if we can add the data that helps us 
understand how to address this, how to prevent it, that will 
take us a long ways.
    We're going to continue to work with those who want to try 
to help those family units, whatever shape they take to protect 
those domestic partners as best we can, but we understand that 
there are a lot of professionals who have been doing this for a 
while in those communities, and we should try to work with them 
because they know how to do it best to tailor programs for that 
community.
    What may work in California may not work in another State.
    Mrs. McBath. You're absolutely right, and I'm just really 
glad about the, you know, reauthorization and appropriated you 
know additional funding it's really going to reach different 
demographics of individuals that were not included in this 
appropriated funding before such as our Native American 
populations, so I'm really looking forward to being able to 
really continue to champion.
    And anything that you need from me, my staff, anything that 
you need from us please don't hesitate to call on us because 
we're really going to continue to doggedly pursue this for the 
sake of making sure that our families are safe and healthy 
thank you.
    Secretary Becerra. Georgia's got a great champion and be 
proud of yourself thank you.
    Mrs. McBath. Thank you very much I yield back the balance 
of my time.
    Chairman Scott. Thank you. The gentlelady from Iowa, Ms. 
Miller-Meeks.
    Mrs. Miller-Meeks. Thank you, Chairman Scott, and Secretary 
Becerra. Before I begin my questions, I want to thank you for 
the guidance that HHS recently issued granting more flexibility 
for the provider relief funds. I wrote a letter to you with my 
colleague representative asking the Department to issue this 
type of guidance and this much needed flexibility will allow 
providers to fully use the provider relief funds as they 
continue to recover from the impact of the COVID-19 pandemic. 
So, thank you and the Department for the guidance update.
    Also, Secretary Becerra, on May 6, also my colleague, Dr. 
Murphy who you recently heard from any myself, wrote to the CDC 
Director Walensky, asking questions about the troubling 
information that had come to light with respect to the role the 
teachers unions had played in altering the CDC's school 
reopening guidance.
    A response to that letter was requested by May 20, but we 
have still not received a response a month later. Mr. 
Secretary, can you tell me what the Biden administration is 
worried about revealing, and will you commit to us to get us a 
response to that letter within the next week?
    Secretary Becerra. Congresswoman we absolutely commit to 
get you a response as quickly as we can. We'll keep your team 
updated on where we are. A critical question all of us, whether 
it's our teachers or whether it's our children in school, and 
certainly the families who will see these kids come back home 
after being in school, we all want to make sure we're protected 
and don't see COVID flare up again.
    So, we'll try to get back to you as quickly as we can. By 
the way thank you for your work on the provider relief fund 
because we listened to a lot of your all comments in making 
sure we came out with the guidance that would be helpful in 
regulations.
    Mrs. Miller-Meeks. Thank you again for that and given the 
number of children that have committed suicide while schools 
are closed, I think it's extraordinarily important that we 
actually are listening to the science rather than the teacher's 
union, and that's particularly troubling in light of the public 
testimony Dr. Walensky gave subsequent to our letter.
    She testified that teacher's union input one guidance was 
limited to ``what happens if you have immunocompromised 
teachers?'' However, the emails I've covered showed that the 
unions influence worked well beyond that issue, and so if you 
can explain you know if necessary and correct the 
inconsistencies between the testimony of your CDC Director and 
the CDC emails.
    Secretary Becerra. Congressman I can tell you that knowing 
Dr. Walensky that she and her team at CDC used the agency as 
critical, and they make sure that they use all the science they 
have before them to make the decisions for the CDC. That's one 
of the reasons why I think we're able to come out of COVID 
because CDC has based its actions on the facts and science 
before it to guide America in how we move forward.
    Mrs. Miller-Meeks. And given how critical the CDC is, of 
the additional 1.6 billion budget increase for the CDC, can you 
commit that a significant portion of that will be directed 
directly to non-competitive, local public healthcare grants, so 
our local public health officials get the assistance they need 
after having worked 24/7 through a pandemic?
    Secretary Becerra. I commit to work with you. I don't want 
to commit anything in terms of CDC's allocations because I 
obviously would want to talk to Dr. Walensky about that and her 
team, but we can commit to you that we'll do it in a 
transparent way so that you and others can see exactly how we 
are allocating those resources.
    Mrs. Miller-Meeks. Thank you. There are also troubling 
reports earlier this year that the HHS was placing 
unaccompanied alien children with sponsors in the U.S. before 
background checks were completed. Today are all sponsors of 
unaccompanied minors, unaccompanied children receiving 
background checks prior to placing a child?
    Secretary Becerra. Congresswoman, I want to guarantee you 
that under my watch, and certainly under President Biden's 
watch every child who is discharged to a custodian, a 
responsible sponsor, has had that background check done before 
we release that child.
    Mrs. Miller-Meeks. Thank you. The AP reported in March that 
the Biden administration was waiving FBI fingerprint and 
background checks for staff and volunteers at temporary influx 
facilities who directly care for children. Today are all care 
givers at temporary influx facilities being fingerprinted and 
getting background checks prior to working with children?
    Secretary Becerra. Congresswoman, here I can assure you 
again. Anyone who works for the Department of Health and Human 
Services, and especially with regard to the care of the 
unaccompanied migrant children goes through all the appropriate 
and legally required checks before we allow them to work with 
us.
    We have different categories of workers, obviously some who 
have direct care services, some of provide the oversight of the 
discharge process and the review of files, but we make sure 
that anyone at HHS, or who is employed by HHS has gone through 
the corporate checks before they can be employed.
    Mrs. Miller-Meeks. So, you would agree that a lack of 
background checks on caregivers and a lack of fingerprinting 
increases the risk of physical and sexual abuse on children at 
the border, and having unaccompanied minors dropped off at the 
border does increase their risk of human and sexual 
trafficking.
    Secretary Becerra. We are not going to do anything that 
imperils the safety of a child, and I think at least in the few 
months that I've been secretary, I think we've proven that we 
are doing this in a way that not only protects the rights of 
these kids but respects the rights as well.
    Mrs. Miller-Meeks. Well thank you so much for answering my 
questions, and I would also encourage you to visit the border 
and I yield back my time.
    Chairman Scott. Thank you. We will have a 5-minute break 
after the next questioner, and then come right back to either 
Mr. Owens or Mr. Good, if Mr. Owens is not available. The 
gentlelady from Connecticut Ms. Hayes and then we'll take a 
break.
    Mrs. Hayes. Thank you, Mr. Chair and Thank you, Mr. 
Secretary for being here today. Before I start my statement, 
I've heard a lot of concerns about the input of teachers unions 
and school reopening. We had a conversation with the leaders of 
both of the largest teacher unions in the country, and they are 
both committed to doing everything that they can to have full-
time in-person reopening in September, so that is what they are 
looking for as well.
    So just something to note here. Secretary, Mr. Secretary, 
yesterday I introduced a bill, H.R. 3904 Reducing COVID-19 
Disparities by Investing in Public Health Act, which responds 
to the disparities that have emerged in COVID-19 
hospitalizations and deaths by tackling the underlying chronic 
problems, disparities in public health and chronic disease 
prevention and treatment.
    I want to first thank you for the over 261 million dollar 
increase to the National Institute of Minority Health and 
Health Disparities in the proposed budget. The COVID-19 
pandemic has revealed that we need to do more to combat 
systemic inequities that have left communities of color more 
vulnerable in our healthcare system.
    There are significant racial disparities in the race by 
which Americans suffer from chronic diseases like heart 
disease, diabetes, and asthma. African-American children are 12 
percent more likely to suffer from childhood asthma. African-
Americans are 30 percent more likely to die of heart disease 
and twice as likely to have a stroke. Additionally, African-
Americans made up 22 percent of COVID-19 deaths.
    So, I was a little disappointed to see that this budget 
included just a negligible increase for the chronic disease 
prevention and health promotion fund at CDC. The American Heart 
Association and the American Lung Association recommended that 
this fund be increased threefold, so having seen the impacts of 
these chronic underlying conditions, and the need for increased 
funding, when I saw that the Office of Minority Health was flat 
funded in Fiscal Year 2022, I was to say the least, 
disappointed.
    Can you talk a little bit about how important funding for 
these areas are, and what efforts your department will make to 
increase funding to combat chronic diseases and the 
corresponding disparities that accompany them?
    Secretary Becerra. Congresswoman, thank you for the 
question, and thank you for being a champion of eliminating 
those health disparities. One of the pillars, at least under my 
Administration at HHS will be equity. I've made that clear to 
all of those lieutenants within this agency, and it's a large 
agency as you know.
    I am reflecting the commitment that President Biden has 
made to move forward on equity, and what I can tell you is in 
the investments we're making whether it's on minority health 
where we are investing a quarter of a billion dollars in the 
National Institute of Minority Health and Health Disparities, 
or whether it's the issue of maternal health that we were 
investing several millions dollars to try to address the 
disparities that we see in outcomes for women in maternal 
health.
    That's all to make sure, excuse me, that's all to make sure 
that we address these disparities that have existed for far too 
long. And so, what I can tell you is that we're committed. You 
may not see it in the line item on the budget, but we are 
absolutely committed to making progress in addressing these 
disparities.
    I wouldn't be in this position if that weren't the case.
    Mrs. Hayes. Well, thank you. I appreciate that. And I just 
I'm glad to hear that because this isn't about feelings of a 
particular community, but data has shown us, and the 
disparities that were revealed during COVID has shown us that 
there are huge equity gaps that need to be addressed in our 
systems, in our processes, and our functions.
    What can we in Congress to do help support your department 
in securing funding, or even in promoting these efforts? Did I 
lose you?
    Chairman Scott. Mr. Secretary I think inadvertently muted.
    Secretary Becerra. Yes, I did, I did, but I was drinking 
water. Congresswoman what I would say is first the most 
important thing you can do is keep tenaciously testing the 
Secretary of Health and Human Services to make sure that we do 
address these disparities. I hope you will keep coming at me 
and saying, `Secretary, show me what you've done,' and I 
guarantee you that if I'm worth my weight in salt, I will have 
done what you would like to see, and that is to address these 
things.
    And the fibers in my being, my DNA, is all about making 
sure we address these disparities, so keep me in the task.
    Mrs. Hayes. I can absolutely commit to doing that. Thank 
you, Mr. Secretary. With that Mr. Chair I yield back.
    Chairman Scott. Thank you. And now we'll take a 5-minute 
break and as soon as the Secretary comes back, we'll reconvene 
with either Mr. Owens if he's available, or Mr. Good would be 
next if he's not available. A 5-minute break.
    [Whereupon a brief recess was taken to reconvene this same 
day.]
    Chairman Scott. Back to order. And the next person is Mr. 
Owens on screen I don't see him. My distinguished colleague 
from Virginia, Mr. Good.
    Mr. Good. Good afternoon, sir. Thank you, Chairman, and 
Thank you, Secretary Becerra for being with us today. And I 
appreciate the opportunity to talk with you. Secretary I would 
like to discuss how your department is handling the thousands 
of unaccompanied migrant children who are illegally entering 
our country.
    It's been disheartening to see President Biden reverse 
policies that would mitigate the crisis at the border, such as 
the MPP, or Migrant Protection Protocols commonly referred to 
as remain in Mexico, and that Vice President Harris has yet to 
visit the border as others have noted, even though the 
President has named her as our border tsar with responsibility 
of thousands of children falling under your jurisdiction.
    I'm sure you're extremely disappointed in frustrated with 
the refusal of your superiors to control the situation at our 
southern border, as you struggle to deal with and try to clean 
up the mess they're making of our border and our immigration 
policies. Secretary Becerra do you think it would be helpful if 
the President were to visit the border to see first-hand the 
crisis he has exacerbated and continues to create there at the 
border.
    Secretary Becerra. Congressman, thank you for the question. 
It's crucial. This is an important one. I think the President 
and the Vice President are committed to making sure that we 
take on this challenge that immigration presents.
    He did present early on a proposal to Congress to try to 
reform a broken immigration system. This is what happens when 
you have a broken immigration system right? For our purposes, 
we have to take care of quite a number of kids who have come 
across without any adult with them, and it's a tough issue.
    But I guarantee you that the President's committed, along 
with the Vice President to tackle this as best we can, and 
hopefully Congress will take up immigration reform.
    Mr. Good. But you don't think it would be helpful for him 
to actually visit and to send a message that he's engaged, or 
for him to even know what you're dealing with first-hand by 
going to the border, you don't think it would be helpful for 
the President to come?
    Secretary Becerra. Well, he and his team, and that includes 
me, have been very engaged.
    Mr. Good. I just want to know that you don't think it would 
be helpful for him to come?
    Secretary Becerra. I think the President has to be on top 
of all of these issues.
    Mr. Good. Let me move on please because I want to know if 
you think it would be helpful for him to be there himself. How 
about the border tsar? Do you think it would be helpful to you 
if she were to visit to get a better sense of what needs to be 
done?
    Secretary Becerra. Well, the Vice President has already 
shown her commitment to this issue. She just recently returned 
from a trip to Mexico, returned to America.
    Mr. Good. I'm referring to the border, I think she's a 
little confused. We don't need her to go to Europe's borders, 
but to go to our border. Do you think it would be helpful for 
her to come to our border?
    Secretary Becerra. I think it's important to have the top 
two leaders of our Nation engaged, and they are both engaged 
with their team.
    Mr. Good. I agree with that. How about yourself. Have you 
yet since you've become Secretary, or do you plan to visit the 
border?
    Secretary Becerra. Congressman, I've been to the border so 
many times over the course of my life, and in my career and I 
certainly have been there as Secretary of Health and Human 
Services.
    Mr. Good. So, I'm sorry, when were you last at the border?
    Secretary Becerra. I was there about two or 3 weeks ago 
when I visited one of our sites there in the El Paso area.
    Mr. Good. Well, and I'm sure that you would say that it's 
been helpful to see how much worse it has become during this 
Administration, to see it up firsthand. The world is watching 
and observing the utter chaos and the lawlessness that's become 
the disaster on our border, yet it doesn't seem to be 
sufficient urgency from this Administration to address the 
problem.
    Do you have any sense of when, if ever, this Administration 
might gain operational control of our border?
    Secretary Becerra. Congressman, look we are not separating 
kids from their parents. We are not seeing people die in the 
hands of Federal Government officials. I will tell you that 
what the Biden administration has done is handled this in a 
lawful manner.
    It is a challenge, but I respect that we have a President 
who's willing to treat people as human beings and is respecting 
of the law.
    Mr. Good. Well, I think we are facilitating the separation 
of children from their parents the way that we are encouraging 
illegals to stream across the border, that we're allowing 
unaccompanied children to come across, and we're trying to help 
and facilitate that versus preventing it.
    In previously Administration were to secure the border, it 
looks more impressive with each passing day as we see the crime 
and the drugs and the suffering of victims, including the 
children, that are streaming across the border.
    It does seem to be that there's been disagreement within 
even this Administration though on how to handle it, and if I 
run short on time, I'm going to reference the article which 
Chairman, Mr. Chairman I'd like to submit for the record 
please, this article from Politico article from last month that 
was titled, ``Becerra's cautious border play rankles the White 
House.''
    It seems as if you were in favor of the refugee camps of 
the 15,000 before the Administration reversed it to 62,000. Do 
you see any operational reason, or any benefit to go to the 
62,000 instead of 15,000?
    Secretary Becerra. First Congressman, that article is 
inaccurate. And second, I believe we're going to handle the 
influx of refugees as they come. The President is Committee to 
make sure that we do our part as a world partner to make sure 
that people who are seeking to escape persecution and death 
have a place that they can go, and America has always been a 
shiny light in that regard.
    Mr. Good. Thank you, sir my time is expired, so Mr. 
Chairman I yield back. Thank you.
    Chairman Scott. Okay, without objection the article will be 
submitted to the record.
    Mr. Good. Thank you, sir.
    Chairman Scott. Is Mr. DeSaulnier ready to respond, to ask 
questions? The gentleman from California, Mr. DeSaulnier.
    Mr. DeSaulnier. Thank you, Mr. Chairman. Mr. Secretary it's 
such a pleasure to see you. Always proud to see a graduate of 
McClatchy High School. Usually, those graduates go to really 
good schools like the University of California Davis Berkeley, 
but you know, really glad to see you.
    I have two questions. COVID has really accelerated the 
demonstration I think for all of us for behavioral health, 
particularly for young people. We had a terrific hearing at a 
Subcommittee on health with Ranking Member Allen. Really 
encouraging bipartisan acknowledgment that this is an important 
area from my perspective.
    And I appreciate Ranking Member Allen's contribution, and 
all the Members contribution. We know that ACA and with parity 
that was really a good thing.
    Chairman Scott. If the gentleman from California wants to 
suspend briefly, I think the recorded studio is having a 
problem with the livestream. If you can just suspend for a 
moment.
    Mr. DeSaulnier. Probably a Stanford grad.
    Chairman Scott. Yes. We're back live, the gentleman from 
California.
    Mr. DeSaulnier. Well, let me finish that thought. So 
behavioral health, particular emphasis on kids. We've got I 
think in a lot of ways the good thing in this stigma is it's 
falling apart dramatically, so Americans are seeking out 
behavioral health services. But we don't have as many people 
going in to the professional, so we've got this supply and 
demand problem.
    I wonder if you could tell me, and I'd love to work with 
you on this, is how do we address this? We've got this great 
policy in the ACA that allows for parity. We've gone some 
challenges around that that the Committee and Subcommittee are 
working on, but we need to get more infrastructure.
    We need to get more providers. And of course, the expertise 
and the knowledge on neuroscience and how the brain works to 
stress is growing exponentially, and with a particular emphasis 
on kids. We know that there's a lot of emerging research in 
COVID on the impact on kids.
    So how do we work together with you and your department to 
meet the needs for people, particularly young people, around 
behavioral health as we come out of COVID?
    Secretary Becerra. Congressman, thanks for the question and 
the sincere way in which you posed it. But at the end of the 
day, we got to put our money where our mouth is, and we've 
always talked about making mental health at parity with the way 
we treat physical health.
    And we've never done that. And fortunately, you all did us 
a great service in the CARES Act, and of course in the American 
Rescue Plan, and actually provided real dollars to try to 
tackle this. We just put out about a month ago a three billion 
dollar let of money, half of it for mental health, half of it 
for substance use disorders. That's real money that hits the 
ground in these communities where you are, where I am.
    We have to do more of that. This budget that the President 
presents provides over a billion and a half dollars for the 
community mental health services block grant to go even 
further. We hope that you'll help us with the American Family 
Plan to make these investments.
    But at the end of the day as you and I know, it's whether 
we're willing to put our money where our mouth is to make this 
happen, and fortunately today more and more were willing to say 
that there's a family Member who needs mental health services.
    Mr. DeSaulnier. Great. We'll look forward to working with 
you. The plaque that is gun violence in the United States, very 
difficult issues for the Congress, very partisan. I wonder if 
there's a possibility in the department, and I really feel 
strongly and have for a long time that this is a public health 
issue.
    And if we look at it analytically, respect the second 
amendment, respect that we have differences of opinion, and my 
comments won't de-emphasize the importance of urgency as every 
day goes by.
    But maybe a little longer view is now that we've got CDC 
with some funding at least for research, but couldn't we look 
at a longer view and hopefully address the urgency of this, but 
just gun safety. And surely, we can all agree that evidence-
based research on gun safety with recommendations to Congress 
and the Administration to enact gun safety policies could be 
something we could all focus on an agree to.
    I wonder if you could comment on that, how much discretion 
you might have to actually pursue that within the department.
    Secretary Becerra. Congressman, you, and I come from a 
State where treating gun violence as a healthcare problem, as a 
public health crisis is not new. And fortunately, President 
Biden has recognized that we have to do more. We are going to 
expand research. If you help us with our budget request, we 
will be able to expand our research to help other states beyond 
California.
    But at the end of the day, we have to recognize that this 
is a crisis. It's a healthcare crisis, not just a gun violence 
crisis, and the quicker we do that the more lives, especially 
young lives that we'll save, so look forward to working with 
you on that.
    Mr. DeSaulnier. And just because it's personal to me I 
always remind people that over 100 people who die of gun 
violence every day in the country, two-thirds of them are 
suicide, and that far outstrips the second causes of suicide in 
the United States. We know the proximity of the guns 
accelerates the success of people committing suicide.
    I really look forward to working with you Mr. Secretary on 
both subjects, and really important work that we have to do, 
and again I'm so proud of you.
    Chairman Scott. The gentleman's time is expired.
    Mr. DeSaulnier. I yield back thank you.
    Chairman Scott. The gentleman from Utah, Mr. Owens.
    Mr. Owens. Secretary, we have had a series of hearings in 
recent months looking over the impact of COVID-19 on different 
student populations. Republicans have invited parents to those 
hearings to talk about the negative impact on school closures 
on their children and families.
    Two of those parents have explicitly said that one of the 
lessons are nation should learn from this pandemic is that 
schools are essential services and should never, ever be closed 
for an extended period of time. Do you agree that we should 
resolve as a nation to never close our schools indefinitely as 
so many school districts have done this year?
    Secretary Becerra. Congressman, thank you for the question. 
Would I agree that we should never have to close our schools? 
We should always do what we can to prevent the need to keep a 
child from going to a school, and that's why we're trying to 
prepare for any pandemic in the future, and COVID is going to 
teach us a whole lot.
    Mr. Owens. OK. President Biden's 2022 budget requests 
enormous increases of early childhood care and educational 
programs, both new and existing programs. For early education 
that includes about 200 billion to impose a universal preschool 
program for all third, and fourth grade children. I'm sorry, 
three-and 4-year-old children, as well as an 11.9 billion 
dollars for Head Start program which has increased to 1.2 
billion since 2021.
    The proposed universal preschool and existing Head Start 
program are largely duplicative in early education programs. 
How do you see these two competing programs co-existing, and 
what studies have you done to understand how this proposal will 
impact the existing small businesses already serving these 
children?
    Secretary Becerra. Congressman first there is no conflict. 
They will work in concert to make sure that families have the 
resources they need to make sure that they not only have 
childcare services available, but it's quality childcare 
services.
    We are so far behind in making that available. We are the 
greatest democracy, richest democracy in the world, but we seem 
to be the only industrialized nation that doesn't realize or 
figure out a way to actually make sure that parents can go to 
work and not fear what's going to happen to their kids during 
their work hours.
    We can make these investments and make it work for 
everyone. And I guarantee you this is not a dollar wasted when 
you help a family provide quality childcare for their kids.
    Mr. Owens. Since the outbreak of the pandemic an astounding 
amount of Federal funding has been put into early care and 
educational system, including a 40 day and American Rescue Plan 
Act alone. This act excluded all Republican input, and reflects 
poor policymaking, especially with respect to accountability.
    On April 14, the Committee sent a letter to you asking 
important information about the oversight of this unprecedented 
influx of new Federal childcare funds. Sadly, we have not 
received a response. With respect to the 50 billion in the ARP 
for childcare, how are you working to ensure the funds are 
spent responsibly, and to avoid a funding cliff for childcare 
providers and to support long-term solutions for family's 
childcare needs?
    Secretary Becerra. Congressman, let me invite you and your 
team if you'd like to work with us as we implement some of the 
programs under the American Rescue Plan. As I mentioned to you, 
and I said in my opening statement, transparency is going to be 
a big deal for us. We want to make sure that we demonstrate the 
program integrity so that we make the right use of these 
dollars that you've made available to us.
    We thank you for making those dollars available to us so we 
could actually help families provide the childcare that they 
need for their kids. And when we do a program if you have any 
questions, we're going to make ourselves available, so please 
feel free anytime early, before we start implementing, or 
during its implementation to ask us any questions you have.
    Mr. Owens. Thank you, Secretary. I yield back.
    Chairman Scott. Thank you. The gentleman from Michigan, Mr. 
Levin.
    Mr. Levin. Thank you so much Mr. Chairman, and it's so 
great to see you, an honor to call you Secretary Becerra. 
Thanks for appearing before us today. I'm going to try to 
shoehorn in two questions, or two sets of questions, one about 
the ACA and one about care workers, so let's see if we can do 
it.
    As you know there's a lawsuit brought by Republicans, 
California versus Texas, which threatens the future of the 
Affordable Care Act. In fact, I think you rallied states in 
defense of the ACA in your former role of California's Attorney 
General.
    I applaud the Biden administration for reversing the 
position taken by the previous Administration which supported 
partisan Attorney's General who argued that the law should be 
struck down. But the threat of this lawsuit is still there, a 
decision by the Supreme Court could be handed down any day.
    So, would you explain what this means for my constituents? 
Which parts of the ACA are at risk if this Republican lawsuit 
were to prevail, what kind of chaos could result of the 
republic Attorney's General succeed, and what would happen to 
the existing insurance market?
    How many people do you think might be harmed as a result? 
Give us your sense?
    Secretary Becerra. Congressman, first great to see you, and 
please pass along my best regards to former Congressman Levin 
as well.
    Mr. Levin. You know I will.
    Secretary Becerra. Absolutely, please give him a big hug 
for me.
    Mr. Levin. He's so proud of you sir.
    Secretary Becerra. Oh, he's an important mentor in my life, 
and someone who really taught me some real values in how you 
can exercise those in Congress. We're going to find out real 
soon. It's in the hands of nine individuals, nine Americans.
    And if they choose to find it constitutional as they have 
in the past, then we're going to be able to grow that number 
from 31 million Americans who have good health insurance 
coverage as a result of the Act to even more. If they somehow 
for some reason decide that it is not constitutional, well then 
you all have some really important work to do and so do we, to 
somehow protect all those Americans who don't have to worry 
about having a pre-existing condition.
    And all of a sudden now they're going to suffer and face 
the consequences they had in the past where you could be 
discriminated against you getting insurance coverage simply 
because you have asthma, or you have some other type of pre-
existing condition.
    All those kids were under the age of 26 who have health 
coverage through their parents policy will all of a sudden find 
that if you're 18 to 26 you're out of luck, and those parents 
will no longer be able to provide them coverage.
    Those seniors who have preventive healthcare services and 
help paying for their prescription medication, will find 
they're out of luck if the Affordable Care Act goes away. All 
of those things disappear if somehow a majority of those nine 
justices believe that the Affordable Care Act is 
unconstitutional.
    But Congressman, having been the Attorney General who got 
to have his team argue that case before the Supreme Court, I 
can't tell you I'm totally confident, but I actually have a 
great deal of confidence that the Supreme Court, those justices 
will find a way to do the right thing for America, and protect 
the Constitution and its values by protecting the affordable 
care act. That's my hope, we'll see.
    Mr. Levin. Thanks. I hope you're right for sure. And you 
know I'm a former union organizer. My first job in that space 
was helping nursing home workers organize with SCIU I think 
almost 40 years ago, but we won't dwell on the passage of time. 
Making sure the direct care workforce has a safe workplace, a 
living wage, and great benefits is a cause near and dear to my 
own heart, and I know it is to yours.
    And I know from my--first-hand experience that this 
critical workforce is made up largely of women of color and 
immigrants who are paid on average about $12.00 an hour. So, 
Mr. Secretary how will HHS partner with the Department of Labor 
and us to invest in the direct care workforce, and how will you 
do it in a way that improves worker recruitment, retention, 
development and make sure that they're paid well and protected 
in their workplaces?
    Secretary Becerra. Congressman, critical because it's hard 
to believe that we don't want to pay people who care for our 
dearest loved ones in the right way, and that's why the 
President's budget places true value in supporting those 
caregivers. We're requesting 73 million dollars in increase for 
a total of 280 billion dollars, to provide support for the 
National Family Caregivers and Native American Caregivers 
support programs that are out there, helping caregivers.
    We want to continue to see those Americans who take on the 
tough task of caring for our family Members receive the wages 
they deserve, and we are looking forward to working with you to 
pass the American Families Plan that gives an opportunity to 
invest further in caregiving for whether it's our grandmother, 
or our child making sure that we do it the right way, paying 
real wages.
    Mr. Levin. Thank you so much sir. We're here to work with 
you and Mr. Chairman I yield back.
    Chairman Scott. Thank you. The gentlelady from Michigan Ms. 
McClain?
    Mrs. McClain. Great thank you very much Mr. Secretary. I 
want to thank you for being here today. I just have a few 
questions. First would you agree that obviously the health and 
safety of our citizens remains the utmost priority?
    Secretary Becerra. Absolutely.
    Mrs. McClain. OK. And I've listened to the testimony. You 
stand behind the Fiscal Year 2022 budget request of 131 billion 
for HHS, even though it's a 23 percent increase, correct?
    Secretary Becerra. That budget we have put forward and 
having gone through all the elements of it and hope that you'll 
support it.
    Mrs. McClain. OK. And do you commit to ensuring a 
transparent and responsible use of taxpayer dollars?
    Secretary Becerra. Of course.
    Mrs. McClain. Thank you. So, I'm glad that you agree with 
me on the basics. And I believe that there is a crisis. You 
testified that you agreed with me there's a crisis, a pandemic 
crisis. Do you feel that we're coming out of the COVID pandemic 
crisis?
    Secretary Becerra. The President, his efforts to get so 
many millions of Americans vaccinated is an ambitious goal to 
get 70 percent of adults with at least one shot in arm by July 
4. All of those efforts is investments in the American Rescue 
Plan and support of Congress to pass it. All of those efforts 
have led us to the point, well, you're now beginning to see 
some states open up, and so we're not out of the woods, but we 
are certainly in a far better place than we were a year ago.
    Mrs. McClain. Do you believe we have a crisis at the 
border?
    Secretary Becerra. We are certainly facing the challenges 
that come from having a broken immigration system, and I have 
to deal with those in one aspect when it comes to those 
unaccompanied migrant children. But without a doubt for decades 
having an immigration system that's broken, creates these kinds 
of challenges.
    Mrs. McClain. So that's a yes, we do have a crisis at the 
border? I'm confused with the answer, sorry.
    Secretary Becerra. Well, we have a broken immigration 
system that is creating all of these challenges that we must 
face. It's not just this Administration. Previous 
Administrations. I remember when I was a Member of Congress.
    Mrs. McClain. I agree as we sit here today, I think we have 
a crisis on the border. We have a broken immigration system as 
well. So, I'm just, are we in agreement, or do you think we 
don't have an issue with the border?
    Secretary Becerra. Well, I'm glad you agree that we have a 
broken immigration system. It definitely creates these 
challenges that while we're taking them on, it makes it tough, 
and I hope that you all will take on the President's proposal 
for immigration reform.
    Mrs. McClain. I don't know why it's a struggle to answer 
the question about a crisis at the border, but I'll take it as 
a not answer, I guess. Where my confusion comes in is you've 
diverted 2 billion dollars of funding to deal with the crisis, 
non-crisis, pick whatever word you want.
    You know 850 million from the stockpile money, as well as 
$850 million of COVID testing money, so can you see my 
confusion is if we don't have a crisis at the border why are 
you diverting funds from COVID and from our stockpile that 
would help us deal with the COVID crisis we have now, or a 
future pandemic?
    So, I'm very confused if we have a non-border crisis why 
are we diverting 2 billion dollars.
    Secretary Becerra. Congresswoman, thank you for the 
question, and I've tried to explain this in the past. We have 
an obligation under the law to provide care for these 
unaccompanied minor children regardless of what their ultimate 
outcome will be if they have to return back to their home 
country or not.
    While they're here temporarily it's our obligation to make 
sure they are safe and healthy.
    Mrs. McClain. And that obligation comes at a cost.
    Secretary Becerra. Absolutely.
    Mrs. McClain. Because for every action there's a cost, 
right?
    Secretary Becerra. Well, there's certainly a financial 
cost, no doubt. But we're going to do it right because we 
should not pick corners simply because the child may not be 
someone we know or have had in this country for a long time.
    Mrs. McClain. But it's coming at a cost to our non-crisis 
at the border, so if we don't have a crisis at the border why 
would we need to divert two billion dollars to take care of 
that non-crisis?
    Secretary Becerra. So, Congresswoman we are handling the 
challenge that the unaccompanied children present. At the same 
time, we're making sure that we're making use of those dollars 
to pay for those services in the ways that you all in Congress 
have provided to us.
    So, all the moneys that we've used, we used transparently, 
that's why you're able to cite certain figures.
    Mrs. McClain. OK. So, we are going to continue. Do you see 
more money being diverted to this issue in the future?
    Secretary Becerra. Congresswoman until you all fix this 
broken immigration system, we're going to continue to face 
challenges like this, and I have under law the obligation to 
make sure to care for these kids. Until you all deal with the 
crisis, the critical aspects of immigration the way that they 
should be dealt with, this broken immigration system is going 
to continue creating these challenges.
    Mrs. McClain. Right. And we can start by limiting the 
number that come in, but with that I'm out of time. Thank you, 
sir, for your time. I appreciate it and I yield back.
    Secretary Becerra. Thank you.
    Chairman Scott. Thank you. The gentlelady from Michigan.
    Ms. Stevens. Thank you, Mr. Chair, can you hear me all 
right?
    Chairman Scott. We can.
    Ms. Stevens. OK great. The other gentlelady from Michigan 
representing from Troy down over to Canton and Thank you, Mr. 
Secretary, for your testimony today which was very well-written 
and put together and your answers to today's questions have 
been tremendous.
    I've been seeing that there's a lot of emphasis on 
immigration and we've got a large Committee here today, but 
it's interesting because our jurisdiction and Ed and Labor's is 
pretty specific for why you are here.
    And the last time I checked there's certainly a lot that we 
should be discussing within our jurisdiction, and that's 
exactly what I wanted to talk to you about Mr. Secretary, which 
is you know our older Americans who have been so hard hit by 
this pandemic.
    While the need has been growing for years, the pandemic has 
caused an unprecedented increase in demand from older Americans 
for meals and other critical older American Needs Act services 
that help them stay safe and well in their homes. You know I 
frequently participate in the Meals on Wheels program that 
operates in Waterford, Michigan.
    But we see ourselves defeating this virus and making lots 
of progress in the pandemic. The needs for programs like these 
are likely to remain, so just wanted to hear from you Mr. 
Secretary about your plans to continue to serve older adults 
who now rely on OAA services as Federal COVID stimulus program 
began to wind down, thank you.
    Secretary Becerra. Congresswoman, thank you for the 
question, critical. You may be aware that in May, early May the 
Administration for community living within the Healthy Human 
Services Department released about a billion and a half dollars 
in funding to states and territories, and that was money that 
we thank you for because it came from the American Rescue Plan, 
and that was for our older American Act programs.
    Those dollars are going to help fund vaccine outreach and 
coordination to help address social isolation to too many of 
our seniors are experiencing to provide family caregiver 
support, and to offer nutrition support for our seniors.
    Ms. Stevens. Great. And Secretary Becerra, we know that the 
pandemic has also had a severe impact on the mental health of 
young Americans that's come up in today's hearing. And 
according to the American Academy of Pediatrics over 40,000 
children have lost a parent to COVID 19.
    Has HHS begun to collect data on children and teens 
affected by COVID-19 related loss, and how those efforts are 
going to inform the department's mental health awareness and 
treatment programs? And is there any way that Congress might be 
able to be of an assistance to you in those efforts?
    Secretary Becerra. Excellent question, and I hope that you 
and some of your colleagues would followup because we are 
collecting a great amount of data, and it will be very useful, 
not just for our programming of resources, but for you all 
making policy that will take us in an even better direction.
    So please be in touch with my team because that data can 
help drive good decisions on where we go next.
    Ms. Stevens. Yes. And it certainly begins almost as 
empirical right, so one of the things obviously not related to 
your jurisdiction that we're starting to see in Michigan is a 
major demand for guidance counselors in our schools.
    I've heard some reports that guidance counselors used to 
see in some of our schools on average, 17 to 20 students, and 
now that's upwards of 100. And so, this isn't within your 
jurisdiction, but just thinking about that support network that 
goes into our school system.
    And so with that I'm going to cede back my time to the next 
question Mr. Chair partly because our Secretary has just been 
doing such a phenomenal job, and it's obviously no question why 
he is in this role, and you know was able to answer things that 
might have been better for you know the Homeland Security 
Subcommittee, but obviously you know we are going to keep 
pushing on what we need to do to continue to keep all Americans 
healthy in a strong HHS Department.
    So, with that, thank you, Mr. Chair, thank you, Mr. 
Secretary, and I yield back.
    Chairman Scott. Thank you. The gentlelady from Tennessee, 
Ms. Harshbarger?
    Ms. Harshbarger. Thank you, Chairman and Ranking Member 
Foxx, and welcome Secretary Becerra. We appreciate your time to 
discuss the 2022 budget for HHS. As a pharmacist, I look 
forward to opportunities to work with you and your department 
in areas where we should hopefully have bipartisan agreement, 
improving our healthcare delivery system and addressing 
problems and I really thank Representative Keller for 
mentioning the PBM issues with the DIR fees.
    And because of that, because of being a pharmacist I have 
introduced legislation, it's H.R. 1829, the PBM accountability 
study that would address why some of the drug pricing is so 
exorbitant. And everybody on this Committee has independent 
pharmacies in their district who's struggling with this, and 
I'm glad the Administration's budget also proposes to focus on 
things like substance abuse and mental health disorders.
    That's going to be big in my district, because I do have a 
couple of questions for you sir. First one does deal with drug 
pricing. When the Part D program, the Medicare Part D program 
was created in the bipartisan Medicare prescription during the 
modernization act of 2003, the law included an important 
provision known as the non-interference clause, and that 
inhibits the HHS Secretary No. 1, from interfering in private 
cross-negotiations under the part D program.
    And No. 2, establishing single national formulary for the 
Part D program. And because of that it's my understanding that 
this was put in the law expressly to keep the government from 
interfering in the American health system in determining which 
medications are covered, which are not covered as is commonly 
the case in many foreign countries that are single payer 
systems.
    And honestly, the evidence has been very clear that this 
approach establishing a competitive marked based system in Part 
D has been successful in balancing cost containment with robust 
beneficiary access. But nevertheless sir, the political talk is 
all about the need for negotiation, Medicare Part D, and in 
particular it talks about government.
    The talk is government negotiation. And some have proposed 
eliminating the non-interference provision of the law. And my 
question Secretary Becerra is you know that's very confusing, 
and can you clarify for me whether or not there is negotiation 
happening today in Medicare Part D? And if so, who's doing this 
negotiation?
    Secretary Becerra. Congresswoman, thank you for the 
question, and I know something that we'll have an opportunity 
to discuss further. By the way can I just say thank you to you 
and if you'll convey the thank you to one of your colleagues in 
the pharmacist world for all the work that they have done to 
make vaccines available locally to the community, especially 
those independent pharmacists who really are the ones that know 
their community.
    It's been indispensable to have them step up to the plate, 
and can you please convey on behalf of HHS our thanks for what 
they've done?
    Mrs. Harshbarger. Absolutely sir. They are an integral part 
of the healthcare system, and we need more authority and things 
like that. Start with us first.
    Secretary Becerra. At a time when we're losing that 
personal contact with all those service providers it is sure 
nice to have some of those pharmacists who we have known for 
decades right, to be, and we trust. And so, it's been great, so 
please convey our thanks to them.
    Mrs. Harshbarger. I will do that.
    Secretary Becerra. On the question?
    Mrs. Harshbarger. Yes, go ahead. No, I want you to answer 
the question.
    Secretary Becerra. Yes, yes. We're working, and as you know 
this has been an issue that not just this Administration, but 
previously Administrations have tried to tackle. And in fact, 
we're now in court on a number of these matters. But what I 
will tell you is this, President Biden has made a commitment to 
reduce the prices of prescription drugs.
    We're looking for the best way to do that. We know that 
there are a number of proposals that are out there, different 
ways that other countries have found to do it. What I could 
commit to you is this: We will do everything we can within our 
current power, but we're hoping you all, working with you we 
can get more power to actually bring down the prices of 
prescription drugs.
    Mrs. Harshbarger. That's the goal, and that's where my 
expertise lies. I want to change topics and ask you one other 
thing. I understand from your previous recent hearing 
appearances in the House Energy and Commerce Committee and the 
Senate Finance Committee you have been asked on a number of 
different occasions to affirm that you'll stay the commitment 
to uphold all laws, including the enforcement of the partial 
birth abortion act.
    And your response to Representative Gus Bilirakis was, 
``There is no law that deals specifically with the term partial 
birth abortion.'' Do you still maintain this position that 
there's no Federal law that deals specifically with that term? 
And that's just a simple yes or no sir.
    Secretary Becerra. Congresswoman I wish life were just a 
simple yes or no. What I can say to you is what I tried to say 
to the Congressman and to others who have asked this question. 
We're going to make sure we uphold the law we follow the law as 
we protect women's rights to healthcare.
    Mrs. Harshbarger. It's simple. If you can read this, and if 
you can't read it, I'll read it for you. It's 18 U.S. Code 1531 
Partial Birth Abortions Prohibited. And you know there's a 
couple things I want to enter into the record. It was a 
PolitiFact article Chairman, it is ``Becerra's wrong that no 
law addresses partial birth abortion,'' so if I could enter 
that, that would be fantastic. OK.
    Chairman Scott. The gentlelady's time has expired. She has 
asked unanimous consent without objection the document will be 
entered.
    Mrs. Harshbarger. Thank you.
    Chairman Scott. The gentlelady's time is expired.
    Chairman Scott. The gentlelady from Minnesota Ms. Omar.
    Ms. Omar. Thank you, Chairman. I know my colleagues on the 
other side of the aisle have a reawakened interest in deficit. 
I agree with them that taxpayer dollars must be well-spent, but 
part of running a government is making sure that revenue comes 
in so that we can pay for all of the good work your department 
is doing Mr. Secretary.
    The Republican party pushed through tax cuts in 2017 that 
were nothing more than massive trillion-dollar corporate 
giveaways, serving essentially only to help the rich get 
richer. One of the things that they promised would happen was 
that companies would reinvest their tax windfalls in research 
and development.
    And how did that work out? According to campaign for 
sustainable prescription drug pricing between 2017 and 2018 
pharmaceutical companies more than doubled shareholder 
dividends while investing only 6 percent more in research and 
development which brings me to my question.
    President Biden support negotiating with drug companies. 
Critics of policies such as H.R. 3 claim that this would 
prevent companies from competing. Mr. Secretary, do you believe 
pharmaceutical industries, stock buybacks and dividend 
constitute innovation, and will those help develop any new 
drugs?
    Secretary Becerra. Congresswoman, thank you for the 
question. I think the President has been very clear that we 
wanted to have a vibrant domestic source of medicine, but we 
also want to make sure that we're getting a fair price for 
those medicines for the people whether it's under Medicare or 
Medicaid, or any other program. And so, the President has made 
a commitment and I'm going to try to follow through on that to 
make sure that as we try to lower the prices of those drugs, we 
look at every type of proposal, including H.R. 3 to get us 
there.
    Ms. Omar. Thank you, Mr. Secretary. I would also like to 
ask you about the future of our healthcare workers. Throughout 
the COVID-19 pandemic contact tracing and translators with 
experience in hospitality, community engagement and other 
fields have used their transferrable skills to streamline 
access to COVID-19 testing, vaccinations and treatment for 
communities heavily impacted by COVID-19.
    What plans does HHS have to ensure that contract tracers 
without prior public health experience can find employment and 
fully transition into the healthcare field?
    Secretary Becerra. Congresswoman, you're probably aware 
that this Administration, by the way with your help in passing 
the American Rescue Plan, is going to be dedicating a number of 
funds and resources to try to help us with the healthcare 
workforce. We understand COVID-19 taught us that were not 
prepared for primetime when it came to dealing with something 
like this pandemic.
    All those gaps in coverage, all those places in America 
that get missed, it's a lot of it because we don't have the 
workforce that we need. We also have to make sure we're paying 
that workforce properly so that people will want to go into 
those fields. So, we believe with some of the resources that 
you've made available through the American Rescue Plan that we 
can actually improve the condition of our public health system 
by improving the conditions of our workforce.
    Ms. Omar. Thank you. Recently I had the opportunity to 
visit an influx care facility in Texas. One thing we heard 
consistently from operators and the HHS staff working there, 
was that the importance of uniting and accompanied minors with 
these sponsors in the U.S. as quickly as possible.
    They outlined to us what some of the barriers were in 
unification, including many core specific issues like delayed 
and processing of background checks and the inability for 
fingerprinting to take place during the quarantine and COVID 
closures. Can you share with us what steps HHS is taking to 
unit children with their sponsors as quickly and safely as 
possible, while still taking COVID precautions into 
consideration?
    Secretary Becerra. First, thank you for your visit to the 
city and for the oversight that you and others are performing. 
We're doing everything we can to try to make sure we find a 
responsible custodian. And I want to emphasize responsible 
because we're not going to let a child go until we feel 
confident that that child will be cared for because we've seen 
other instances where that hasn't been the case.
    We continue to increase the number of personnel that we 
have that can help us do that intake process to be able to 
discharge that child, but it's a difficult process, and as 
you've mentioned COVID has made it more difficult. Let's put it 
this way, we can no longer rely on those licensed care 
facilities that typically would take these children and provide 
them the full set of services and then do the discharge the way 
we used to because those facilities have had to pare down the 
number of kids they accept.
    And so, these emergency intake sites that you visited are 
the ones that are doing some of this work. It is tough, but 
we're going to do it right.
    Ms. Omar. I appreciate you. I yield back my time Chairman.
    Chairman Scott. Thank you. The gentlelady from Illinois, 
Ms. Miller?
    Mrs. Miller. Yes, Thank you, Mr. Chairman, Ranking Member 
Foxx, and Mr. Secretary. The Trump administration was the most 
pro-life Administration in this Nation's history, working hard 
to defend unborn human lives. I'm sad to say that the Biden 
administration is shaping up to be the most pro-abortion 
Administration in history.
    It's truly sad to see our Nation which was founded on the 
idea of natural rights that belong to all humans, dehumanize, 
and attack the most vulnerable among us, the unborn. Secretary 
Becerra, under your leadership of the Department of Health and 
Human Services, the Department has decided to disband the Human 
Fetal Tissue Ethics Advisory Board created by the Trump 
administration to evaluate grant research conducted by the FDA 
and the NIH and ensure that the U.S. Government was not funding 
or participating in unethical research.
    Fetal tissue may sound like an abstract term, but there's 
nothing abstract when researchers are ordering skulls, bones, 
hearts, eyes, and livers from the bodies of unborn babies who 
are too vulnerable to defend themselves.
    Human beings have inherent dignity and should never be used 
as a means to an end. Using fetal tissue from babies killed in 
elective abortions to further research priorities is using 
human lives as a means, rather than treating them with the 
dignity that all human beings deserve.
    So, my question is why did you decide to disband the Human 
Fetal Tissue Research Ethics Advisory Board? Shouldn't we do 
all we can to ensure that taxpayer funded research is done in 
an ethical manner? And then will you commit to investing in the 
creation of ethical alternatives to the use of aborted fetal 
cells in research, drug, and vaccine development?
    Secretary Becerra. Congresswoman, thank you for the very 
important question. I want to make sure we're very clear on 
something. The work that we do at HHS and that NIH and the 
research, is done completely according to the law. There are 
well-established and rigorous regulatory frameworks for the use 
of fetal tissue in research. Any research funded by the NIH 
using fetal tissue goes through all of the appropriate 
guidelines and oversight.
    There is no doubt that we have had some scientific 
breakthroughs and life-saving treatments that have become 
available to Americans as a result of the work that's been done 
according to the law. And the legal and ethical oversight that 
has been in place by decades by the way, not just recently, but 
for decades, and has been supported by democratic and 
Republican Administrations has allowed us to move forward 
because at the end of the day this is a President, and this is 
an Administration that is pro-care and making sure that we 
offer our families the care that they deserve.
    Mrs. Miller. So, do you commit to rigorously enforcing a 
prohibition against the sale of aborted fetal baby parts for 
profit?
    Secretary Becerra. I can absolutely commit that we will 
make sure we follow the rigorous regulatory framework for the 
use of fetal tissue research.
    Mrs. Miller. To enforce the prohibition against the sale of 
aborted fetal baby parts, skulls, bones, hearts, eyes, and 
livers from the bodies of unborn babies?
    Secretary Becerra. Congresswoman I think I'm being as fair 
as I can be. We're going to make sure that we not only abide by 
the law but enforce the law when it comes to fetal tissue 
research.
    Mrs. Miller. It's also come to my attention that your 
department will be resuming intramural research using aborted 
fetal tissue. President Trump suspended the use of fetal tissue 
from elective abortions for NIH conducted research to protect 
the sanctity of human life. Can you justify this decision to 
the Committee please?
    Secretary Becerra. The previous Administration did a lot of 
things that we're not going to do. What I will tell you is that 
what we will do is make sure that as we move forward, whether 
it's on research or any other items that are under the HHS 
agenda, we will do them according to the law and in a 
transparent accountable fashion.
    Mrs. Miller. Thank you. We want transparency with 
accountability. And another question in light of vaccines in 
children, an FDA advisory panel recently met to discuss the use 
of COVID-19 vaccines in children as young as 6 months old. The 
meeting took place on the same day Moderna asked FDA to expand 
the emergency use of the COVID-19 vaccine to children as young 
as 12.
    Pfizer's vaccine has already been authorized for children.
    Chairman Scott. The gentlelady's time is expired. If you 
could very quickly State your question so that he could give a 
brief answer.
    Mrs. Miller. OK sure. Do you believe we should be treating 
children differently than adults when it comes to vaccinating 
children with a product that has not been fully approved? And 
do you believe that schools should require authorized COVID-19 
vaccinations for their children before attending classes this 
fall?
    Secretary Becerra. Congresswoman we can followup because I 
know the time is expired. I'll simply say this. We always 
looked at children differently than we do adults, and let the 
science drive where we go, and CDC has made that, and NIH and 
FDA have all made that very clear it that before we move on 
vaccines, we do it with the science behind us.
    Chairman Scott. The time has expired. Thank you.
    Mrs. Miller. Thank you and I yield back.
    Chairman Scott. Thank you. The gentlelady from New Mexico, 
we're running short on time, but usually we will tolerate it, 
so I apologize. Ms. Leger Fernandez from New Mexico.
    Ms. Leger Fernandez. Thank you, Chairman Scott, and Thank 
you, Secretary Becerra, boy what a difference 6 months makes. 
Because of President Biden's leadership, Congress's passage of 
the American Rescue Plan, and in particular your department's 
work, there's a sense of optimism. I feel it. I think everybody 
feels it as vaccinated people are gathering in public again.
    They're visiting our small businesses, and we're all 
looking forward to a more prosperous future. So, you're opening 
statement correctly noted that the pandemic hit the most 
vulnerable the hardest. I want to focus on a few of those most 
vulnerable that we might not talk about enough.
    And as I talk about it, I'm really going to also focus on 
the need for facilities. So, one is our woefully underfunded 
Indian house service facilities, two with the survivors of 
domestic violence, and three, those suffering from substance 
abuse who need in-patient treatment.
    So, as we are opening up, we know that our domestic 
violence shelters are overcrowded. They've had to turn away 
women and children because they don't have the rooms and beds, 
they need given COVID's distancing requirement. I really do 
appreciate your answers to my friend, Representative McBath on 
providing services for the prevention of family violence.
    And as I've visited the shelters in my district, they truly 
appreciated the American Rescue Plan's funding, but they kept 
going to the fact that they need help to build and keep 
facilities operating. They need access to affordable housing 
for victims as they leave shelters.
    So, Secretary, could you briefly discuss what measures are 
included in the IG's budget and proposals to address the 
facility needs, the facility and housing needs?
    Secretary Becerra. Congressman, great to have you onboard 
and I look forward to working with you. You have big shoes to 
fill, but I suspect you're more than ready for it, so I look 
forward to working with you. I will simply say this. President 
Biden made it very clear where his values are when it comes to 
Indian country.
    He has made a historic investment in the Indian Health 
Service agency that we operate here at HHS. And we're going to 
make sure that we are on the ground working. And I probably met 
with tribes from throughout the country already more than I 
think people would have expected. You know the work we have to 
do because for far too long HIS was underfunded, and we're 
going to try to do everything we can.
    If you help us pass this budget to try to really get on the 
ground and provide some of the infrastructure and the services 
that are needed back home. You will also notice that this 
budget calls for a 2-year cycle for appropriations so that back 
home in Indian country folks have a better sense of the type of 
funding they can expect to come out of the Congress and the 
Federal Government because it is difficult to budget and plan 
your healthcare needs for your communities if you can only rely 
on 1-year funding.
    So, we're trying to do the things that tribes throughout 
the country have said to us they'd like to see us do.
    Ms. Leger Fernandez. I truly appreciate it because you know 
it's amazing. I think the public doesn't know that we really 
only fund 36 percent of what's spent per capital nationally. 
For healthcare, only 36 percent for tribal care, and I think 
there's a 39-billion-dollar shortfall. I think we have a little 
disagreement on the shortfall between what some of the 
advocates are looking at, and what IHS is looking at.
    The other place where we have a really big need for bed is 
with regards to substance abuse. As I travel, I just read you 
know New Mexico has been very hard hit with substance abuse, 
mental health issues that lead to that. And you've talked a bit 
about the operational funding, but what I hear over and over 
again, and this is in Indian country, this is in rural New 
Mexico, this is rural America.
    It's affecting Latinos. It's affecting Native Americans. 
It's affecting all Americans, is we don't have the beds that 
are often needed for in-patient, which means sometimes people 
are dying in jails because they get picked up. They're dying 
alone, and they need in-patient treatment often times, so tell 
me what IHS is proposing regarding that aspect.
    Secretary Becerra. As you know more than 2 billion dollars 
that the President calls for in his budget will try to address 
a number of those concerns, but it's going to be difficult to 
make up for years of underfunding in one budget, and I would 
look forward to working with you, and this is what I said to 
tribes as I've visited these last several months that I've been 
Secretary.
    We look forward to working with folks on the best ideas in 
how we move forward both in terms of facilities and in 
services, because we know in both cases there is a dire need to 
be ready and go and making it better.
    Ms. Leger Fernandez. Well, thank you so much Secretary 
Becerra. I will followup with you also with regarding the 
issues around the beds that are needed in domestic violence 
shelters as well, and my time is up, and I yield back. Thank 
you, Chairman Scott.
    Chairman Scott. Thank you. The gentlelady from Indiana, Ms. 
Spartz.
    Mrs. Spartz. Thank you, Mr. Chairman and Mr. Secretary for 
testifying in front of us. As a Member of the Judiciary 
Committee, I visited the border several times, and I was 
surprised to learn of the change in the policies that your 
agency did from the Trump policy related to the unaccompanied 
minors, so to release unaccompanied minors to potential 
sponsors, Trump administration required all sponsors and adult 
household Members to undergo background checks.
    I was told that you changed your policy which I will look 
at the press release from your agency on May 5th, and you 
confirmed that you did change your policy. So, my questions for 
you, by cutting corners, and eliminating this proper background 
check, why would you change this policy, and don't you put life 
of these kids at risk?
    Secretary Becerra. Congresswoman, thank you for the 
question, and a critical question because we want to make sure 
kids are safe. What we did was we took into account where there 
was a parent, not just an adult, but the actual parent of the 
child that while we did do a check, and we do a thorough 
analysis to make sure that this is the parent of the child, we 
feel far more confident if this is the actual parent of the 
child that we can try to make sure that the discharge occurs as 
quickly as possible.
    Mrs. Spartz. I get it but your policy does not say that you 
don't do it just for parents. It just says for any sponsor, 
maybe not a parent, you don't have to do check household 
Members, regardless of who they are. Isn't it by creating this 
policy you potentially don't know where the kids go? How are 
you even tracking the child welfare?
    Now you have created a situation where this life can be at 
risk, regardless, and then you don't even know where the 
parents, what kind of household they live, so you now aren't 
checking anyone in that household. Isn't it potentially cutting 
corners and putting their life in danger? Or do you believe 
that is not?
    Secretary Becerra. Congresswoman, I urge you to reread the 
guidance that we put out and the instructions, because I think 
you have misread it, but I'm more than willing to sit down with 
you to go through and explain it later on with my team. We do 
not put any child in danger.
    We make sure that we place them in the hands of a 
responsible custodian.
    Mrs. Spartz. But is it correct that you are not requiring 
to do the adult household Members of sponsored background check 
unless there is a reason to, but as a policy it was a change of 
policy? Do you agree with that? Because that's what it says in 
your press release.
    Secretary Becerra. Congresswoman, we don't release any 
child into the hands of any person, including their parent 
until we can confirm that they are not only the parent or a 
responsible adult, but that we have the confidence that the 
children will be safely cared for. So, no child, regardless of 
who the custodian might be, parent, adult family Member, or 
not.
    Mrs. Spartz. But you don't check background checks. You 
don't do background checks.
    Secretary Becerra. Yes, we do, do background checks.
    Mrs. Spartz. You're actually doing and required to do 
background checks on all household Members of that sponsor?
    Secretary Becerra. Congresswoman, as I said, I urge you to 
read our policy.
    Mrs. Spartz. I just read it, so maybe you communicated, or 
that's what I was told by people on the ground in the shelters. 
That's what your press release says, so maybe you need to 
communicate that policy better, but we'll try to clarify that 
and full office view, and I yield the balance of my time to 
Congresswoman Foxx.
    Ms. Foxx. Thank you, gentlewoman, for yielding. Secretary 
Becerra you recently testified before the Senate Finance 
Committee that you'd be open to revisiting the ACA definition 
of affordability for employer-sponsored coverage. Currently 
employers must offer plans that cost 9.83 percent or less of 
the employee's household income.
    But you talk about revisiting this definition, do you mean 
lowering the affordability threshold which will either move 
more employees onto the ACA strain, or increase costs for 
employers? According to 2020 coverage data from the Treasury 
Department, the cost per family to taxpayers on the ACA 
marketplace is $5,722.00, while the cost per family for 
employer-sponsored insurance is $3,974.00.
    How would this proposed change to the definition of 
affordability be affordable to taxpayers?
    Secretary Becerra. Congresswoman, I'm more than willing to 
followup with you and your team if you'd like to explore this. 
What we're going to do is if we're going to make any changes, 
it's to make sure that the care, the healthcare coverage is 
more affordable. We're not about to make any changes that would 
cost an American more money to access the quality of healthcare 
that would be available through the ACA.
    Ms. Foxx. Well, when taxpayers subsidize healthcare for 
those who are on the ACA, that is costing taxpayers money. And 
by the way in your recent testimony every time before the 
Committee you've been in-person, with that Mr. Chairman I yield 
back.
    Chairman Scott. Thank you. The gentleman from New York Mr. 
Jones.
    Mr. Jones. Thank you, Mr. Chairman. A few minutes ago, the 
Secretary was lectured on the importance and the sanctity of 
human life by a Member who just yesterday voted against 
awarding the congressional Gold Medal to our brave police 
officers who risked their lives, and in some instances even 
died to save us in that violent insurrection on January 6.
    And I think it's important to call out the hypocrisy of 
that. Secretary Becerra today I would like to ask you a few 
questions regarding Head Start. As you know Head Start programs 
across the country provide vital early education to children 
from low-income households ensuring that they are well-prepared 
to enter primary school.
    These facilities work to develop social skills and 
emotional well-being in young children as well as offer them 
nutritious meals, health screenings and mental health supports. 
As we build back better from the COVID-19 pandemic, we must 
recognize that the public health crisis has presented unique 
challenges for low-income communities, the same communities 
served by Head Start programs, and many families lost sources 
of income and daily childcare services.
    Despite most Head Start facilities closing their doors in 
order to protect public health, many still work tirelessly, to 
provide resources and support to children and families facing 
new challenges as a result of the pandemic. So, Mr. Secretary, 
we know that the Head Start Act has not been reauthorized since 
2007, and in that time, Head Start programs in many parts of 
the country have found the disconnect between the income 
eligibility thresholds of 100 percent, and even 130 percent of 
the Federal poverty line to be inconsistent with how expensive 
it actually is to live in this country, and what it actually 
means to be in poverty.
    This is especially true in high-cost areas like the one I 
represent in New York, and of course the one that you 
represented when you are a Member of Congress. What actions 
will you take to ensure that Head Start is available for young 
children in need, but who currently might not be eligible due 
to outdated eligibility requirements?
    Secretary Becerra. Congressman, I could not agree with you 
more in the way you've articulated this. We have too many 
families who are modest income, working really hard, but are 
losing their opportunity to qualify for Head Start, and even 
for families that do qualify we just don't have the resources 
to help the way we should.
    And so, the investment that this Administration has made of 
over a billion dollars in Head Start will take us a little 
farther in making sure families have that opportunity. You and 
I would probably agree how tremendously important it is to give 
that child a chance to start on the right track as they get 
ready for kindergarten, and Head Start is crucial.
    But what we can't do is let hard-working low-income 
families miss out simply because the rates have you know become 
unbalanced so that they don't qualify, even though they really 
don't have the resources to pay for something like that on 
their own.
    Mr. Jones. Thank you. I want to keep our focus on Head 
Start. You know that in Fiscal Year 2020 Congress deliberately 
allocated resources for Head Start programs to address the 
concerning rise of childhood trauma throughout our Nation, gun 
and domestic violence, prescription drug abuse, disaster 
related displacement, loss of a parent and other traumatic 
events can leave a child further behind emotionally, 
physically, and educationally.
    With those critical funds Head Start programs pursue 
trauma-informed care training and increased access to mental 
health counselors. They have also developed unique strategies 
to support Head Start families. But nevertheless, these Head 
Start programs are already reporting a significant uptick in 
pandemic related trauma with children and families, and while 
there is a desire for the Administration to expand Head Start 
and move forward, many programs are still grappling with COVID-
19.
    Would you support increased and specified funding in Fiscal 
Year 2022 to help Head Start programs and address the mental 
health and childhood trauma issues for existing families?
    Secretary Becerra. Congressman I would love to be able to 
say that that's what we will do. I will work with you to make 
sure we have the funding for that. The only hesitation I have 
is that I don't want to lock out sources of funding for other 
valuable vital services within Head Start, but you are 
absolutely right. If we don't tackle this, we're letting the 
child become really a time bomb as they grow older, so we 
absolutely have to do something to provide that mental health 
service.
    Mr. Jones. Thank you. And finally, can you speak to the 
role that Head Start will play moving forward as you seek to 
expand early learning opportunities through your proposals?
    Secretary Becerra. If I had my way Congressman, we would 
make sure every child, your child, my child, who cares whose 
child it is, have a chance to have that start. And we want them 
to be ready to learn, and you've got to give them that chance 
at a Head Start.
    Mr. Jones. Thank you, Mr. Secretary. I yield back Mr. 
Chairman.
    Chairman Scott. Thank you. The gentleman from Wisconsin, 
Mr. Fitzgerald.
    Mr. Fitzgerald. Thank you, Mr. Chair, and Thank you, Mr. 
Secretary for being here. I probably have a unique perspective 
as one of the Members of the Committee today having worked in 
Wisconsin legislature during the pandemic, and as you probably 
are aware, the Deputy Secretary Andrea Palm was part of the 
Evers Administration.
    You know there's a patchwork of local ordinances, both at 
the municipal level and at the county level. Many of them are 
antiquated, as well as State statute. And when the pandemic 
hit, I quickly identified I think many of my colleagues 
identified that there were significant issues that hadn't been 
addressed. And it became kind of a push and pull, often times 
amongst the different levels of government as to what was an 
adequate response, or a response that would make sense.
    And I disagreed with Governor Evers in Wisconsin as the 
Senate Majority Leader, and I also disagreed with Secretary 
Palm on their approach in that how long they held kind of 
things close to the vest on what their approach would be. Let 
me ask you a couple questions.
    If there's a resurgence in COVID, or a variant, what's the 
Administration's position on lockdowns and mask mandates? I 
know that candidate Biden, President Biden now, had absolutely 
said that he would support some type of national mandates on 
those fronts. Where are you guys at on that right now?
    Secretary Becerra. Congressman, thanks first for the 
question, and your question while maybe hypothetical, could 
appropriately happen. And so, what I would say to you is that 
what the President has always said is that we're going to have 
science guide our best practices, and we're going to try to 
make sure that we are right there with our State and local 
partners, never abandoning those partners.
    And what we're going to do is work with them because the 
ultimate decision is up to the states and local government 
leaders how to proceed. The Federal Government does not mandate 
to a local community how to do things, but we do have the 
jurisdiction. The President has been great in asking the states 
if it involved transportation and goes beyond states to those 
kinds of things where he does have authority.
    We're going to do everything we can to protect America. 
We're going to do everything we can to beat back the COVID. 
We're going to do everything we can to give people what they 
need as quickly and as early.
    Mr. Fitzgerald. Would you go as far as to say that you 
would call for a mandate on that?
    Secretary Becerra. Well as you've heard the President say 
before those decisions are really State decisions. They're not 
for the Federal Government, and so right now we've been working 
pretty closely with the Governors and our State partners to 
make sure that you provide them with every type of support that 
we can, so as they move forward for their states, they do this 
in a safe a manner as possible to promote their health and the 
return to normality for all these people.
    Mr. Fitzgerald. Let me ask you a further question on 
vaccinations then. It seems that with certain segments, age 
groups, we've kind of hit the wall on vaccinations. There's 
just a number of people that are saying I'm not going to take 
the vaccination. I'm not going to force any of my children to 
take the shot. What is your approach on that, and what are you 
going to do about that?
    Secretary Becerra. We continue to reach out. We think that 
there are still millions of Americans who want to have a 
vaccination, who are willing to come forward. We want to find 
them. We're going to go to them. We're not going to wait for 
them to come to us, so we want to make it available.
    You no longer have to wait in line. You don't have to worry 
about your age, as long as you're 12 and over, and we're going 
to do everything we can to work with trusted partners in the 
community to reach those folks. We are continuing our efforts. 
We just established for example a youth forum to help us reach 
out to young Americans who haven't yet been vaccinated.
    And so, we're going to continue to do all the work, whether 
it's establishing a tollfree number, a website, a way to get 
information on where the closest vaccination site is to you, 
and of course mobile clinics and all the rest.
    Mr. Fitzgerald. No mandates though? No mandates on 
vaccination?
    Secretary Becerra. As I said before, we leave that to the 
states to decide how they go about doing that. We're going to 
be their good partner and not abandon it.
    Mr. Fitzgerald. Let me just ask one more question on the 
COVID topic.
    Chairman Scott. The gentleman's time has expired. Ask a 
quick question, and a quick answer.
    Mr. Fitzgerald. Yes. Well, hospitals and healthcare 
workers, I mean huge issues still exist, and I'm wondering what 
the Administration is doing to shore up hospitals and the 
shortage of healthcare workers.
    Secretary Becerra. We're going to do everything Congressman 
we can to make sure that we have the PPE and all the supplies 
that we need. Healthcare workers should be the last people who 
could run out of those kinds of supplies. We're working with 
hospitals. We've got to provide a relief fund. Congressman, we 
can give you a more detailed response, but we're going to be 
there every way we can.
    Mr. Fitzgerald. I yield back. Thank you.
    Chairman Scott. Thank you.
    Ms. Foxx. Mr. Chairman there's interference when the 
Secretary is speaking.
    Chairman Scott. I think that was on Mr. Fitzgerald's part. 
Well, let's see how it goes with the gentlelady from North 
Carolina Ms. Manning.
    Ms. Foxx. OK.
    Ms. Manning. Thank you, Mr. Chairman, and Thank you, Mr. 
Secretary for being with us today. I want to talk about the 
kind of health insurance plans that the Trump administration 
took steps to increase. They increased enrollment in junk 
health plans, consumer protections, under the Affordable Care 
Act, and these include in products like short-term limited 
duration insurance policies which do not cover essential health 
benefits.
    They charge higher premiums for people based on illness, 
and they discriminate against people with pre-existing 
conditions. Could you talk to me about what steps the Biden 
administration plans to take to reduce the harmful impact of 
these kinds of plans on consumers?
    Secretary Becerra. Congresswoman, thank you for the 
question. And we intend to enforce the Affordable Care Act. The 
Affordable Care Act was all about providing consumers with real 
coverage and at an affordable price, not duping people into 
thinking they've got health insurance, and the day they use it 
find they've got this massive bill they can't afford.
    We are interested in making sure that if an insurer wants a 
plan out there that it is not junk. And so, we're going to work 
really hard with the powers that we have, and any you decide to 
give us, to make sure that no insurer goes out there and sells 
a faulty product that's nothing but junk to the American people 
when it comes to healthcare.
    Ms. Manning. Thank you, Mr. Secretary. And like many 
Americans, I am deeply concerned about rising prescription drug 
costs. This became an issue with my family. I have personal 
experience with a daughter who was diagnosed with a chronic 
illness, and I was stunned by the cost of the medications that 
she needed to live a normal life.
    So, what is the Biden administration going to do to help us 
bring down the cost, the really outrageous costs, of so many 
kinds of prescription drugs?
    Secretary Becerra. And Congresswoman, here's where I hope 
you all will decide to help us with some changes in statutory 
law, and that is the President said, ``You let me negotiate 
drug prices I will do it.'' To the degree that we have the 
power to do that, we'll try to do it. As you know some of those 
issues are tied up in court.
    He has said we're going to look at every way that has been 
devised, including in other countries, to figure out how we can 
lower the cost of prices of drugs. The President is very 
focused on this. Prescription drug prices are just too high, 
and there's no reason for it, and we're going to do everything 
we can. We hope we can work with you so that we have even more 
authority to bring down the cost of those drugs.
    Ms. Manning. Thank you, Mr. Secretary. The people in my 
district need the relief, and the people all over the country 
need the relief, so we look forward to working with you on this 
issue. I'd like to turn to a different issue, and that's the 
impact that COVID has had on women with postpartum depression 
and other mental health issues.
    Certainly, the isolation forced on people by the pandemic 
has exacerbated these kinds of issues. Can you talk to us a 
little bit about the funding in the budget to address maternal 
mental health issues?
    Secretary Becerra. Congresswoman, thank you. This one is 
really important because in a country as sophisticated and as 
talented and as wealthy as America, we should not have women 
who are actually dying postpartum. And so, one of the things 
that we have done is not only invested some additional funds in 
providing maternal health services to women, but we've now put 
out a program that so far, a couple of states are looking at.
    Michigan has signed on to a program that actually provides 
a woman with postpartum care beyond 60 days, which is what 
currently is provided under Medicaid. We're willing to help 
that State extend postpartum care for that woman for up to a 
full year and we will be great partners in helping finance 
that. And we hope that there will be states who take that up.
    Ms. Manning. Thank you so much. This is a huge issue. There 
are many of us here who look forward to working with you on 
addressing maternal health issues, so thank you for that, for 
all your dedication. Mr. Chairman, I yield back.
    Chairman Scott. Thank you. Thank you. Your colleague from 
North Carolina Mr. Cawthorn.
    Mr. Cawthorn. Excellent Mr. Chairman thank you very much. 
Dr. Foxx thank you for your leadership. Secretary Becerra, 
congratulations on being appointed as Secretary. What we have 
seen out of the Department of Health, and Human Services I 
believe is nothing short of rank hypocrisy.
    I'm confused when the health of the American people and 
their best interest has become a political tool. Quite frankly, 
I find it disgusting. And now sir as head of the Health and 
Human Services, I assume you are aware that CDC policy it 
states that children two or over must wear a mask in public, 
correct?
    Secretary Becerra. Congressman, the guidance we provide is 
based on science, and its guidance to the states, and they can 
decide how to implement it.
    Mr. Cawthorn. Correct. But your guidance is that children 
two and older must wear a mask?
    Secretary Becerra. We want everyone to be safe Congressman, 
affirmative.
    Mr. Cawthorn. So, children two and older must wear a mask. 
Now I also know that science has indicated that young people, 
especially our young children, are less likely to have serious 
symptoms from COVID 19, is that what your findings have told 
you?
    Secretary Becerra. Less serious doesn't mean they don't 
become serious. We want to make sure every American is 
protected if that's possible, and we leave that to the states 
to decide exactly how.
    Mr. Cawthorn. Of course, but according to you the science 
that has been released by CDC, children that are very young are 
less likely to have serious symptoms, much less likely than 
older people and people with diabetes. Now Secretary Becerra, 
you are aware that the youngest age recommended for a vaccine 
currently is 12 years old. Is that also, correct?
    Secretary Becerra. Right now, the CDC guidance says 12 
years and older.
    Mr. Cawthorn. Understood. So now let me get this straight, 
and please forgive me if I'm reiterating some things. But the 
CDC recommends that a child two or older has to wear a mask in 
public, yet they also advocate for children not to get a 
vaccine until 12 years old, is that what you understand?
    Secretary Becerra. CDC is trying to make sure we protect 
all of our loved ones.
    Mr. Cawthorn. I understand we're trying to protect everyone 
sir, but you understand that you have to wear a mask at 2 years 
old until you're fully vaccinated, but you can't get vaccinated 
until you're 12 years old, correct?
    Secretary Becerra. Do you understand the science behind 
saying a mask helps protect a child, and the science behind 
saying when a child can get vaccinated? You're mixing apples 
and oranges, I think.
    Mr. Cawthorn. Well, I disagree with you their Secretary, 
but so putting us all together essentially, a 2-year-old is not 
recommended for the vaccine, but the only way that you can take 
a mask off in public is to be vaccinated. So essentially CDC's 
policy is to keep masks on children for up to 10 years, what is 
your defense for that?
    Secretary Becerra. First, I think you have described it 
improperly. What I will again repeat is that we are trying to 
make sure that no one, including a child, contracts COVID 
because it can be dangerous for everyone including a child. The 
safer we all are means the sooner we can return back to normal.
    Mr. Cawthorn. I understand sir, but the current CDC 
guidelines which have no sunsetting period are saying that they 
have to have a mask on after 2 years old. They can't get a 
vaccine until they're 12.
    And now I don't expect you to get into the weeds of our 
psychology, although you are the Secretary of Health and Human 
Services, but are you aware that studies have shown that masks 
on children impact social integration? It disadvantages our 
young children from developing the necessary skills to discern 
emotions.
    You know it creates a depression, even delayed speech. Now 
I assume you're aware of these studies?
    Secretary Becerra. Congressman, again I hope you'll 
recognize as you've said, CDC is offering guidance. It is not 
mandating. It is offering guidance based on the science.
    Mr. Cawthorn. Now I never said you were mandating, but 
you're offering guidance with a significant amount of blue 
tape.
    Secretary Becerra. But you did say that kids have to wear, 
and what we do is provide guidance. If the child is wearing a 
mask it's probably because the parents have made the decision 
to have that child wear a mask, not the CDC.
    Mr. Cawthorn. And I believe it has been well-founded that 
almost every single blue State in this country follows the 
guidance that the CDC is putting out.
    Secretary Becerra. I hope every State would follow the 
guidance.
    Mr. Cawthorn. I assume Mr. Secretary I have limited time. 
What kind of emotional damage do you think keeping these 
children masked will do to our next generation?
    Secretary Becerra. We're going to try to make sure that no 
child goes through any emotional trauma. Losing your parent 
could be as traumatic as anything I can think of, and if you're 
not safe from COVID, there's a good chance that you might lose 
a loved one, so we want to make sure everyone is as safe as 
possible.
    Mr. Cawthorn. Well, Mr. Secretary I too want everyone to be 
protected, but Mr. Secretary I've got to say sir I'm disgusted. 
Studies clearly indicate that the primary time for social and 
emotional development among our children begins and ends 
precisely in the same timeframe you would muzzle America's 
youth.
    Now I know you say it's just a recommendation, but many, 
many, many people are following it. You know that young 
children are unlikely to be severely impacted by COVID, but you 
don't care. You know that COVID is statistically a medical 
afterthought for children between ages 2 and 12, 2 to 12, but 
you don't care.
    I know it's not a mandate, but CDC's guidelines with strict 
access to vaccinations for individuals under 12 currently, but 
you just don't care. You know that study after study have shown 
that mask wearing at a young age can impact social, emotional 
and a range of capabilities, but sir you simply don't care.
    And if you want me to send you those studies, I'm more than 
happy to have my staff have those sent to you. And Secretary 
Becerra, let me tell you what you do care about sir, from my 
evaluation you care about power. You care about muzzling 
America's future, our children, and forcing them to wear a mask 
from ages 2 to 10, 10 years before they can breathe the air of 
freedom in this Nation.
    Sir I will remind you that we are not descended from 
fearful men. I believe we can beat this virus. I believe that 
our young children are absolutely very close to being immune, 
and sir with that I yield back.
    Chairman Scott. Thank you. The gentleman from Indiana, Mr. 
Mrvan.
    Mr. Mrvan. Thank you, Mr. Chairman. Secretary Becerra, the 
Child Abuse Prevention and Treatment Act supports the 
community-based services for primary Federal program to provide 
funding for child abuse and neglect. It also requires that 
every State has a system in place to identify and provide an 
initial response to child abuse and neglect.
    Earlier this year my colleagues and I, including Ms. 
Stevens, and Ms. Stefanik of this Committee, wrote a bipartisan 
letter to the Appropriations Committee that requested a 
meaningful funding increase for CAPTA. I'm glad that the 
President's budget called for 235 million for CAPTA programs, 
an increase of 49 million above last year's enacted level.
    We know that CAPTA has been underfunded for many years, and 
not enough families have access to prevention services. Why do 
you think, and why is it important now is the time for greater 
investment in CAPTA?
    Secretary Becerra. Congressman, thank you for the question. 
I think you'll agree that for far too long we have underfunded 
these services and I think we're interested in trying to move 
forward as quickly as we can, do a better job. I hope that you 
all, and many of your colleagues are interested in helping us 
move forward because I mean the consequences of not acting are 
severe, and so I thank you for the work that you're doing on 
this, and I hope that you'll find that my team is ready to work 
with you to not only increase the funding, but really implement 
it in a way that works for each local community wherever they 
may be.
    Mr. Mrvan. Thank you, Mr. Secretary. In my district I 
attended an open house for Ashley's House, a transitional 
residency offering background services for survivors of human 
trafficking. It is operated by Dr. Calioni Gopel, a 
psychiatrist specializing in sexual trauma of, and victims of 
human trafficking who shared with me the challenges and grant 
opportunities for residency services.
    My question is will you consider opportunities for 
residence services, providers for survivors of human 
trafficking, and can you share HHS's approach toward human 
trafficking?
    Secretary Becerra. Thank you, Congressman. I look forward 
to working with you on that because we know that human 
trafficking occurs here in the United States more often than 
people want to believe and having the responsibility to care 
for these unaccompanied migrant children who are coming across 
the border so often times we see in the past where at least 
reported to be used for trafficking purposes, whether labor or 
sex, that's a very important issue.
    So definitely we look forward to working with anyone, you, 
or others, who are interested in trying to deal with this issue 
and making sure that we're extending more services to those who 
might be trafficked.
    Mr. Mrvan. Thank you, Mr. Secretary. With that Mr. Chairman 
I yield back my time.
    Chairman Scott. Thank you. I understand the gentlelady from 
California, Ms. Steel.
    Mrs. Steel. Thank you very much.
    Chairman Scott. You're recognized for five minutes, thank 
you.
    Mrs. Steel. Thank you. Thank you, Chairman Scott, and 
Ranking Member Dr. Foxx, and thank you for joining us today, 
Secretary Becerra. I have heard directly from many families in 
southern California that a first-rate State officials who 
advocate to keep our schools shut down. These actions put 
students' futures, and in many instances, their lives in 
danger.
    Many families feel officials failed to provide federally 
mandated accommodations. The Director of School Mental Health 
for Los Angeles Unified District recently stated he was worried 
about those that fell through the cracks due to students being 
kept from school.
    As of March 2021, 80 percent of students in Florida were 
attending schools in person, full or part-time without turning 
schools into super spreaders. At the same time almost 6 million 
California children were unable to attend their classes because 
nearly all California public schools remained closed.
    According to Gallup nearly 3 in 10 parents say their child 
is experiencing harm to their emotional or mental health 
because of social distancing and closures. So, my question is 
you mentioned during your confirmation hearing that the 
ultimate decision on school reopening is a local one, yet State 
officials forced schools to stay closed longer.
    I have heard from parents and have seen many heartbreaking 
stories about children who suffered mental health damage 
because they were not allowed back in the classroom. Do you 
agree that the dangers of keeping these children out of the 
class this year far outweigh the risk of bringing them back?
    Secretary Becerra. Congresswoman, thank you for the 
question. Well, first I should mention how President Biden has 
made it very clear he'd like to see children back in school. I 
think we all would like to see them back in school, and we want 
to make sure that we're doing the reopening of our country as 
safely as possible.
    We've saw, you know we've had to go back just a few months 
to see how bad things can be, and how many Americans, more than 
600,000 American lives we've lost. And so, when it comes to the 
reopening of school, we have offered guidance to our local 
school district partners so they can make the best decisions 
possible, as safely as possible, but there's no doubt that 
we're hoping, and the President made it very clear we'd like to 
see kids back in school and do so safely.
    And when it comes to opening every part of our country, not 
just our schools, we're working with our State and local 
partners to make sure it's done with the science driving our 
decisions.
    Mrs. Steel. Thank you very much. I yield back.
    Chairman Scott. Thank you. The gentleman from New York Mr. 
Bowman.
    Mr. Bowman. Thank you, Mr. Chairman and Thank you, Mr. 
Secretary for being here today, and thank you for your lifetime 
of care and service to our country. I have great respect for 
all that you've done and all that you're going to do. Prior to 
coming to Congress, I worked in public education. I worked as a 
teacher, a school counselor, and a middle school principal for 
10 years. Actually, I had the privilege of opening up my own 
community public middle school in Northeast Bronx.
    And you know as I've spent a career serving my students, I 
learned throughout that time that it's really important for 
social services and healthcare to be connected to the work that 
we try to do in schools, both for children and families. 
They're not just spaces for academic support, obviously they 
are, but children come with so many social and emotional needs 
that the interagency collaboration between schools and social 
services need to be sort of centered as we go forward.
    Can you just comment on that and also speak about what 
collaboration looks like on the Federal level between HHS and 
the Department of Education?
    Secretary Becerra. Absolutely Congressman, and can I just 
say thank you for your service. I know that some of those years 
were probably very tough, but at the end of the day it can't be 
more enriched than watching children become leaders of this 
country for tomorrow, so thank you for what you've done, your 
service here today, but perhaps even more so, your service 
educating America.
    And you're absolutely right. Schools are more than just 
educational institutions, they are hubs of a community, and we 
should make use of them. In some communities, especially in 
intercity communities sometimes it's the only green space that 
people have. And so, we should know that we should be using 
that school as an asset, not just to teach our kids, but to 
bring the community together, to have gatherings of neighbors, 
to provide health resources to children and families.
    Our schools are precious, and you know this because you 
were there for so many years, and we should make true 
investments in our schools, not just in providing instruction 
to our children.
    Mr. Bowman. Are you familiar with the community school 
model, the model there you know there are several different 
models? One is the full-service community school where you know 
a family can come, a parent can come drop their child off at 
school, and then go to the nurse, go to the doctor themselves 
within that school facility, even receive dental supports in 
some cases, and also additional mental health supports for 
parent and child.
    Are you familiar with it? Have you seen it work, and how 
can you do more of that and provide a pathway at the Federal 
level to make sure that happens?
    Secretary Becerra. Having served 24 years in Congress and 
represented a modest income district with a lot of working 
families who have to in some cases, have two jobs, and 
therefore need support for their kids who I myself grew up as a 
latch key child. We understand what it takes, and this concept 
is not new, it's just having the resources.
    You can't put it all on the school district, but in some 
places the cities are actually working with the school 
districts, so they're combining city resources for recreational 
services and so forth with the district, and in many cases, 
you've got non-profits who are coming in.
    But quite honestly, it's the parents, it's the community 
that step forward to make that possible and I mean why would 
you not want to have one stop shop at a school where you can 
provide all these services principally for families who really 
don't have that much.
    Mr. Bowman. Another thing I wanted to ask about was the 
early childhood stage of a child's life which is so important 
right, when we think about the first 1,000 days of a child's 
life, and I know we talked a little bit today about Head Start, 
and pre-Head Start programs.
    So, I wanted to highlight, I don't know if you're familiar 
with the term ``ACES, Adverse Childhood Experiences.'' I'm sure 
you probably are. And ACES when they become compounded lead to 
toxic stress, chronic trauma and long-term negative health and 
education outcomes.
    What's your vision for you know doing more in early 
childhood space to ensure we combat ACES, so that children are 
ready to enter kindergarten, you know, hitting the ground 
running because they grew up in a more nurturing space starting 
the first 1,000 days of life.
    Secretary Becerra. Congressman, Frederick Douglas once 
said, ``It is easier to build a strong child, than to prepare a 
broken man.'' And ACES, and what we learned from that is if you 
reach a child even though they've suffered through a trauma, 
you can actually repair that child and let them grow up and be 
healthy, but if you wait too long you're going to have a broken 
man or woman to deal with, and it is far more expensive, and so 
better to invest early in a child than to wait to try to repair 
them when they're men and women.
    Secretary Becerra. Thank you so much and I yield back. I 
look forward to work with you, you're such a breath of fresh 
air, thank you so much.
    Mr. Bowman. Thank you.
    Chairman Scott. Thank you. The gentlelady from Louisiana 
Ms. Letlow.
    Ms. Letlow. Secretary Becerra, I appreciate you coming to 
our Committee today to discuss Administration's Department of 
Health and Human Services policies and priorities. I was 
encouraged to hear during your testimony that the Department 
will look to continue focusing on rural communities.
    Much of the Fifth District of Louisiana is rural. My 
constituents and I see daily the unique challenges that rural 
America faces in healthcare. Many of which have been 
exasperated by the COVID-19 pandemic. Our rural hospitals and 
providers in the Fifth District are an extremely important 
lifeline that provides hearing services of critical importance 
to our rural communities.
    During the COVID-19 pandemic many were in danger of 
physical disaster, but thanks to the Provider Relief Fund, most 
were able to survive the pandemic and have been able to 
continue providing a central care to their communities today. I 
hope that this department will do everything in its power to 
ensure our rural hospitals and providers have the necessary 
tools and resources to continue serving their communities.
    I was also pleased that you mentioned the importance of 
training for health professionals. There is a considerable 
shortage of health professionals in the workforce today, and as 
we look toward the future specifically, I would like to bring 
up our nurses. During the pandemic, the demand for nurses has 
skyrocketed, and in Louisiana we have seen this demand create 
staffing shortages.
    The Louisiana State Board of Nursing estimated that the 
nursing shortage in our State would nearly quadruple from 2019 
to 2025. Nurses are an integral part of our healthcare system, 
and we need to ensure that we have a healthy and vibrant 
nursing workforce. The care and comfort nurses provide the 
patients, and their families is reassuring, and it helps many 
individuals get through some of their most difficult times.
    I hope that we can work to address the nursing shortage 
that is increasing not only in my State of Louisiana, but 
across the Nation. We are headed toward a true crisis if we 
cannot address the shortage of staffing for health 
professionals.
    According to the American Association of College and 
Nursing, U.S. nursing schools turned away over 80,000 qualified 
applicants in 2019. This includes around 1,400 just in my State 
of Louisiana. Secretary Becerra, what do you believe needs to 
be done to address the critical issues of nursing education and 
curbing staff shortages now and into the future?
    Secretary Becerra. Congresswoman, wow great questions 
because you're thinking ahead, and especially for nurses, we 
all talk about doctors and my wife is a doctor. But she talks 
about nurses more than she talks about doctors because she 
understands that there's nothing a doctor can do very well 
without the nurse.
    And I hope that you work really hard on this, and you know 
you have a partner here because we need to increase the 
attraction to nursing by our young people who are talented and 
want to serve, and I hope that what we can do is make sure that 
these young people are willing to go anywhere, including rural 
America because that's where it's toughest to recruit some of 
these folks.
    And so, we could come up with programs that will give that 
incentive to that young person to go into a nursing program, 
and we could provide a program to give incentive to providers 
to have a better policy when it comes to how they recruit those 
future nurses of America.
    We're making an investment in rural America, close to half 
a billion dollars to try to reach out to those healthcare 
providers in rural America. We have a fund of close to 8 or 10 
billion dollars to try to help rural America go through this 
pandemic with a provider relief fund, and so we look forward to 
working with you, hopefully you'll agree that we do this 
transparently to get moneys out to every community but 
including our rural communities.
    Ms. Letlow. Thank you, Secretary. I have one followup 
question. As a mother of two beautiful children, I believe in 
the sanctity of life. I'm deeply concerned the department's 
budget did not include the Hyde Amendment, this long-standing 
policy to prevent taxpayer dollars from funding abortions must 
be retained.
    I am further concerned about the department's decision to 
resend the previous Administration's protect life goal, and now 
allow abortion providers to receive Title 10 funding. The 
majority of Americans do not want their tax dollars funding 
abortion procedures.
    Secretary Becerra, as a former Member of Congress who has 
voted on bills that included the Hyde Amendment, can you 
explain to the Committee why the Administration has decided to 
abandon this 40-year old precedent?
    Secretary Becerra. Congressman, thank you for the question. 
And I do very much look forward to working with you even on 
these tougher issues. I respect that sometimes we have very 
deep seeded beliefs and values in the way we look at some of 
these issues even though we may look at them differently.
    What I can tell you is we're going to make sure that we 
provide access to good healthcare to all people, we're going to 
respect the law, and ultimately, it's Congress's decision what 
will be included when it comes to the issues of the Hyde 
Amendment.
    Ms. Letlow. Thank you, Mr. Secretary. I yield back my 
remaining time.
    Chairman Scott. Thank you. The gentleman from Wisconsin Mr. 
Pocan.
    Mr. Pocan. Thank you very much Mr. Chairman, and Mr. 
Secretary it's great to see you again as always. You recently 
added to your staff someone from my staff, and she had been 
there all eight and a half years, plus earlier she's amazing, 
so take care of her all right. She's very, very talented.
    Secretary Becerra. She's listening to you Congressman, so 
be careful.
    Mr. Pocan. OK. Well, I just want to let you know we miss 
her, but you have a great add to your office. Let me ask you a 
question about ACA ensured denial of claims. There was a report 
recently from Kaiser Family Foundation that said one out of 
every six in-network claims in 2019 was denied under the ACA, 
and it was a 17 percent denial rate, but that rate is higher 
than the 14 percent rate in 2018, double the 8 percent denial 
of claims experienced by Medicare advantage plans.
    You know obviously, besides certainly those high rates, 
those plans have ranged from 1 percent to over 50 percent 
depending on the insurer. I'm just wondering a little bit about 
that because I know that you know CMS does not currently 
require healthcare.gov insurers to report all the transparency 
data required by the Affordable Care Act. Additionally, data 
reported by issuers are not audited by CMS, and the Federal 
Government has not made the data publicly available in a format 
that's easily useable.
    Should I be concerned? What are we doing around this? I 
just want to make sure that you know again we've got healthcare 
coverage as extensive as possible for everyone.
    Secretary Becerra. Congressman, first great to see you and 
thank you for letting us steal some of your talent. I will say 
this. I want you to stay on top of these things. I want you to 
be a bulldog on this stuff, and I want you to keep us 
accountable as well because I intend to do that also.
    We're going to do the auditing, we're going to do the 
accountability to make sure that if you're going to get money 
from the Federal Government to administer a plan, if you're 
doing it right, you're not shortchanging Americans who deserve 
to have a policy covered.
    Mr. Pocan. Great, and I appreciate hearing that and I 
assumed nothing less to be perfectly honest, but I did want to 
raise the issue because you know I think as much as I so 
strongly support the ACA, we want to make it really live up to 
its promise that when you all created it before I got to 
Congress.
    An issue I had mentioned one other time briefly to you 
about Kratom is that I know we haven't put a new head of the 
FDA in yet. But you know we have had some issues, this is a 
drug, a natural substance I should say, not a drug, that has 
helped many people get off of the addictions like heroin, and 
it's been something where the FDA has previously had a pretty 
Neanderthalic response to helping people get off of things like 
heroin, or people with chronic pain conditions, and not have 
addiction properties.
    We found out recently there was a 2018 HHS letter that 
rescinded a recommendation to the DEA, or to the FDA by the 
U.S. Drug Enforcement Agency to classify some of the Kratom 
alkaloids are schedule one substances which would have made it 
even harder for people to get help or for us to do the research 
we wanted to.
    This letter was kind of kept from the public view for a 
couple of years, and only through a request we found it. I 
guess my question is given some of the past mishandling we've 
had, and the lack of transparency, it would be great if you 
could work with the FDA to issue a comprehensive public report 
about it, and you know especially without the FDA head.
    Yet they recently took an action on a company seizing their 
product. Again, this is a legal product that's helping a lot of 
people. I'd like to try to make sure of that, and any efforts 
you could do to help us would be much appreciated.
    Secretary Becerra. Congressman, it appears what I can tell 
you is that the Acting Commissioner Woodcock, she is working 
hard on all of these subjects. I know that we are looking at 
the subject that you mentioned with regard to Kratom. We can 
try to keep you abreast as best as possible.
    But what I could tell you I think what Doctor Woodcock 
would tell you is FDA operates based on the science, and the 
scientific independence that FDA has enjoyed for a long time is 
something we're going to respect. We will work with Dr. 
Woodcock and the FDA here at HHS, as part of HHS, but we 
respect the fact that the FDA has had this independence to make 
scientific decisions, so that way folks don't have to fear that 
politics entered into those final decisions that they're 
making.
    But something you mentioned, we're going to probably have 
about 90,000 people who died over the past 12 months from 
opioids, and so we absolutely have to do something, I look 
forward to working with you on it.
    Mr. Pocan. Yes, and NYDA, when they were up for a hearing 
recently, they also said the research is very promising. So, I 
just wanted to make sure that we don't have the wrong actions 
happening at a time that we're really getting some good 
research right now to help us. Thank you very much. It was 
great to see you again Mr. Secretary. Thank you, Mr. Chairman, 
I yield back.
    Chairman Scott. Thank you. I don't see any other 
Republicans, Dr. Foxx do you want to be recognized now?
    Ms. Foxx. Yes sir.
    Chairman Scott. We have a couple of other Democrats that 
will be seeking recognition. Ranking Member is recognized for 
her questions for five minutes.
    Ms. Foxx. Thank you, Mr. Chairman and I think my question 
comes very, very timely after what the Secretary just said, and 
thank you, Mr. Secretary for being here. Your emphasis on 
scientific decisions. Excuse me, when President Biden was 
elected, he pledged to ``follow the science,'' and you have 
done that many times today and said you're going to enforce the 
law.
    I'm very concerned though by the erupt departures from the 
CDC shortly after President Biden's inauguration of Dr. Nancy 
Messonnier and Anne Schuchat, two knowledgeable, well-respected 
and experience professionals. News reports say they were 
pressured for their positions which disagreed with your 
Administration.
    So please tell me why these two scientific, well-known, 
experienced professionals left the Biden administration? Were 
their departures related to policy and scientific 
disagreements, with incoming Biden political appointees?
    Secretary Becerra. Congresswoman, you've asked something 
really important because I'm not aware of those reports, and I 
know the two individuals, both of them immensely talented, 
dedicated career employees who've done tremendous things, and I 
have nothing but great things to say about their service to our 
government and to the public.
    What they've done to help us through COVID, and all the 
rest is just astounding, but I know of nothing of the sort in 
terms of their decisions being based on what you described. But 
I can guarantee you that I believe in the independence of the 
FDA to make decisions based on science.
    I visited FDA and the entire time. I mentioned that today.
    Ms. Foxx. OK. This is with the CDC, so you might want to 
talk to your CDC Director about that.
    Secretary Becerra. I'm sorry. I apologize. I mean CDC.
    Ms. Foxx. Yes, yes.
    Secretary Becerra. They are being applied; I apologize 
forgive me.
    Ms. Foxx. OK. Well, Mr. Secretary the Biden administration 
did not start from scratch with COVID-19 vaccine development 
procurement and distribution efforts. Operation Warp Speed is 
one of the greatest technical and logistical accomplishments in 
U.S. history.
    As a result of President Trump's leadership and unwavering 
support for OWS, incredible American scientists and private 
sector innovators partnering with the Federal Government, 
produced, and delivered hundreds of millions of effective and 
safe vaccines. The Biden administration inherited a well-oiled 
machine.
    In fact, by January 2021, OWS had already purchased 400 
million doses of vaccine, and delivery around the country was 
underway. What are you doing to ensure that the tools and the 
structure created by Operation Warp Speed are not lost in the 
lessons learned from this historic endeavor are applied to 
programs managed by your department in the future?
    Secretary Becerra. Congresswoman, I think what we've seen 
accomplished under the leadership of Mr. Perna has been 
tremendously important, and I hope that what we continue to see 
is the building from all those lessons that we've learned 
moving forward because what we can't do is face the situation 
where we lose 600,000 lives in this country again, and I think 
that everyone working together, it makes no difference what 
your political background is, your partisan affiliation.
    If you want to do good work, we want you to serve and we're 
looking forward to having people continuing to work on behalf 
of the American people. And my apologies again for having 
slipped up on CDC/FDA, we've just been talking about FDA, I 
meant CDC throughout that, although again both agencies I think 
we recognized base their actions on science to my knowledge.
    Ms. Foxx. Well, we hope, but we keep hearing that said over 
and over again, but what we see happening is not necessarily 
consistent with what you say. I'd also like to point out that 
in recent comments that have been made where you talked about 
women with postpartum depression. Women dying postpartum, a 
woman with postpartum care.
    You know I'm glad you dropped the silly use of the word 
people from that. You know when we see the first man have a 
baby, we'll know we've had a scientific breakthrough, or maybe 
the Lord at work changing his grand scheme for the way we 
should be operating. With that Mr. Chairman I yield back.
    Chairman Scott. Thank you. Our next questioner will come 
from the Chair of the Budget Committee since we're talking 
about the budget, the gentleman from Kentucky, Mr. Yarmuth.
    Mr. Yarmuth. Thank you, Mr. Chairman, and hello Mr. 
Secretary. It's great to see you. And I'm so pleased that so 
many of my colleagues are, that you're sitting where you're 
sitting. You know we've spoken a lot about immigration today, 
and I just had to make the comment that after spending 
virtually every day with you for 7 months back in 2013 as part 
of the gang of eight in the house.
    I can't think of anyone I would trust more with the welfare 
lives of your children at the border than I would you because 
you've shown during that whole time, and through your actual 
career, how much you do care about the people regardless of 
where they're from. And I deeply respect that.
    And some of the comments that question your motivation and 
your caring from Mr. Cawthorn, just were way above the bay, and 
you're owed an apology for that. But I do want to reference 
what Mr. Cawthorn talked about because it seems to me that we 
don't really know everything about COVID-19 right now.
    That when you say following the science, sometimes the 
science is incomplete, and sometimes the science is unknown. 
And so just wouldn't you say that it's true that we still have 
no idea as to what long-term affects might burden young people 
who contract the disease even though they may not have a 
difficult time with it when they get it, is that not the case?
    Secretary Becerra. That's absolutely correct.
    Mr. Yarmuth. And as a matter of fact, there's some evidence 
that young people do have long-term consequences from having 
contracted the disease. We've got a lot more observation to do 
before we conclude that it would be safe for a three-or 4-year-
old to contract the disease, and that we should probably do 
everything we can to keep those kids from contracting the 
disease.
    Secretary Becerra. Precisely.
    Mr. Yarmuth. The one thing I wanted to ask you about, there 
are so many things in the American Families Plan, the American 
Jobs Plan, I think that are crucial, and I applaud the 
President and the Administration for including them.
    I think the 2-years of early childhood education probably 
next to doing something about climate change are the one thing 
that we can do to guarantee a vibrant future for our country 
and our society because those kids need every bit of foundation 
that they can get.
    And the whole issue of childcare and elder care and free 
community college, those things are things that you know I 
think an advanced society should make available to its 
citizens. The one thing I'm concerned about is capacity. And 
but I know we talk about for instance adding long-term care as 
a Medicare benefit. It would be great to do that, you know, if 
we could find the money to do that, but just making it 
available, giving them the benefit doesn't guarantee they have 
access because there's not capacity.
    So, my question is, and I know that these things have to be 
worked out still, is the Administration making plans? For 
instance, in childcare, to make sure that 225 or 250 billion 
dollars for childcare that some of that goes to capacity 
building, so that we aren't just giving people an empty promise 
when we say will you have this benefit now.
    Secretary Becerra. Congressman, absolutely. We'd like to 
make sure that the progress can't be retracted or dismantled, 
and so we need to make sure that we're creating that 
architecture that lets us always know that we're going to be 
able to deal with childcare the right way.
    Mr. Yarmuth. Great. And that's why it's probably very 
appropriate to call it infrastructure.
    Secretary Becerra. Absolutely. As I said as Frederick 
Douglas said more than 160 years ago it's easier to build 
strong children than to repair broken men. Building kids, and 
building the future of America, and that's infrastructure.
    Mr. Yarmuth. Absolutely. Well, I look forward to working 
with you to get the Americans Family Plan, the American Jobs 
Plan passed, and on other matters as well. Thank you for being 
with us and I yield back.
    Chairman Scott. Thank you. I don't see any Members who have 
not been recognized. If not, I recognize myself for questions. 
Thank you, Mr. Secretary for being with us. I have a couple of 
quick questions, and a couple that probably deserve a longer 
answer. First, you are preparing for the next pandemic. Will 
part of that preparation include Buying America, so that we 
have an industrial based making masks and things like that?
    We've heard from a lot of domestic mask manufacturers that 
said they can't compete with masks being subsidized from other 
countries. Can we count on you to consider the industrial base 
and purchasing in America to the extent feasible?
    Secretary Becerra. Absolutely and thank you to you and your 
colleagues who voted for the American Rescue Plan because you 
made moneys available for us to make those investments in 
domestic manufacturing.
    Chairman Scott. Thank you. I talked to an ophthalmologist 
earlier this week who said that he was volunteering to help do 
vaccinations and man the phones for questions. Are the Medical 
Corps of Retired Physicians part of that preparation?
    Secretary Becerra. Absolutely. And we just started up a 
youth corps as well to help get youth vaccinated. We're now 
turning to their peers.
    Chairman Scott. Good. We have we mentioned CAPTA, the Child 
Abuse Prevention and Treatment Act. The House with bipartisan 
support of this Committee and the full House passed stronger 
CAPTA, much more money and prevention and other improvements.
    As you're aware that's over at the Senate, any help you 
could provide would be helpful. The other question is on the 
prescriptive drug negotiation, it will save the Federal 
Government a lot of money. One of the criticisms of the bill is 
that corporations who with making less money might do less 
research.
    Isn't it true that a lot of the savings will be put to the 
Federal Government, will be spent on research?
    Secretary Becerra. That's absolutely correct. In fact, 
we're going to be providing them even more incentives to do 
more production because of the research possibilities.
    Chairman Scott. Thank you. You were in Congress when the 
Religious Freedom Restoration Act passed, and it has been I 
believe abused in many ways, including allowing discrimination 
in Federal contracts which I don't think was ever anticipated. 
There are some groups that have been granted waivers, and are 
discriminating not only on employment, but also in services.
    Would you give a second look at contracts that allow a 
Federal contractor with Federal money to say we don't hire 
Catholics, and we're not going to provide services to those of 
the Jewish faith?
    Secretary Becerra. Congressman, we're against any form of 
discrimination. We want to protect people's rights, including 
religious freedom rights, but we also want to make sure folks 
aren't discriminating, so we will take a close look. If there's 
anything that you know in particular, please let us know. But 
we're going to do everything we can to make sure we enforce the 
law.
    Chairman Scott. Thank you. The American Rescue Plan 
improved the affordability and eliminated the cliff on 
subsidies for those getting healthcare through the marketplace. 
Can you briefly describe why it was important to eliminate the 
cliff and to improve the subsidies?
    Secretary Becerra. Congressman, that's one's a no brainer 
in so many ways. You have families in the middle of American 
who are working hard, they've got protection under the 
Affordable Care Act, all of a sudden if they're fortunate to 
get a slight increase in their salary as a raise, all of a 
sudden that triggers their loss of all their subsidies, and 
from 1 day to the next they've got coverage that they can 
afford.
    All of a sudden it becomes really difficult. No one should 
have to go through that kind of experience where they fall off 
the cliff. Thank you for what you did in the American Rescue 
Plan to save millions of American families. And today we've got 
not only families who can afford to continue their care, but 
we've got a lot of individuals who are signing up under the 
Affordable Care Act and getting plans for less than $10.00 a 
month in premiums.
    More than 31 million Americans today have coverage, 
healthcare coverage, good quality healthcare coverage because 
of the Affordable Care Act.
    Chairman Scott. And that cliff can be very expensive 
because you can be paying 9 and 1/2 percent of your income, 
$9,500.00 if you go a couple of dollars further and lose your 
subsidies, you may be looking at a sticker price of $15,000.00. 
And we got rid of that cliff so that people don't have to 
suffer that shock.
    On the No Surprises Act, one of the provisions in there was 
a requirement that the Health and Human Services work with the 
Department of Labor, and we provided funding. Can we count on 
you to work with the Department of Labor to make sure that the 
funding is equitably distributed so that both agencies can get 
their work done?
    Secretary Becerra. We're meeting regularly with the DOL 
team, and I can commit that to you.
    Chairman Scott. Thank you. And my time has expired, so I 
will remind the Committee that pursuant to Committee practice 
materials for submission to the hearing record must be 
submitted to the Committee Clerk in 14 days following the last 
day of the hearing, so that's close of business June 23, 
preferably in Microsoft Word.
    Only a Member of the Committee or an invited witness may 
submit materials for inclusion into the record, and materials 
must address the subject of the hearing. Please submit 
materials to the Clerk electronically by emailing submissions 
to [email protected].
    Again Mr. Secretary, I want to thank you for participating 
today. The Committee may have some additional questions as you 
know, we'll submit them for a response in writing. The hearing 
record will be held open for 14 days in order to receive those 
responses.
    I remind my colleagues that pursuant to Committee practice, 
witnesses questions for the hearing must be submitted by the 
Majority Committee Staff, or the Committee Clerk within 7 days, 
and questions submitted must address the subject matter of the 
hearing.
    I now recognize the distinguished Ranking Member for any 
closing statement that she may have.
    Ms. Foxx. Thank you, Mr. Chairman, and Thank you, Mr. 
Secretary for being here today. Committee Republicans remember 
well how vicious Committee Democrats were to the previous 
Administration secretary. I'll make the same commitment to you 
that I made to Secretary Walsh last week.
    We'll keep our disagreements professional, and we will 
continue to treat you and other Administration officials with 
the respect your office deserves, no matter how unwise we 
believe your actions appear to us.
    I'm disappointed though, that Democrats no longer demand 
the Cabinet Secretary clear their calendars. Chairman Scott was 
uncompromising with Secretary DeVos on this very point, but I 
noticed that dictate is non-existent for Secretary Becerra.
    A pandemic response in June 2021 is much different from the 
crisis we were combatting in June 2020. The American people are 
following the science and returning to their normal lives. And 
it's past time for Democrats here in the people's house to get 
back to business in person.
    Our families are grappling with many challenges, some of 
their obstacles cannot be solved through public policy and 
should be addressed with a renewed sense of social solidarity. 
But some of their troubles are the result of irresponsible 
action from the Department of Health and Human Services.
    Forced isolation is intensifying a mental health crisis. 
Crowded, unsafe conditions for unaccompanied alien children at 
HHS facilities put these children's health in jeopardy, and a 
rushed vetting process leaves them vulnerable to human 
trafficking.
    Healthcare and consumer good prices are soaring. The 
Medicare trust fund is on the brink of insolvency. China is too 
closely intertwined with our biopharmaceutical manufacturing 
and research initiatives. The Democrats don't seem to care.
    President Biden's bloated budget proposal is as insulting 
as it is morally bankrupt. It seeks to strip Americans of their 
employer provided health insurance, impose a socialist 
healthcare system, coerce Americans to fund abortions, and 
mortgage our children's future.
    I reject the Democrats radical and unpopular agenda, and I 
know very well that the American people do also. Mr. Chairman I 
yield back.
    Chairman Scott. Thank you. And I'll now recognize myself 
for a closing statement, and I want to remind the Ranking 
Member that during the previous Administration the Secretary of 
Health and Human Services appeared before this Committee just 
once, and we appreciate Secretary Becerra as making himself 
available for four and a half hours today.
    Every Member was able to ask five minutes' worth of 
questions, some regrettably went a little over, but we know 
this is not the last time that we're going to see the 
Secretary, so I appreciate his being with us today. And I want 
to thank you for discussing the department's budget request, 
and your vision for transforming our public health system.
    Today we reflected on the critical progress we've made 
under this Administration to confront COVID-19, and to recover 
from the pandemic. However, this hearing has made clear that 
our work is far from over, particularly as people across the 
country continue to lose their lives to the virus.
    We know that stronger investments in public health lead to 
healthier communities, and to that end, I'm pleased that we 
discussed how the department's budget request, the American 
Jobs Plan, and the American Families Plan will finally defeat 
COVID-19 and help people care for themselves and their loved 
ones as we build back a better economy.
    So, thank you very much Secretary Becerra. I look forward 
to continuing our work together as we end this pandemic and 
ensure that people across the country will have access to 
quality healthcare. And if there's no further business to come 
before the Committee without object the Committee stands 
adjourned. And thank you, Mr. Secretary for being with us 
today.
    Secretary Becerra. Thank you.
    [Additional submission by Hon. James Comer, a 
Representative in Congress from the State of Kentucky follows:]


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    [Additional submission by Hon. Bob Good, a Representative 
in Congress from the State of Virginia follows:]

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    [Additional submission by Hon. Diana Harshbarger, a 
Representative in Congress from the State of Tennessee 
follows:]

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    [Questions submitted for the record follow:]
    
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    [Whereupon, the Committee adjourned at 1:27 p.m.]