[Senate Hearing 117-234]
[From the U.S. Government Publishing Office]
S. Hrg. 117-234
NOMINATION OF XAVIER BECERRA
=======================================================================
HEARING
BEFORE THE
COMMITTEE ON FINANCE
UNITED STATES SENATE
ONE HUNDRED SEVENTEENTH CONGRESS
FIRST SESSION
ON THE
NOMINATION OF
XAVIER BECERRA, TO BE SECRETARY,
DEPARTMENT OF HEALTH AND HUMAN SERVICES
__________
FEBRUARY 24, 2021
__________
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
Printed for the use of the Committee on Finance
__________
U.S. GOVERNMENT PUBLISHING OFFICE
47-302 PDF WASHINGTON : 2022
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COMMITTEE ON FINANCE
RON WYDEN, Oregon, Chairman
DEBBIE STABENOW, Michigan MIKE CRAPO, Idaho
MARIA CANTWELL, Washington CHUCK GRASSLEY, Iowa
ROBERT MENENDEZ, New Jersey JOHN CORNYN, Texas
THOMAS R. CARPER, Delaware JOHN THUNE, South Dakota
BENJAMIN L. CARDIN, Maryland RICHARD BURR, North Carolina
SHERROD BROWN, Ohio ROB PORTMAN, Ohio
MICHAEL F. BENNET, Colorado PATRICK J. TOOMEY, Pennsylvania
ROBERT P. CASEY, Jr., Pennsylvania TIM SCOTT, South Carolina
MARK R. WARNER, Virginia BILL CASSIDY, Louisiana
SHELDON WHITEHOUSE, Rhode Island JAMES LANKFORD, Oklahoma
MAGGIE HASSAN, New Hampshire STEVE DAINES, Montana
CATHERINE CORTEZ MASTO, Nevada TODD YOUNG, Indiana
ELIZABETH WARREN, Massachusetts BEN SASSE, Nebraska
JOHN BARRASSO, Wyoming
Joshua Sheinkman, Staff Director
Gregg Richard, Republican Staff Director
(ii)
C O N T E N T S
----------
OPENING STATEMENTS
Page
Wyden, Hon. Ron, a U.S. Senator from Oregon, chairman, Committee
on Finance..................................................... 1
Crapo, Hon. Mike, a U.S. Senator from Idaho...................... 3
CONGRESSIONAL WITNESSES
Feinstein, Hon. Dianne, a U.S. Senator from California........... 5
Padilla, Hon. Alex, a U.S. Senator from California............... 6
ADMINISTRATION NOMINEE
Becerra, Hon. Xavier, nominated to be Secretary, Department of
Health and Human Services, Washington, DC...................... 8
ALPHABETICAL LISTING AND APPENDIX MATERIAL
Becerra, Hon. Xavier:
Testimony.................................................... 8
Prepared statement........................................... 55
Biographical information..................................... 56
Responses to questions from committee members................ 77
Crapo, Hon. Mike:
Opening statement............................................ 3
Prepared statement with attachment........................... 137
Feinstein, Hon. Dianne:
Testimony.................................................... 5
Lankford, Hon. James:
Submissions for the record................................... 142
Padilla, Hon. Alex:
Testimony.................................................... 6
Wyden, Hon. Ron:
Opening statement............................................ 1
Prepared statement with attachments.......................... 146
Young, Hon. Todd:
Submissions for the record................................... 226
Communications
Alcala, Cassandra................................................ 229
California Hospital Association.................................. 235
Evans, Patrick J................................................. 235
Hispanas Organized for Political Equality........................ 239
National Hispanic Medical Association............................ 240
National Human Services Assembly................................. 241
Taffe, Anne C.................................................... 242
(iii)
NOMINATION OF XAVIER BECERRA,
TO BE SECRETARY, DEPARTMENT OF
HEALTH AND HUMAN SERVICES
----------
WEDNESDAY, FEBRUARY 24, 2021
U.S. Senate,
Committee on Finance,
Washington, DC.
The WebEx hearing was convened, pursuant to notice, at 2:08
p.m., Dirksen Senate Office Building, Hon. Ron Wyden (chairman
of the committee) presiding.
Present: Senators Stabenow, Cantwell, Menendez, Carper,
Cardin, Brown, Bennet, Casey, Whitehouse, Cortez Masto, Warren,
Crapo, Grassley, Thune, Toomey, Cassidy, Lankford, Daines,
Young, Sasse, and Barrasso.
Also present: Democratic staff: Ian Nicholson, Investigator
and Nominations Advisor; and Joshua Sheinkman, Staff Director.
Republican staff: Kellie McConnell, Health Policy Director;
Gregg Richard, Staff Director; Jeffrey Wrase, Deputy Staff
Director and Chief Economist; and Nicholas Wyatt, Tax,
Infrastructure, and Nominations Policy Advisor.
OPENING STATEMENT OF HON. RON WYDEN, A U.S. SENATOR FROM
OREGON, CHAIRMAN, COMMITTEE ON FINANCE
The Chairman. The meeting will come to order.
Colleagues, this is nominations week here in the Senate
Finance Committee. This is the second of three nominations
hearings, and we are very pleased to be able to welcome
Attorney General Xavier Becerra, President Biden's nominee to
lead the Department of Health and Human Services.
With the pandemic raging, so many Americans are struggling
to get by, and our health-care system is strained to the max.
There may not be a higher-stakes job in the executive branch
outside the President.
Attorney General Becerra brings more than 2 decades of
experience in the Congress. He was a senior member of the House
Ways and Means Committee, which overlaps this committee on many
important health issues. He was closely involved in major
accomplishments on health care, including the Affordable Care
Act. For 4 years, he has led the second largest department of
justice in America, overseeing thousands of employees and a
billion-dollar budget. Anybody who discounts the experience of
leading a California agency that large and influential to the
fifth largest economy in the world is straining awfully hard to
find something to critique.
The Attorney General defended the Affordable Care Act from
absurd and dangerous far-right attacks. When the pandemic hit,
he went to bat for Californians by increasing access and
affordability for COVID treatments, protecting workers from
exposure, and securing key safeguards for front-line health-
care workers.
Having started my career in legal aid for senior citizens,
as a co-founder of the Oregon Gray Panthers, I appreciate the
Attorney General got his start in legal aid for the less
fortunate. This is a nominee with the right policy experience,
the right leadership experience, and the right experience
fighting for people without power. That is exactly what is
needed at the Department of Health and Human Services, after 4
years of management that took America in the wrong direction.
Now in this committee, a special focus of our work is going
to be tackling inequality in every form. In America, inequality
is a killer. If you did not believe it before the pandemic,
there can be no questioning it today. People of modest means,
people targeted by discrimination, people marginalized in
society, they are the Americans who have suffered
disproportionately in the pandemic. That is because they were
vulnerable before the pandemic, and Federal policy did not do
enough to protect them.
I will pick through a few examples. First, Americans are
getting clobbered every time they walk up to the pharmacy
window to pick up their prescription drugs. In a country as
wealthy as ours, it is shameful that you still hear about
people rationing their own medicine and suffering terrible
consequences because they cannot afford their medicine.
Second, the pandemic has proven there needs to be a new
focus on mental health in America. With so many lives lost and
so many people out of work, it should not be a surprise that
people in Oregon and across the country are struggling when it
comes to mental health care. Compared to physical health
issues, mental health has gotten short shrift for far too long.
Now the laws say they are equally important, but I will tell
you, that is often not the way it is handled in the real world.
That needs to be changed. We are going to talk some more about
it this afternoon.
Third, the pandemic has shined a spotlight on many long-
running disparities in health care in the country, many of them
that stretch back generations. One of them is maternal health
care. The American people want this to be a pro-family Nation.
It is totally unacceptable that pregnancy and childbirth in the
postpartum period are so dangerous to American women,
particularly when you compare our country to wealthy nations.
This is especially serious for black and Native American women,
and it is getting worse as the years go by. In fact, here is a
shocking statistic. Women today are more likely to die in
childbirth than their mothers were a generation ago. Addressing
the crisis goes hand-in-hand with the need to expand and
improve women's health care overall, since the last 4 years
have been a women's health nightmare.
I am looking forward to working with the Attorney General
in the Biden administration on these issues, and more. It has
been a difficult 4 years for too many vulnerable Americans who
struggle to pay for medicine and secure health care. If AG
Becerra and his team start every day actually focusing on
expanding health care and improving health services instead of
limiting them, they will already be doing better than the last
administration.
This is a nominee who is highly qualified. He has had a
valuable range of experience that will help him succeed in this
job, and this is a historic nomination because the Attorney
General would be the first Latino Secretary of Health and Human
Services.
Finally, I want to congratulate him on a late-breaking
development. Today, he won in Federal court, defending
California's net-neutrality law. And I see the chair of the
Commerce Committee, who has done so much on that issue, and we
are looking forward to seeing the Attorney General score more
wins for the American people.
With that, let me recognize our friend, Ranking Member
Senator Crapo, for his opening statement.
[The prepared statement of Chairman Wyden appears in the
appendix.]
OPENING STATEMENT OF HON. MIKE CRAPO,
A U.S. SENATOR FROM IDAHO
Senator Crapo. Thank you very much, Senator Wyden. Welcome,
Attorney General Becerra.
The Department of Health and Human Services is a sprawling
department, with over 80,000 employees and responsibility for
over $1 trillion in annual spending. HHS and its agencies
directly affect everyday life, including running programs that
provide health-care coverage to nearly 150 million people. The
HHS Secretary will shape Medicare and Medicaid, Obamacare, and
many other important programs in the Finance Committee's
jurisdiction. These responsibilities are formidable in normal
times, but the COVID-19 pandemic has made the HHS mission even
more critical, as these programs will play a key role in the
pandemic response.
This hearing is important for us to understand how Attorney
General Becerra would carry out these monumental
responsibilities. A few weeks ago, I outlined several issues in
the health-care space where I intend to focus my efforts as
ranking member, including fostering innovation to improve
patient care and making our health-care system more efficient.
The COVID-19 pandemic has threatened Americans' physical and
economic health, but it has also reinforced the value of
innovation and provided an opportunity to test changes that
foster it.
HHS has used its authority under the public health
emergency to waive numerous requirements to ensure Medicare
beneficiaries and other patients receive care during the
pandemic. Patients have benefited from expanded access to
telehealth and expedited approval of COVID-19 vaccines,
diagnostics, and treatment. Going forward, Medicare and
Medicaid patients should have the same access to those
innovative items and services as those with commercial
insurance.
We must carefully evaluate our response to the pandemic and
implement appropriate reforms based on the lessons we have
learned. HHS should partner with this committee in that effort.
Another long-term priority for many on this committee is to
finally address Medicare's looming financial problems.
Medicare's financial stability was a key issue discussed by the
bipartisan Bowles-Simpson Commission, on which I served with
Attorney General Becerra a decade ago.
Although the Commission's proposal did not reach the
required super-majority of 14 out of 18 votes for adoption, it
did produce a constructive bipartisan blueprint to reform and
secure our entitlement programs. Medicare's finances remain
unsettled, with the Medicare trustees currently projecting that
the hospital insurance trust fund will go broke in 2026. And
unforeseen circumstances could move the insolvency date even
closer.
The new administration should work with Congress in a
bipartisan way to ensure that Medicare is able to serve current
and future beneficiaries. In yesterday's hearing before the
HELP Committee, many of my colleagues raised concerns about the
enforcement of California's restrictive actions related to
COVID-19, including the ban on indoor religious services that
was rejected by the Supreme Court.
They also raised questions about challenges to HHS's
authority to provide a conscience exemption from the Obamacare
contraception coverage mandate. A coalition of pro-life
Americans sent a letter to all Senators in opposition to the
nomination of Xavier Becerra to be Secretary of Health and
Human Services.
And, Mr. Chairman, I ask that that letter be included as a
part of the record.
The Chairman. Without objection, so ordered.
[The letter appears in the appendix on p. 138.]
Senator Crapo. Nearly a year ago, the committee worked
together to expand unemployment compensation in response to the
economic devastation caused to workers by shutdowns. As time
has passed, there has been substantial reporting of fraud
perpetrated against California's unemployment insurance
program. Fraudsters, including international criminal
organizations, have siphoned off perhaps more than $11 billion.
That raises questions regarding what specific steps were taken
to combat unemployment fraud, and when those steps were taken.
Finally, Attorney General Becerra, you have long been an
advocate for moving all Americans to a government-run Medicare-
for-All plan, raising concerns with me that your policy
preferences could undermine the Medicare programs that rely on
private insurance. You and I have talked about this privately,
and I will discuss it further with you during the question
period. I strongly support private insurance so patients can
choose the coverage option that best meets their need.
The popular Medicare Advantage program that covers 24
million beneficiaries must be allowed to continue to thrive.
And the successful Medicare Part B program must continue to
serve its 47 million enrollees without government interference.
The number of issues I have raised indicate the scope and
importance of this position, and I look forward to hearing your
testimony and your responses to questions. Thank you.
[The prepared statement of Senator Crapo appears in the
appendix.]
The Chairman. I thank my colleague. We are going to have a
big debate on that, on how the Department of Labor handles
unemployment, and we are going to talk through all of these
issues, I am sure.
Now we have the senior Senator from California, Senator
Feinstein, who is here for an introduction of the nominee, and
we welcome her for her comments.
STATEMENT OF HON. DIANNE FEINSTEIN,
A U.S. SENATOR FROM CALIFORNIA
Senator Feinstein. Thank you very much, Mr. Chairman and
Ranking Member Crapo. Thank you for the opportunity to appear
before the committee to introduce California's Attorney General
Xavier Becerra as President Biden's nominee to be Secretary of
Health and Human Services.
I am so proud to have known this man as both a friend and a
colleague. He spent decades serving our State, currently as the
State's Attorney General, and previously as a 12-term
Congressman from Los Angeles.
Mr. Becerra was the first in his family to receive a 4-year
college degree, earning his bachelor of arts in economics from
the University we share, which is Stanford, and later his J.D.
from Stanford Law School.
As a member of the House of Representatives, he was a
strong advocate for the health care of his constituents, and he
fought to make the Affordable Care Act law. As California's
Attorney General, he has been a staunch defender of the
Affordable Care Act, leading 20 States and the District of
Columbia in defense of the Act before the Supreme Court.
As part of his focus on protecting the health of Americans,
Mr. Becerra worked with Nebraska Attorney General Doug
Peterson, a Republican, to lead a bipartisan coalition of 43
Attorneys General to reduce youth exposure to tobacco products
like e-cigarettes, which we have all become very concerned
about, and which continue to pose significant health risks to
children.
He has also worked on a bipartisan basis with multi-State
coalitions of Attorneys General on health priorities that align
with the work of this committee, which includes increasing
access to COVID-19 treatments, as well as addressing the opioid
epidemic and the considerable harm it has caused to families.
As our State's Attorney General, AG Becerra led the
Nation's second-largest Department of Justice, behind only the
U.S. Department of Justice. So he is skilled, and just
extraordinarily good. As Secretary, he will lead the Nation's
top health agency charged with enhancing the health and well-
being of all Americans.
In this global pandemic, he will hopefully play a lead role
in overseeing the implementation of President Biden's national
strategy for COVID-19 response, which is integral to defeating
the virus that has plagued our country for far too long.
His history-making nomination as the first Latino to manage
this department comes at a time when this pandemic is effecting
communities of color at much higher rates than white Americans.
And those of us who know him personally know the level of his
concern, and the strength of his dedication to protecting the
health and safety of all hardworking Americans and their
families.
I deeply believe--and I have had the privilege of making
this statement to another committee as well--that Xavier
Becerra is the right candidate to lead the Department of Health
and Human Services at this time, and I would give my strongest
recommendation to this committee to approve his nomination.
And, Mr. Chairman, it is good to see you again after this
morning's hearing, and I am grateful to be here. Thank you so
much.
The Chairman. Thank you very much, Senator Feinstein. We
are very pleased to have you here. And I would also like to
note that California now has 100 percent of their United States
Senators here for the launch of the nomination of the AG. And
we welcome our new colleague, Senator Padilla.
STATEMENT OF HON. ALEX PADILLA,
A U.S. SENATOR FROM CALIFORNIA
Senator Padilla. Thank you, Chairman Wyden, Ranking Member
Crapo, for inviting me to address this committee today to
introduce my friend, California Attorney General Xavier
Becerra.
As we recognized in yesterday's HELP Committee hearing, our
Nation is going through one of the toughest times we have faced
in recent memory. The COVID-19 pandemic has taken an incredible
toll on our lives and our communities across the United States.
COVID-19 deaths in the United States just surpassed
500,000, a grim milestone for our country. As has been
referenced, the devastation has disproportionately impacted
working-class families and communities of color, very similar
to the communities that both Attorney General Becerra and I
grew up in.
These communities are hurting and dying at alarming rates,
and they desperately need someone who knows these communities
at their core. The Los Angeles Times published an article this
past Saturday documenting the disparity in vaccination rates
across, in this particular case, Los Angeles County, where
wealthy neighborhoods like Beverly Hills are receiving vaccines
at five times the rate of predominantly minority communities
such as south Los Angeles. And that is why I am honored to
introduce Attorney General Becerra today as the nominee for
Secretary of the Department of Health and Human Services.
If confirmed, Attorney General Becerra will be the first
Latino Secretary of Health and Human Services, an honor I know
that he will not take lightly. Throughout his upbringing and
time as a public servant, Xavier has shown his passion for
people and his commitment to improving the lives of those he
represents.
His parents immigrated from Mexico, just like my parents
did, with the dream of building a better life for themselves
and their family. As has been noted, Xavier received his
undergraduate and law degrees from Stanford University. And
while at Stanford, he met his wife, Dr. Carolina Reyes, a
widely respected obstetrician who helps care for women with
high-risk pregnancies in under-served communities.
Xavier's first job out of law school was working with
individuals with mental health disorders, a health issue that
is too often overlooked, especially in communities of color. He
was elected to Congress in 1992, where he quickly gained and
maintained a reputation for being a strong supporter of
reproductive health, protections for seniors, mental health
parity, and the Children's Health Insurance Program, also known
as CHIP.
Xavier was instrumental in both the drafting and the
passing of the Affordable Care Act, which has helped provide
access to quality health care for millions of previously
uninsured Americans, and his work did not stop there.
As Attorney General of California, he has made it his
mission to tackle structural inequalities within our health-
care system. He has been the leading force behind a lawsuit to
protect the Affordable Care Act, and to maintain the
protections for people with preexisting conditions and for
those suffering from a mental illness.
Over the past year, Attorney General Becerra fought to
protect front-line health-care workers from further exposure to
COVID-19, and he stood up for homeowners struggling to meet
their mortgage payments.
Now, while I understand the politics of the moment may
compel some to try and paint a distorted picture of Attorney
General Becerra, let me point out that many of you have worked
with him for decades here in Congress. Republicans and
Democrats know Xavier Becerra to be a thoughtful, open-minded
leader, and always willing to listen to both sides.
It appears to me, as it appears to many, that he is being
held to a much different standard than some of the nominees
that this Senate has supported and confirmed over the last 4
years.
Let me say this: both Attorney General Becerra and I,
throughout our careers, have too often been the only Latino in
the room. Sadly, Xavier and I are not unfamiliar with being
held to different standards. But, members of the committee,
Xavier Becerra is a proven leader who is uniquely qualified to
take on the challenges of this moment, and I urge the committee
to support his nomination. Thank you.
The Chairman. Senator, thank you very much. And we are very
glad that you are here today. And I would say to you and
Senator Feinstein, thank you both for your statements. We know
you have very busy schedules, and feel free to depart should
you wish to.
Senator Feinstein. Thank you.
The Chairman. Thank you both.
Let me also--one other item of business before we turn to
the nominee for his opening statement. I am going to take a
quick moment to enter a number of letters of support into the
hearing record for Secretary-Designate Becerra. As of this
morning, the Finance Committee has received 77 letters of
support for Mr. Becerra from a wide range of groups and
stakeholders representing patients and nurses and doctors and
public health advocates, civil rights groups, and many more.
Without objection, I would like to make those materials part of
today's hearing record.
[The letters appear in the appendix beginning on p. 147.]
The Chairman. And with that, Attorney General Becerra, we
welcome you, and we look forward to your opening statement.
STATEMENT OF HON. XAVIER BECERRA, NOMINATED TO BE SECRETARY,
DEPARTMENT OF HEALTH AND HUMAN SERVICES, WASHINGTON, DC
Mr. Becerra. Mr. Chairman, and to Ranking Member Crapo and
members of the committee, thank you for this opportunity to
speak to you. To my good friends Senator Feinstein and Senator
Padilla, I thank them as well for their gracious introductions.
I want to thank my family, if I may begin by doing that.
Dr. Carolina Reyes, who has been my long-term partner--I call
her my north star--she is here with me, and our three
daughters, Natalia, Olivia, and Clarisa, and Clarisa's husband
Ivan. Everything I do, including this, is a family affair. And
I know I am here because my parents, Manuel and Maria, who had
only their health and their hope when they settled in
Sacramento, CA, taught me to earn the American Dream.
A construction worker with a sixth grade education and a
clerical worker who arrived from Guadalajara, Jalisco, Mexico,
they never saw the inside of a college classroom, but they sent
all their kids to one, or to the military. We lost my Dad last
year, on New Year's Day, and when the end came, my Dad knew we
were there with him at his side in our home. Sadly, hundreds of
thousands of Americans have not had closure this past year.
That, Senators, is why I am here today. The COVID pandemic
has killed more than 500,000 Americans, many of them alone
without their families. Millions more have lost their jobs and
their health care. That is not the America my parents would
believe possible.
To meet this moment, we need strong Federal leadership.
That is what President Biden is demonstrating, and if I am
fortunate to be confirmed, I look forward to joining the
President in his critical mission. I understand the enormous
challenges before us and our solemn responsibility to be
faithful stewards of an agency that touches almost every aspect
of our lives. I am humbled by the task, and I ready for it.
The mission of HHS to enhance the health and well-being of
all Americans is core to who I am. When I was a child, my mom
had a health scare. She was rushed to the hospital after
hemorrhaging at home. The image is seared in my memory. We were
lucky. My mom is now 87 years young. Better put, we were
blessed. My Dad, the laborer, he had insurance through his
union, Laborers' Local 185.
We did not have much, but we did not have to face the
threat of unpaid medical bills, or even bankruptcy. Over 2
decades in Congress, I worked to ensure every family had the
same insurance that my family had. I helped expand the
Children's Health Insurance Program. I helped write and pass
the Affordable Care Act.
From the Ways and Means Committee, I fought to strengthen
and modernize Medicare and how we finance it. As Attorney
General, I created a health-care rights and access task force.
We cracked down on Medicare and Medicaid fraud. I have worked
to hold opioid manufacturers accountable for the addiction
crisis. I have taken on hospitals and drug makers who unfairly
jack up prices on patients. And I have protected patients'
rights of privacy.
If confirmed, I will work with you to continue this type of
work and to address HHS's biggest challenges. And that of
course starts with COVID. The President has ambitious goals:
100 million vaccine shots in arms in his first 100 days,
increasing access to testing, sequencing the virus to prepare
for the variants, and reopening schools and businesses. HHS has
a central role in meeting these goals safely and equitably.
As Attorney General, I saw the importance of this on the
front lines. I worked with colleagues in other States, both
Republicans and Democrats, to make COVID treatments more
readily available. I am ready to work with you, with our State
and local partners, our tribal partners, our territorial
partners, and across government, to get this right.
Next, we must ensure that people have access to quality and
affordable health care. If confirmed, I will work with you to
strengthen our Medicare and Medicaid lifelines, to reduce the
cost of health care and prescription drugs, and ensure we are
accountable, spending resources wisely and effectively.
And I will not forget the other ``H'' in HHS: Human
Services. I want to work with you supporting our vulnerable
children, those in foster care, strengthening Head Start, and
expanding access to child care.
Finally, we must restore faith in our public health
institutions. That starts with putting science and the facts
first and showing respect for a career workforce. No one
understands your State and your communities better than you. We
may not always agree, but if I am fortunate enough to be
confirmed, I will always listen to you and keep an open mind. I
will look for common cause, and I will work with you to improve
the health and dignity of the American people.
Thank you, Mr. Chairman, Ranking Member Crapo, and members,
for this opportunity to share my vision.
[The prepared statement of Mr. Becerra appears in the
appendix.]
The Chairman. Mr. Attorney General, thank you. And there
are some obligatory questions that we ask nominees before we
get into member questions.
First, is there anything you are aware of in your
background that might present a conflict of interest with the
duties of the office to which you have been nominated?
Mr. Becerra. No, Mr. Chairman.
The Chairman. Second, do you know of any reason, personal
or otherwise, that would in any way prevent you from fully and
honorably discharging the responsibilities of the office to
which you have been nominated?
Mr. Becerra. No, Mr. Chairman.
The Chairman. Do you agree, without reservation, to respond
to any reasonable summons to appear and testify before any duly
constituted committee of the Congress, if you are confirmed?
Mr. Becerra. Yes, Mr. Chairman.
The Chairman. Finally, do you commit to provide a prompt
response in writing to any questions addressed to you by any
Senator of this committee?
Mr. Becerra. Certainly, Mr. Chairman.
The Chairman. Okay, we will now begin, Mr. Attorney
General, with 5-minute rounds of Senators. I will begin, and
then Senator Crapo.
I think we all understand that the COVID-19 pandemic has
compounded the country's longstanding health disparities. The
fact is, America really has two health-care systems. In the
suburbs, often affluent white families have all kinds of
incredible health care. That is a stark difference to areas
where many more black or Latino families live. They really
face, in many instances, a health-care desert. For those
communities, long drives, long wait times, or a lack of health
providers are enormous constraints.
This is especially true when it comes to mental health. The
United States has the worst record among similar countries.
There is a statistic to remember. Women today are more likely
to die in childbirth than their mothers. Women of color have
borne the brunt of this tragedy. Black, American Indian, and
Alaskan Native women are three times more likely to die of
pregnancy-related complications than their white counterparts.
So our first question is, do you agree that expanding
Medicaid coverage from just 60 days to 12 months postpartum, as
the House COVID-19 relief bill provides, is a necessary step to
reverse this rising maternal mortality crisis?
Mr. Becerra. Mr. Chairman, absolutely. And if my wife were
allowed to say a few words, she would probably say, ``Keep
going. Do not stop.''
The Chairman. Good. If you are confirmed, Mr. Attorney
General, what else would you do right out of the gate to
address the significant racial, ethnic, and geographic
disparities in maternal health?
Mr. Becerra. Mr. Chairman, I have worked on this for many
years. We need better data. We have to be collecting
information that lets us know where to go. If we collect bad
data, we are going to have bad results. So one of the first
things we have to do is make sure that we are collecting good
data. And that is a responsibility that HHS has in many
respects.
We also have to reach out to the communities that know the
people that we are missing. Go to the civic and religious
leaders back home where we know we are missing families. They
are respected. They are trusted. They can help us reach out to
those folks.
We have to train a better workforce, a bigger workforce,
and we have to make sure they are competent in the cultural,
linguistic differences that oftentimes we see. And of course we
have to tackle the social determinants of health that I think--
I am proud to say, now as I watch what Congress is doing, it is
great to see how much it is a bipartisan effort now.
The Chairman. Mr. Attorney General, let's return to the
issue of mental health for a moment. And I think it would be
fair to say, from sea to shining sea, communities are reporting
that demand for mental health services has just soared into the
stratosphere. And it is for virtually every group: for seniors,
even schools--youngsters who have had challenges of learning
are reporting being in need of mental health services. And I
want to say, I think this mental health challenge right now is
the public health equivalent of a four-alarm fire. It is just
that serious, with the situation of care being too expensive or
unavailable, and it is something I take very personally because
my brother was a schizophrenic, and for years there were nights
in our household where he would be out on the streets, and we
were convinced he was going to hurt himself or someone else.
So the question then is, what do we do about it? And one of
the solutions comes from my home State, and it deals with some
of the challenges that we are facing on the streets. I have
talked to several of my colleagues here, and Senator Crapo and
I have had discussions about it. On the streets, very often the
question is, do you look to a mental health counselor? Or do
you look to law enforcement to try to respond in the
appropriate way?
And we have come up with a program in my home State called
CAHOOTS, which is supported by both mental health counselors
and law enforcement. Senator Cortez Masto is our lead sponsor.
A number of other colleagues are for it as well. And our
approach deploys Medicaid, which would be under your
jurisdiction, to set up mobile crisis response teams that can
be dispatched when a person is experiencing a mental health or
substance use disorder that would be appropriately handled from
the mental health side rather than the law enforcement side.
So my question is--and time is short, and I apologize for
that--if you are confirmed, would you be supportive of efforts
like the CAHOOTS program so we can expand it in my home State
of Oregon, but also implement it across the land?
Mr. Becerra. Senator, count me in. I know law enforcement
back home would say the same thing. It is not a good use of our
resources as we watch as a 911 call comes in, and we are now
seeing a person who is in distress, usually mental distress, on
the streets. It is our officers who are asked to respond, and
they will tell you they are not trained professionals on mental
health care or social services. They are trained to do public
safety protection. And they would love to have people working
with them so we can make sure the right professional is the
first responder to these cases.
The Chairman. Okay. Very good. Thank you very much, Mr.
Attorney General.
Senator Crapo?
Senator Crapo. Thank you very much, Senator Wyden.
Attorney General Becerra, as we discussed, you know I
strongly support private insurance to allow consumers to choose
the health-care coverage that best meets their needs. But your
longstanding support for single-payer government-run health
care seems hostile to our current system, from my perspective.
What assurances can you give to Americans who currently
have private insurance, including through Medicare Advantage,
and are satisfied with their insurance provider, that they will
not lose their coverage in the future to some sort of Medicare-
for-All approach or other Federal takeover of health care?
Mr. Becerra. Senator Crapo, first, thank you for the chance
to respond to the question and also the time you gave me to sit
and chat.
I will tell you that we will both agree that the most
important thing is to give everyone in this country coverage,
good coverage. And what I will tell you is, I am here at the
pleasure of the President of the United States. He has made it
very clear where he is. He wants to build on the Affordable
Care Act. That will be my mission, to achieve the goals that
President Biden put forward to build on the Affordable Care
Act.
Senator Crapo. I appreciate hearing that. And could you
just go a little bit further? I would like to know what your
feelings are about the Medicare Advantage program. That is, I
think, one of the most successful parts of our Medicare system,
and one in which the people who choose it, who are increasing
dramatically around the country, are showing by their votes in
support of it that they think it is a program that is meeting
their needs and helping them significantly. But what is your
perspective of the Medicare Advantage program?
Mr. Becerra. Senator, millions of Americans have been on
Medicare Advantage, of our seniors. We see that Medicare
Advantage gives us an easier chance to do what are called
``wrap-around programs,'' to reach out to more people with more
services. And I think we have to take every approach we can.
Because at the end of the day, as I said at the beginning, it
is about getting more health care to people at an affordable
price and with good quality.
And so, whether it is in rural America or urban America,
what we have to do is see how we can make Medicare for our
seniors work better.
Senator Crapo. Thank you. And I want to move to the HI
trust fund. I know that you are aware that the trust fund is in
dire straits. The most recent Medicare trustees report
projected that the HI trust fund would be officially bankrupt
in 2026, at which time it would no longer be able to pay full
benefits for our Nation's seniors and the disabled.
That report failed to include any analysis showing the
fiscal impact of the COVID-19 pandemic on the trust fund.
Earlier this month, the Congressional Budget Office released
its updated winter baseline, and the new baseline takes into
account the increased tax revenue due to stronger economic
forecasts. But while CBO now also predicts that the HI trust
fund will be insolvent in 2026, there is substantial
uncertainty behind their projections.
Given the recent Medicare spending trends, it seems
unlikely that the trust fund could remain solvent through 2025.
Will you commit to me today that, if you are confirmed, you
will immediately direct the Centers for Medicare and Medicaid
Services, the Chief Actuary, to provide an update to me in
writing that shows the current status of the Medicare HI
insolvency date, taking into account the fiscal impact of the
COVID-19 pandemic?
Mr. Becerra. Senator, I can commit to that. We will
absolutely look forward to working with you to give this
committee, you and this committee, the information we need to
make the right decisions when it comes to Medicare moving
forward.
Senator Crapo. Well, thank you. I appreciate that. You
know, Congress has historically looked to reform and adjust
Medicare payments to providers in order to extend the life of
the HI trust fund. However, the last time Congress enacted
significant Medicare savings, the money was used to finance
further spending.
Now here we are, a decade later, and those savings are no
longer available to protect Medicare. What policies do you now
think Congress should consider to extend the life of the HI
trust fund?
Mr. Becerra. Senator, I remember well our experiences on
the Bowles-Simpson Commission, which I thought was a tremendous
experience, because it really brought some thoughtful minds
together.
Here is what I think I can tell you right off the bat. I
believe you and I, in fact everyone here, can agree that our
seniors who paid into Medicare should not be harmed by our need
to come up with policy recommendations and solutions. And so
first and foremost, our beneficiaries must come first in any
discussion about this.
Secondly, as you know, and as we worked on in Bowles-
Simpson, and I know you have done since, there are short-term
solutions, and then there are the longer-term solutions. And
none are easy. Otherwise, we would have done them already. But
here is what I would suggest to you.
President Biden is prepared to tackle this, because our
seniors depend on it. And we have seen what Medicare has done
in pulling so many seniors out of poverty from the 1960s,
before it was enacted, to today. And so what I will tell you,
the team at HHS, should I be fortunate to be confirmed, will be
ready to sit down with you to discuss this and more on
Medicare's future.
Senator Crapo. All right; thank you very much. I am out of
time. I would have asked you, and I will probably ask you to
just respond to this in writing afterward, that I would like to
know how soon we can expect that opportunity to develop a
comprehensive legislative proposal from HHS that will extend
the life of the trust fund.
Thank you.
The Chairman. Thank you, Senator Crapo.
Senator Stabenow?
Senator Stabenow. Well, thank you very much, Mr. Chairman
and Ranking Member Crapo. It is wonderful to have you in front
of us, Attorney General Becerra. And it was wonderful to serve
with you in the House of Representatives and work on so many
issues that related to health care and behavioral health. And
as I told you, I think when I called right after you were
nominated, I was very excited to see that someone of your
values and experience and competency would be nominated by
President Biden to lead this incredibly important agency.
And I do say, I know some have said that they are concerned
that you are not a doctor. Well, our former HHS Secretary was a
drug company executive, a CEO, and you were on the other side
as an Attorney General and Congressman fighting high drug
prices. So that is the side I am glad to have an HHS Secretary
on. So it is wonderful to have you here.
And I have to say, I am so pleased this morning that there
has been so much focus on mental health. I want to ask, and
thank Mr. Chairman, about all of these issues. Because I know
you, as well, have experience in behavioral health, and as has
been stated, your career started as a Legal Aid attorney
supporting clients with mental health issues, among others. And
you have worked to enforce the Mental Health Parity Act in
California, made reforms to decriminalize mental illness, and
more.
So I want to just add my voice today, as you and I have
talked about privately, because more than half of the adults in
the U.S. right now report mental health as being negatively
impacted for them due to stress over the coronavirus, which
certainly is not a surprise, given what has happened to people.
But as of August 2020, one in four young adults between the
ages of 18 and 24 say they have considered suicide in the past
month because of the pandemic, which is incredibly concerning.
Drug overdoses are accelerating, with CDC reporting the most
overdose deaths ever--ever--over the last 12-month period.
So we want to make sure you are hearing it today, that
people with mental illness or substance abuse disorders are not
left behind in what is happening. And the good news is that we
are seeing some great progress through the creation and
expansion of new certified community behavioral health centers.
And I know Oregon is benefiting from this, which has allowed
funding to be able to do some creative things.
We are seeing a difference. In fact, the most recent HHS
budget found that these services led to a 63-percent decrease
in emergency room visits for behavioral health and a 60-percent
decrease in time spent in jails--which is why these
comprehensive community services are so widely supported by law
enforcement--and a 41-percent decrease in homelessness.
And so let me just ask. We have now comprehensive community
centers--actually 340 of them across 41 states. But communities
across the country, every State wants to be able to do this
like we have Federally Qualified Health Centers with
comprehensive funding. We now have this model for behavioral
health. And it really needs to be permanent and comprehensive.
So I wondered if you would talk about some of your goals,
again about ensuring coverage, paying for behavioral health,
and can I count on you to work with us to move forward to make
this very effective, proven program now permanent as a
nationwide expansion of the Certified Community Behavioral
Health Clinic program?
Mr. Becerra. Senator, thank you for the question. I have to
first say, thank you for the work that you have done. If there
is someone who has been the patron saint for this issue, I
think you are--you get to qualify for that title, because it is
so important. Many of these folks, as you know, feel like no
one really cares. And their esteem goes up when someone talks
about their issues, the respect that they deserve increases,
and so I will say this.
The money that you all made available to help us expand
some of these centers, most of it, I think $500 of the $600
million is already on the streets, on the ground trying to
help. The more we coordinate directly with our local partners,
we will be more effective. We have to also reach out more
effectively with our Indian Health Service folks. And I think
what we can do is elevate this issue, because the law, as the
chairman said, the law is already there. We are supposed to
treat mental health services with parity.
We are supposed to provide the behavioral health service.
What we are learning is that these centers completely help us
do it better.
Senator Stabenow. Well, thank you so much. I know my time
is up, Mr. Chairman, and so I will just ask, for the record,
questions related to expanding access to home health services
and Alzheimer's, maternal/infant health, cost of prescription
drugs. There is a lot that we need to do together that will
make a real difference in the lives of Americans across the
country. So thank you, Mr. Chairman.
[The question appears in the appendix.]
The Chairman. Thank you, Senator Stabenow.
Senator Grassley?
Senator Grassley. I will bet you are just waiting to talk
about abortion [laughing], and I am going to start with
something that is a fact. During the second trimester of fetal
surgery--fetal surgery--doctors may administer anesthesia to
reduce pain experienced by the unborn.
So, a question: do you believe it should be routine to also
give anesthesia to unborn children during late-term abortion to
minimize the pain that they are capable of experiencing?
Mr. Becerra. Senator, you are asking, I know, an important
question, but a very technical question. And you are moving
into an area which I know carries with it very deeply held
beliefs, where folks sometimes have differences, and I respect
that. I also want to make it clear that I respect the law and
the science.
And what I can tell you is that, in my career of having
worked to protect the health of all Americans--men, women,
young, old--what I would do as Secretary is what I have done as
the Attorney General of our State. And that is, I would follow
the law and expect others to follow the law.
And while we may not always see it the same way in terms of
how we get there on a particular issue, I will tell you that,
on health care, these are challenges we have to confront for
the American people. So I would look forward to trying to reach
that common ground with you and others.
Senator Grassley. Well, I appreciate that. And I think you
made my question more complicated than I meant it to be. I was
not asking if you were for late-term abortions or not. I was
asking about, during that process, whether or not you thought
that the baby ought to have a pain killer in the process of
that abortion, like we have as a requirement for fetal surgery.
So maybe you cannot answer that question, but I did not
mean to get into whether or not you support late-term abortions
or not.
Mr. Becerra. And, Senator, let me try to address that, if I
can, more directly. It still might not be enough for you, but I
tried to make clear that I would rely on the science and the
experts, as the Secretary of HHS, to help us make decisions to
the degree that the agency has any role in making some
decisions related to that. I would rely on the science and the
experts.
Senator Grassley. Okay. Thank you.
Now I want to go to something that the chairman, Senator
Wyden, and I worked together on, and worked in good faith and
arrived at quite a compromise. And it deals with the subject of
prescription drugs.
I believe Congress must pass something like what he and I
worked out last year in a bipartisan way, because we have this
60-vote requirement, and I think it might be very difficult to
get something through that would take 60 votes, that some
people in your political party are thinking about doing. And
most of that deals with whether or not we are just going to put
a cap on increases in drug prices as the best way to get to
solving the high cost of prescription drugs, or whether we are
going to have the government negotiate prices, where basically
the government dictates prices. And also we have some letters
from CBO over a long period of time that say that it really did
not save money, where the Wyden-
Grassley bill saves about $95 billion.
So this is my question: do you know if the Biden
administration would be interested in enacting a bipartisan
prescription drug pricing reform bill like, for instance, along
the lines of what Senator Wyden and I worked out, that actually
saves the taxpayer dollars and can get 60 votes in the United
States Senate? And it will be a lot easier to get it up under a
Schumer majority leader position than it was under a McConnell
leadership position. Or do you think they want the alternative
of trying to get something a lot stronger from the Democrat
point of view along the lines of what I suggested?
Mr. Becerra. Senator, you have asked a great question,
which probably would be easier for me to answer if I were still
a House member or a Senate member, because those negotiations
really are up to you all.
But I will tell you this: there is no doubt that President
Biden wants to see us lower the price of prescription medicine.
And he and his team--and if I am fortunate to be part of that
team--will be working with you on a bipartisan fashion to reach
a solution. And I want to congratulate you and Chairman Wyden
for the work that you have done in the past to try to bring
members together.
Senator Grassley. One second left. We passed a bill that I
have been working on for 6 years, and you will be in a position
to get the regulations and get it underway. It sets up an
alternative program for rural hospitals. It is called the Rural
Emergency Hospital program. And it would work this way: a
critical access hospital would have the alternative--they would
not be forced to do this; this would be an alternative--that if
they want to give up their residential beds and preserve the
other things that hospitals would do, then they could do that.
And it is my way of keeping--when there is only 4-percent
occupancy in most of these critical access hospitals and it is
a very expensive thing for them to operate, this will maintain
rural health services, short of residence beds.
So I do not know whether you know enough about the bill
that we passed, but I think it is very critical. The American
Hospital Association worked with us, the Iowa Hospital
Association. And I would like to get that thing up and running
as fast as we could.
Mr. Becerra. Senator, I know the time has expired, but let
me just say--and we can follow up with this question--that I am
absolutely looking forward to working with you on this. People
often forget that California, as big as it is, has some very
large rural areas.
And I was approached by many of our State legislators when
I was trying to tackle the whole issue of hospital over-
consolidation--you know, hospitals gobbling each other up. And
I said you have to make sure you are very careful, because in
some of our rural communities, there may be only one facility.
And they may not have any choice, if they are going to survive,
but to have a major player come in and take them over. And so,
please make sure that you do not think that a rural facility,
which is standing out there by itself, is just like all these
other places in urban America.
The Chairman. Colleagues, we are just going to have to move
on. And----
Mr. Becerra. I will follow up. But, Senator, I look forward
to working with you.
Senator Grassley. Thank you.
The Chairman. I thank the Senator from Iowa.
Senator Cantwell, and then Senator Thune.
Senator Cantwell. Thank you, Mr. Chairman.
Attorney General Becerra, I am so excited and proud of your
nomination because of the diversity and breadth of experience,
and basically just following many of the decisions you have
made over your career. So I very much appreciate seeing you
here today as President Biden's nominee.
Following up on Senator Grassley's drug questions, because
it is topical at the moment, we had a chance to discuss drug
shortage issues, the fact that the price of insulin is just too
darned high, and other issues. Do you think there is more that
the FDA and the FTC should do in this area?
Mr. Becerra. Absolutely. We cannot afford to see drug
shortages continue. We have to plan ahead. We have to work on
the supply chain. We have to make sure that we do not encounter
a situation where Americans in one part of the country have the
medications they need, but in other parts they do not.
Senator Cantwell. Well, there is no reason to see the
spikes that we have seen in insulin. Is that correct, and that
there are policies that we can be putting in place?
Mr. Becerra. Well, and in some cases what we are finding is
that these are artificially created. Yes.
Senator Cantwell. Thank you for saying that. I hope--
Senator Grassley just left the room, but he and I have done
some work on this in his role on Judiciary. But I plan to do a
lot on this issue as it relates to the Federal Trade Commission
and its oversight.
Turning to the broader issue of affordability of health
care, we also had a chance to talk about the basic health plan,
something that was part of the Affordable Care Act to take care
of people above the Medicaid rate, but at a very cost-effective
way to bundle people who do not have access to insurance and
make it a more interesting market, but still leave States in
control of helping to negotiate on those programs.
So the end result of that has been 800,000 people in the
State of New York buying insurance at basically $500 in annual
premiums and saving more than $1,000 for what we would save
from those individuals on the Silver Plan.
So is this something, this concept, something that we
should continue to look at as a way to both leverage and bundle
up people who are not quite as interesting to the market right
above that Medicaid rate?
Mr. Becerra. Certainly, Senator. I think Minnesota as well
has also done this. And it is another innovation. It is another
way, especially for States that are willing to put skin in the
game, to make this happen, to try to get to the point where we
are providing more coverage, better coverage, at lower cost.
Senator Cantwell. Well, I think my colleagues who have
talked about already that we do not want this, we do not want
that--we have combined the best in the context of allowing a
State to still be in charge of that end product, but to allow
people to propose from the private provider some sort of
discounted rate, and I definitely think that we need to be
getting more out of the providers on discount. That is not to
say that you cannot have other public options, but I just think
this one has been working and successful on that front.
Also, the issue of N95 masks and frauds has come up in the
State of Washington. I want to know that you will do everything
you can. I personally believe that we need a task force at this
point in time between the FDA and Border and Customs and DOJ,
and others, to look at this issue. Again, the FTC was given--we
have given the FTC broad authority now to fine immediately
anybody who takes advantage of the COVID pandemic to manipulate
or to over-charge.
We have health-care workers whom we are asking to go into
these situations, and then they are finding out big vast
amounts of supply of these masks do not meet the standards.
So we need to be aggressive here with the FDA on a task
force to make sure that we are looking at this.
Mr. Becerra. I could not agree more, Senator. I think HHS
would be more than willing to work--as you know, our
jurisdiction comes more on the side of certifying what it takes
to have a mask that works. We will work with our partners to--
by the way, State and local and tribal and territorial partners
are important too, because they are the ones that are on the
ground. As the AG in California, I have worked to go after some
of the fraud, the gouging that has gone on with some of these
products during pandemics and disasters.
And so, we are willing to work with you. I have had that
experience as a prosecutor doing this. And now, if I am
fortunate to be confirmed as Secretary of HHS, we will partner
with all those different agencies that you have mentioned to
try to get to this.
Senator Cantwell. Thank you. Thank you, Mr. Chairman.
The Chairman. I thank my colleague. And just very quickly
before we get to Senator Thune, we have a bipartisan effort on
insulin prices out of this committee; a report that we did.
Prices have gone up 12-fold in recent years, and the drug is
not 12 times better. It is essentially a product of price-
gouging. And Senator Grassley and I put together this report.
We are going to put it into the record, without objection,
after Senator Cantwell's good statement.
[The report appears on the committee's website: https://
www.
finance.senate.gov/imo/media/doc/Insulin%20Committee%20Print.
pdf.]
Senator Thune. Thank you, Mr. Chairman.
Mr. Becerra, welcome to the committee. You have heard a
number of my colleagues, starting with the chairman, talking
about a big range of public health issues that we have to deal
with, starting with the pandemic.
Senator Crapo talked about Medicare and Medicaid, and
Senator Grassley talked about rural health. I would like to
bring up IHS here in just a minute. But in examining your
record--and I want to come back to this for just a minute
because it does seem like, as Attorney General, you spent an
inordinate amount of time and effort suing prolife
organizations like Little Sisters of the Poor, or trying to
ease restrictions or expand abortion.
You are going to have a big job as Secretary of Health and
Human Services, if confirmed. So how do you assure us that--
because I think the majority of the American people would not
want their Secretary of Health and Human Services focused, or
fixated on expanding abortion when we have all these public
health issues to deal with.
So how do you assure us that that is not going to be
something that continues over from your time as Attorney
General?
Mr. Becerra. Senator, thank you very much for giving me a
chance to answer the question. And here, I think I tried to say
to Senator Grassley, I understand that Americans have
different, deeply held beliefs on this particular issue. And I
absolutely respect that.
By the way, I have never sued the nuns, any nuns. I have
taken on the Federal Government, but I have never sued any
affiliation of nuns. And my actions have always been directed
at the Federal agencies, because they have been trying to do
things that are contrary to the law in California. It is my job
to defend the rights of my State and uphold the law.
What I will say to you is this: as I try to uphold the law,
I recognize that people will look at these things a little bit
differently. And here is where I think there is an
opportunity--and now as Secretary of HHS, if I am fortunate to
be confirmed--for working with all of you to try to see if we
can find that common cause on how we move forward on this very,
very difficult issue, but very important for so many Americans.
Senator Thune. Let me shift to, as I mentioned, the Indian
Health Service. I know there is a significant tribal population
in California. I want to draw your attention to specific issues
that we faced with Indian Health Service in the Great Plains
region.
IHS-run facilities in South Dakota have lost accreditation
on more than one occasion for failure to comply with safety and
quality measures, and multiple health-care providers have been
exposed for abusing patients.
We have to talk about the leadership and management
failures that have led to this situation. It cannot be blamed
all on funding. HHS has got to be involved and active in
driving improvements at IHS, and demanding excellence from its
leadership.
If confirmed, what specific actions would you take to hold
IHS accountable to the patients it serves, as well as to the
Congress, which often faces obstacles in getting answers to
important oversight questions?
Mr. Becerra. I know this one is important to you, Senator,
and so many who have a number of our tribal communities in
their State. Transparency--we must work much better at
providing you and others, and those in these tribal
communities, with the information they need, better data. But
mostly it is accountability, and that I commit to you.
And I say that as someone who has represented more than 100
tribes in the State of California for many, many years; we owe
it to our tribal governments, our native communities, to be
there. We owe it to them because they have sovereign rights.
We have a trust responsibility. And so what I can tell you
is, we will work with you. I will say one thing. IHS has done
something right working with tribal communities, because they
have had more success than many States in actually putting
vaccines in arms recently. And we do need to applaud them when
they have done something well.
Senator Thune. I have a bill with Senator Barrasso that
would improve management hiring practices at IHS, and I would
like, if you end up getting confirmed, to work with you on
that.
Mr. Becerra. I look forward to working with you.
Senator Thune. I know you heard about 340B a few times
yesterday, so I will try to keep this quick. But to me, the key
to 340B is that it enables hospitals and covered entities to
provide community benefits that otherwise may not be available.
If confirmed, will you commit to ensuring the strength of
the 340B program and the community that it supports?
Mr. Becerra. Absolutely. Not just in your rural
communities, but I have inner city communities that I have had
to represent who depend on 340B.
Senator Thune. Good. All right, one last quick question.
And I would say that probably the one bright spot of the
pandemic has been telehealth. That is something that I have
been working with this committee on for a long time.
As we continue to look at options for expanding telehealth,
what will your approach be to taking administrative action at
HHS and CMS, and what legislative approaches from the Congress
would you support?
Mr. Becerra. Well, we have learned a lot, Senator, from
COVID. And we have seen how important it is to have broadband
reach all our communities. We have seen how we have to have
some flexibility. But mostly what we can do is talk to the
communities that are actually now benefiting from it in our
rural parts of America, in other parts that did not have
broadband before, to find out what it is that we can do to do
it better. But I do not think we are going back to the old days
when it comes to telehealth.
Senator Thune. Thank you, Mr. Chairman.
The Chairman. Senator Menendez?
Senator Menendez. Thank you, Mr. Chairman. Mr. Becerra,
welcome. It is good to see you again. A few quick questions
that hopefully you can help glide through with me so that I can
get to some other things.
You were a member of the Ways and Means Committee of the
House of Representatives, which is almost the equivalent of the
Finance Committee. I say ``almost'' because we have pride here
in the Finance Committee. [Laughter.]
Is that not correct?
Mr. Becerra. That is correct.
Senator Menendez. And as such, were you there during the
period of time in which the Affordable Care Act was being
legislated?
Mr. Becerra. That is correct.
Senator Menendez. Were you instrumental in various parts of
the Affordable Care Act?
Mr. Becerra. I was in those rooms.
Senator Menendez. And as part of that, you became familiar
that the Affordable Care Act created the opportunity for
millions to get health-care coverage who did not have it
before. Correct?
Mr. Becerra. I was very active on those provisions.
Senator Menendez. And to create affordability for millions
who found it less affordable; who created Medicaid expansion.
Is that fair to say?
Mr. Becerra. That is correct.
Senator Menendez. And who also closed the doughnut hole for
prescription drugs for seniors. Is that fair to say?
Mr. Becerra. That is fair to say.
Senator Menendez. You had all of the experience during that
whole period of time. It also created a special provision for
women's health. Is that fair to say?
Mr. Becerra. Yes, it is.
Senator Menendez. Now as Attorney General of California--
California is the fifth largest economy in the world, is it
not, if it were an independent country?
Mr. Becerra. That is correct.
Senator Menendez. As Attorney General, what was the size of
the office of the Attorney General?
Mr. Becerra. We were several thousand, over a billion-
dollar budget.
Senator Menendez. So several thousand, over a billion-
dollar budget. Now let me ask you this. When you were chosen to
be the Attorney General of the State of California, you took an
oath, did you not?
Mr. Becerra. I did.
Senator Menendez. And in that oath, I believe that part of
that oath was to preserve, protect, and defend not only the
Constitution of the United States, but the Constitution of the
State of California and the laws of California?
Mr. Becerra. That is correct.
Senator Menendez. You do not pass the laws; you defend
them?
Mr. Becerra. That is correct.
Senator Menendez. Now let me ask you this. If you are
successful--and I believe you will be--at being confirmed by
the Senate, and you take that oath, then you are going to
defend the laws of the United States as they exist at the time?
Mr. Becerra. That is correct.
Senator Menendez. I find it interesting that many of my
colleagues have raised issues about you being a lawyer without
sufficient experience. The reality is that thousands of
employees under your direction experienced it first-hand in
creating the most significant landmark legislation on health
care and dealing with issues of Medicare and Medicaid within
the Committee on Ways and Means' jurisdiction. Somehow that
seems to be a problem. But the previous Secretary of HHS was
also a lawyer. The only thing is that he was a lawyer at a drug
company that ultimately did a pretty good job in fleecing
insulin patients. So I hope--I do not think we would see that
from you.
Let me ask you a few specific policy questions. You and I
had an opportunity to talk. Will you work with us on improving
diversity in clinical trials? Because this is an area that we
think lacks diversity. And I have written to all of the
companies that are engaged in clinical trials. Most of them
have been pretty responsive. But it is something I think we
need to do in order to make sure that all of America is
represented in these trials.
Mr. Becerra. Senator, absolutely. As I always say, if you
have bad inputs going in, you are going to produce bad outputs.
And if we are going to start having studies reflect the
American people, we have to have good inputs.
Senator Menendez. Would you work with me and others to
improve diagnoses of black and Latino dementia patients, as we
begin to address Alzheimer's disparities in communities of
color?
Mr. Becerra. Absolutely.
Senator Menendez. One of the things with the pandemic is
that it has magnified the incredible disparities that exist in
our society, particularly in terms of the health care of
minority communities. Will you commit to working with me on
ways to reduce the disparity for communities of color in the
delivery of our health-care system?
Mr. Becerra. Yes, sir.
Senator Menendez. Let me ask you a question. We have had a
bipartisan support here for a program called MIECHV, Maternal
Infant Early Childhood Home Visiting Program. I used to work
with Senator Enzi on it when he was on the committee, and I
look forward to working with others.
Do you support an expansion of this valuable program?
Mr. Becerra. Senator, as you know, my wife is a maternal-
fetal medicine specialist----
Senator Menendez. So I have an in-house lobbyist----
Mr. Becerra. You have me squeezed between you and her, and
the response is, I am absolutely looking forward to working
with you.
Senator Menendez. And finally, we were able--part of my
work here was to ensure that we could include a thousand new
GME slots that Congress provided. I would like to get you to
work with us to ensure that we quickly and efficiently
implement that provision of the law.
Mr. Becerra. Done.
Senator Menendez. Thank you. Thank you very much. Thank
you, Mr. Chairman.
The Chairman. I thank my colleague. We are just going to
move through this list of members. I think next is Senator
Carper, who is available on the web. Is that actually current?
[No response.]
The Chairman. Senator Carper?
[Pause.]
The Chairman. There you are.
Senator Carper. Pardon?
The Chairman. Senator Carper, are you there?
Senator Carper. Hello? Hey there----
The Chairman. We are waiting for you, Senator Carper.
Senator Carper. Oh, good. Good, good, good.
First of all, General, how are you today?
Mr. Becerra. Senator, I am well.
Senator Carper. Have any of our Republican friends
questioned whether or not you have the ability to, I would say,
the strengths for leading a large organization?
Mr. Becerra. We have had some good discussions.
Senator Carper. What I am asking is, has anybody raised the
question of how could you lead an organization as big as HHS;
what have you ever done that would suggest that you could do
that? How would you respond to that?
Mr. Becerra. How I would--I'm sorry? Say that question
again. How I would respond to----
Senator Carper. If someone raised the question about your
ability to lead an organization as big as HHS--it is huge, as
you know. What have you done in your life that would suggest,
well, maybe I am up to that task?
Mr. Becerra. Senator, for 30 years I have been working on
health care. My first job----
Senator Carper. I am thinking more of the administrative
side, running a huge organization. My recollection is, talking
to Kamala Harris, that the job you have right now is not a
small job.
Mr. Becerra. It is the second largest department of justice
in the land. And I would say, over the 4 years that I was
there, we outdid the largest department of justice in the land
every time we were in court.
We have continued to protect the largest State in the
Nation, and we are an operation that I think most people would
love to see--the size of their operation, well over a billion
dollars, and several thousand personnel--and we do a really
good job of protecting the rights and opportunities for
Californians.
Senator Carper. That is a pretty good answer. Thank you.
We talked a little bit about the role of federally
qualified community health centers in vaccination efforts that
are going on. Could you talk to us about why that is important,
particularly why that is important with people of color?
Mr. Becerra. Senator, as you know, too many people are
missed. They fall through the cracks. And community health
clinics have been a godsend for many of these communities,
because oftentimes they are the only facility, the only
available source for good health care. And with community
clinics able to help provide the vaccines, it makes it more
possible for many of our families who have often been left
behind to actually get the care and the protection that they
need.
And so, they have been indispensable. Thank you for the
work that you and others have done to recognize how important
they are, and especially now during COVID.
Senator Carper. I understand there was a hearing, I think
it was yesterday in the House, that focused on development of
additional vaccines beyond Pfizer, beyond Moderna, and they
included--I think there was some discussion at the hearing with
respect to AstraZeneca, and with respect to Johnson & Johnson.
Have you had a chance to come up to speed on what was
covered at that hearing?
Mr. Becerra. I have not heard much about what happened in
that hearing. I was in my hearing as well, in the HELP
Committee. But I do know something about what is going on. It
has been brought to my attention. Certainly HHS will be on top
of whatever happens with any future vaccine, because it has to
run--those vaccines and those trials would run through our
different agencies.
Senator Carper. Would you just take a minute and just kind
of describe, just very briefly, at the 30,000-foot level, the
process, the next steps in approving--getting emergency
approval for both AstraZeneca and the Johnson & Johnson.
Mr. Becerra. The FDA plays a very crucial role, along with
CDC. And there are several other subagencies within HHS that
will have roles that are critical, as we try to continue to
deal with the pandemic. And HHS, I can guarantee you, if I am
fortunate to be confirmed, will make sure it is working with
due speed to make sure that whatever is within our bailiwick to
handle, we will do it quickly, because we know how important it
will be that Americans have a vaccine available. And while we
have seen success, especially under President Biden's tenure,
in reaching more and more Americans--and President Biden has
announced that we have secured up to 600 million shots of the
vaccine for Americans--we will continue to work to make sure
that we are on top of it and ahead of the game when it comes to
making sure we are protecting all Americans.
Senator Carper. How long did you serve in the House?
Mr. Becerra. I was there for 24 years, sir.
Senator Carper. Did you ever meet a guy named John Carney?
Mr. Becerra. Of course. Your colleague, and now your
Governor.
Senator Carper. Yes. He used to be a member of my Cabinet,
and I am enormously proud of him. Usually our congressional
delegation has a chance to catch up with him every couple of
weeks. And one of the comments we continue to hear is
``adequate supply of vaccine delivered in a timely way.'' And
in accordance with expectation, consistent with expectations.
Do you have any thoughts on that for us?
Mr. Becerra. And my response is going to be based as a
leader in my State. And absolutely our States, our local
partners, our tribal communities, our territories, they all
want to know the same thing: that we are going to be working in
partnership with them, that we will coordinate with them, that
we are not going to blind-side them, because they have to
prepare.
They are the ones that are doing most of this on the
ground. They want to know that there is a real partnership so
that we are not doing this as if we are the Federal Government
and we know everything.
And so I would expect that Governor Carney--who is a
champion for the people and the State, and is a real fighter--
would make sure that he is on top of it, because he is working
closely with the Federal Government. And I would look forward,
if I am fortunate to be confirmed, to work with my former
colleague.
Senator Carper. I understand that in a hearing yesterday,
Johnson & Johnson reported that they were close to being--
getting the emergency approval, if you will, the emergency
distribution approval from the FDA.
And I understand that there was also, I believe, testimony
that suggested that AstraZeneca could receive the emergency
approval about a month later, at the beginning of April. Folks
at AstraZeneca have the ability to produce a lot of their
vaccine, I am told. And I hope the same is true of Johnson &
Johnson.
We have been really starved for a vaccine for the last
several months, and I think we could be in a position all of a
sudden to get actually more vaccine than we know what to do
with. And that would be a good problem.
But I would just ask that you be thinking about that,
because it is possible that we could just be flooded with this
stuff in about a month--and to make sure that when it comes and
flows in great quantities, that we are ready to do something
with it.
The Chairman. Senator Carper is asking about an especially
important issue. Mr. Attorney General, would you like to give a
brief answer, because I have a lot of members waiting? But it
is such an important question, would you like to give a brief
answer, or can we move on?
Mr. Becerra. Senator, I will just say to Senator Carper, I
look forward to working with him. We want to be prepared. We
would rather have more than less, to make sure we are saving
lives.
The Chairman. Very good.
Senator Carper. Thank you, Mr. Chairman.
The Chairman. It is a very, very important area.
Senator Cardin and Senator Lankford are next. And,
colleagues, it is our intention, after consultation with the
minority and with Senator Crapo, we will see if we can complete
the business of the hearing by 4 o'clock when we have the vote.
My sense is we cannot, and it would then be our intention to
recess briefly between 4 o'clock and 4:15. And that is what we
have talked about.
Now we are at Senator Cardin, and then Senator Lankford.
Senator Cardin. Mr. Chairman, thank you very much. And to
my good friend, Xavier Becerra, it is good to see you again.
There has been a lot of talk about your career. I enjoyed our
service together on the Ways and Means Committee, and I very
much remember the days of the Affordable Care Act and the work
that you did on that. So thank you for your willingness to
continue to serve our country.
I want to talk about one of the provisions that was
included in the Affordable Care Act which set up the Offices
for Minority Health throughout HHS and also established the
National Institute for Minority Health and Health Disparities
at the National Institutes of Health.
Chairman Wyden talked about meeting the needs of the under-
served communities. You have talked about it. I have no
question about your commitment to provide services to those who
have been left behind in health care in America. But my
question to you is, what strategy do you have to reinforce
these offices that currently exist so that a legacy of dealing
with health disparities will be institutionalized within the
Department of Health and the National Institutes of Health so
that we will have an ongoing commitment to deal with the
disparities in this country?
Mr. Becerra. Senator, thank you for the question. And it is
great to see you again. It brings back great memories of our
work together.
The Office of Minority Health is a critical operation
within HHS. I intend to make it an even more important office
than perhaps its stature was in the past, simply because COVID
has exposed what many of us already knew, and that is, that we
have failings when it comes to approaching all of our
communities in America and giving them the same access.
And so the Office of Minority Health will prove
indispensable if we want to really tackle this beyond COVID.
And so I look forward to working with you and others who are
interested in this, because there are several offices within
HHS that deal with minority health. And certainly the principal
office, I will want to make sure I empower them.
So I look forward to working with you. I am glad you asked
the question. If I am fortunate to be confirmed, I think
everyone in HHS has just heard this, that the Office of
Minority Health will have real prominence under my tenure, if I
am fortunate to be confirmed.
Senator Cardin. Thank you very much.
One of the impacts of COVID-19 that has been a positive
impact is that we have recognized the importance of telehealth.
We have made it easier for providers to provide telehealth
services.
Some of these changes are not permanent in nature. What is
your strategy to try to expand the access to health care
through telehealth, which can easily make health care more
accessible to communities today that are challenged with
accessibility?
Mr. Becerra. Senator, as I mentioned previously in response
to some other questions, we cannot go back to the old days. We
have learned so much from COVID and how indispensable
telehealth has been, especially to our rural communities, but
also to some of our inner city communities. And here it has
become very obvious that if you do not have broadband
accessibility, you are in real trouble. And so we have to do a
much better job.
We are now into the year 2021, and there are still parts of
America that do not have good access to broadband. And now
COVID has explained why it was so essential that we have worked
so hard in the past. So broadband access is critical.
The flexibility that has been necessary to make telehealth
work for everyone--we are not going to go back to the old way
of doing business. And so there are things that we are going to
learn that help us.
I look forward to working with you and members on this
committee and beyond to try to see how we can make telehealth
accessible to everyone.
Senator Cardin. Thank you. On oral health, we have made
progress with pediatric dental care, which is included under
the Affordable Care Act as an essential service. But still our
seniors lack access to certain dental care. Private insurance
does not necessarily provide dental care for routine dental
work.
So we still have a gap. Do you have a strategy to try to
expand access to dental care? As you know, good oral health
care is essential to good general health.
Mr. Becerra. Senator, who can forget Deamonte Driver, who--
--
Senator Cardin. Thank you.
Mr. Becerra [continuing]. Was a young resident in your
State who died because his parents did not really have the kind
of access to health care, in this case dental care, that they
needed. And what was an infection turned into an abscess, and
that turned into a lost life.
And I will tell you that dental health can be critical. You
and I know this. And so I would look forward to working with
you to try to see us expand access to dental health, vision
care, the types of things that sometimes we take for granted
until we are in our later stages of life. But it is so
critical, and the family of Deamonte Driver could tell you
that.
Senator Cardin. And I would ask that you consider
appointing the Chief Dental Officer, which has laid vacant from
the previous administration.
The last point I just want to raise is, you have been
talking about prescription drug costs, and that is certainly an
issue you have to deal with. But in America we have drug
shortages of drugs that are relatively inexpensive but are not
being manufactured by drug manufacturers because they are not
making enough money on them, which is really causing a health-
care issue.
I would just urge you to make it a priority issue, that
there should not be a shortage of drugs in America that are
necessary for health care because the private pharmaceutical
network does not feel it is profitable enough to make those
drugs.
Mr. Becerra. Senator, I agree completely. Profits should
not be the reason we are trying to come up with life-saving
medication.
Senator Cardin. Thank you, Mr. Chairman.
The Chairman. I thank my colleague.
Senator Lankford?
Senator Lankford. Mr. Chairman, thank you. Mr. Becerra, it
is good to see you. I know this is a tough process to go
through, and you have walked through this. You have been on the
other side of this in the House of Representatives. You have
walked through a lot of these issues.
I do need to get some clarity on a couple of things that we
have not talked about so far. As the California Attorney
General, you have sued the Federal Government over 100 times,
including multiple times dealing with issues about conscience
protection that you would specifically have to now enforce on
the other side of it.
And so I am trying to get some clarity on this. There is a
Conscience and Religious Freedom Division at HHS. They have
compiled the 25 different conscience laws that already exist in
statute that are law and to say that HHS in the past was not
always consistent in enforcing those laws, but they were going
to actually be consistent, because they were laws on the books.
So my question for you is, will you continue to enforce
existing Federal law on conscience issues when you get to HHS?
And what will you do with the Conscience and Religious Freedom
Division?
Mr. Becerra. Senator, you--by the way, thank you for the
chance to respond to the question. It is a critical and
important question. And I believe deeply in religious freedom.
And I will make sure that, as Secretary of HHS, you will know
that I will not only respect the law when it comes to these
issues of religious freedom, but I will enforce them as
Secretary of HHS within my department.
Senator Lankford. So the challenge that I have in just
processing through this is some of the history there. Obviously
when you were Attorney General, you had suits that went all the
way to the Supreme Court, that the Supreme Court overturned,
some of your decisions--specifically on conscience issues.
For instance, the issue of the FACT Act that came out of
California requiring pro-life facilities to post in their
facility ``here's a way to get an abortion instead of having
your child up for adoption,'' which feels very much like
promoting abortion, not just providing abortion. It is a very
different issue on that.
You argued that case all the way to the Supreme Court and
ultimately lost because the Supreme Court said what is obvious
to everyone. You cannot require someone to say something they
disagree with. That is a conscience issue.
Another conscience issue was the Little Sisters of the Poor
and other groups like that that said, hey, we do not want to
participate in abortion-related health care, and about 28,000
Californians lost their health care that fit in with their
conscience, based on how you were combating with those folks.
So help me understand the disparity between those two?
Mr. Becerra. So, Senator, again it is important to provide
clarity there. As you mentioned, I was in these cases. My job
as the Attorney General was to defend the laws of our State.
In the first case, you referenced a law in our State, which
by the way had been upheld in court. It was ultimately
overturned by the Supreme Court, but as you said it was
overturned, which means up until the Supreme Court, I had been
defending the law of our State.
In the second case, the actions we took were against the
Federal Government. And once again, we were defending our
State's laws and its rights under the law. Some cases we have
lost, some cases we have won. Where we have lost, I can assure
you that right now California is following the rules that were
provided to us by the Supreme Court.
And so we will always abide by the law. But it is my
obligation to also defend the law.
Senator Lankford. So you are going to be in this unique
situation where you were a litigant against HHS in these areas,
and now you are going to have to flip and actually try to
defend those areas. So I am trying to figure out how that is
going to fit for you, and if there is a conflict of interest in
that.
Mr. Becerra. So to clarify--and that is a great point, and
I say this for everyone to hear--I will have to abide by ethics
rules. I will be signing an ethics agreement. There are certain
cases, because I handled them as the Attorney General within
California, where I will have to recuse myself from certain
cases where I was involved at the State level.
And certainly because of the ethics agreement that I will
have, there will be always a check on what I am doing to make
sure that it does not somehow conflict with what I have done
previously as the Attorney General.
Senator Lankford. Yes, this conscience issue is really
important. For a health-care provider who believes that a child
is a child, whether they are in the womb or whether they are
outside the womb, that is a child that God created and it has
value and worth.
It is exceptionally important to be able to honor the
conscience rights of that individual, and that they not be
compelled to be able to perform an abortion, or to participate
in an assisted suicide, or something where they have a
conscience issue with that. And this is going to be a very
significant issue that you are going to face, that in previous
times administrations just ignored and did not enforce.
Mr. Becerra. Senator, I hear you very clearly. And as I
said, I will respect the law as HHS Secretary.
Senator Lankford. There are multiple grants-in-aid that are
out there that there will have to be decisions made over where
the faith-based entities can get grants or aid at the same
level as nonfaith-based entities.
Here is the challenge. In some previous administrations, if
you were a faith-based entity, you were not allowed to
participate strictly because of your faith and the structure of
that. The Supreme Court has now stepped in with pretty clear
decisions over the past several years to make it clear you
cannot discriminate against someone on the basis of their
faith.
Will you make sure that grants in the aid proposals from
HHS are equal for faith-based entities and nonfaith-based
entities for the same issues?
Mr. Becerra. Again, you raised the issue of, regardless of
what your perspective is, right, wherever we all may fall on
these issues, at the end of the day we have to make sure--at
least I do, if I am fortunate to be the Secretary of HHS--I
have to follow the law. And there I will tell you that we will
make sure that we are following the law.
Senator Lankford. Thank you.
Mr. Chairman, I would like to ask for different letters to
be entered into the record that folks have sent to me and to
other members of this committee.
The Chairman. Without objection, it is so ordered.
[The letters appear in the appendix beginning on p. 142.]
The Chairman. All right; our next colleague is Senator
Brown on the web. And I see Senator Daines here. So Senator
Daines would follow Senator Brown.
Senator Brown?
Senator Brown. Thank you, Mr. Chairman. General Becerra, it
is good to see you. Thanks for your willingness to serve as
Secretary of HHS. Thanks for your commitment through your whole
career--because I have known you a long time--to reducing
health disparities and prioritizing policies to address the
social determinants of health.
A number of communities in my State have passed resolutions
declaring racism a public health crisis. I think it is
important that we know that the history of institutional racism
continues to impact health outcomes for communities, and it is
particularly important that you understand the urgent need to
be intentional about your work. And I know you will be. So
thank you for that.
Cincinnati is home to two CDC NIOSH facilities--National
Institute for Occupational Safety and Health. They are unlike
any facilities in the country, maybe in the world. Their focus
is occupational injury, repetitive injury, occupational health
generally, toxins in the workplace, all of that.
In 2015, Secretary Burwell announced that HHS would be
dedicating $110 million to consolidate and upgrade the current
Cincinnati NIOSH facilities. They are in various degrees of
disrepair, the way CDC was half a generation ago.
CDC and GAO are currently undergoing site acquisition
activities. I understand both the site purchase and a design-
build contract will be finalized this spring. It has moved
entirely too slowly. There was indifference, or worse, from the
previous administration. My request is simple: to ask if you
would work with Senator Portman and me to ensure this project
continues to get the attention it deserves from HHS, including
the funding necessary to stay on track.
Mr. Becerra. You have my commitment to that.
Senator Brown. Thank you. Thank you, General.
In recent years, Congress and HHS have expanded the scope
of benefits available to those enrolled in Medicare Advantage
plans without doing the same thing for those individuals who
choose to remain in traditional Medicare.
We have added benefits: vision, dental. We removed barriers
to care, like the 3-day stay for skilled nursing facility care
for Medicare Advantage beneficiaries--that is the more
privatized Medicare, if you will--but failed to extend those
same advantages to those seniors who stay in traditional
Medicare plans. And those seniors typically are a little older
and a little sicker and a little poorer, generally.
The growing imbalance between the programs concerns me
greatly, especially when the Medicare program has been spending
more money per Medicare Advantage plan enrollee than on people
who choose traditional Medicare, a relatively recent but
inexorable move in that direction.
My question, General Becerra: will you commit to using your
authority hold private insurers accountable in reining in those
Medicare Advantage over-payments to ensure taxpayers and all
Medicare beneficiaries are getting their money's worth?
Mr. Becerra. Senator, you have my commitment. Now in terms
of dealing with Medicare, you are right. We do not have the
dollars to spare and to waste. And so in this process of trying
to strengthen and improve Medicare, we have to make sure we are
doing oversight and keeping everyone accountable.
And so I absolutely agree that that is going to be one of
the principal responsibilities we have. We have to be good
stewards of the Medicare program, taxpayer dollars. And as you
mentioned, with this 3-day rule for post-acute care, there are
ways that we have to make sure that we are keeping everyone
honest. And I will make sure that there is a level playing
field.
Senator Brown. A level playing field here is so important.
In closing, one last one, General Becerra, I would like
to--I want to bring forward to you the issue of the priority of
bringing down the high cost of prescription drugs.
Let me share a story quickly with you from a constituent in
the Columbus area community called Pickerington, from a young
man, someone named Colton. He was diagnosed with ulcerative
colitis in 2014. But his insurance coverage changed 2 years
later and he was forced to pay $1,200 every 4 weeks for the
infusions that kept his disease in remission. I just want to
read you his comments, briefly.
``At the time of this cost increase, I was in college. I
was already feeling the financial burden of student debt.
Budgets for students are already tight enough, but the immense
increase in cost for my infusions left me in a very difficult
position.
``Unfortunately, with the added financial burden for my
infusions, I have had to choose between affording the cost of
my infusions or school. This decision was not a decision at
all, since I needed the infusions to stay alive. Yet the
unreasonable price of my prescriptions forced me to leave
college.
``My life path,'' he writes, ``has been completely altered
by expensive prescription drugs and drug company greed. I often
feel like I am behind all of the people my age, even people
younger than I, because I have had to focus my time and my
money on staying alive. We should not have to give up pursuing
a college education because of crippling medical debt. We
should not have to make every financial decision with the cost
of prescriptions and medical debt in the back of our minds.
Things can be better if our leaders rein in drug company greed
and make the needs of patients like me the priority.''
That is the end of this letter. Now is the time, General,
for meaningful reforms to bring down drug prices. My question
is simple: if confirmed, will you commit to working with me and
other members of this committee--especially Chair Wyden, who
has been so involved in this--to deliver real change that will
make American prescription drugs more affordable?
Mr. Becerra. You have that commitment.
Senator Brown. Thank you, General. Thank you, Chairman
Wyden.
The Chairman. Thank you, Senator Brown. We will be working
on that.
Senator Daines?
Senator Daines. Thank you, Chairman Wyden.
Attorney General Becerra, I just want to be up-front and
tell you I have serious concerns with the radical views that
you have taken in the past on abortion, as well as one of our
very important constitutional protections--that is, religious
liberty. Frankly, it is a record that shows a disregard for
that.
Our present challenges demand an HHS Secretary who is
prepared to combat the COVID-19 pandemic and command a position
of public trust. Many Montanans and pro-life groups across the
country have written to say that you have taken the most
radical positions on this very important issue of life and
abortion.
If you want to push back on that impression, I think you
have an opportunity here to try to gain some public trust, and
to take a look at the record you have had in California and how
you might govern if you are approved here in Washington, DC.
Could you name one abortion restriction that you might
support?
Mr. Becerra. Senator, let me try to respond this way. I
have tried to make sure on this important issue for so many
people where oftentimes--and again, we have different views,
deeply held views--I have tried to make sure that I am abiding
by the law. Because whether it is a particular restriction, or
whether it is the whole idea of abortion, whether we agree or
not, we have to come to some conclusion. And that is where the
law gives----
Senator Daines. But to be clear, is there any line you
would draw? Is there just one, just one restriction that
relates to abortion that you might support?
Mr. Becerra. Senator, you are talking to the spouse of an
OB-GYN who for decades has practiced saving lives of women and
babies. And I can tell you that, from the stories I have heard
from Carolina, my wife, I know how hard many women struggle
just to save the life of their baby.
And so what I would say to you--and I know that, right now
as I speak, my mother has blessed me this morning as I got
ready to come here, and last night I know when she prayed the
rosary, as she does every day, every evening with my aunt, that
she said a prayer and included me in that prayer----
Senator Daines. Well, you know, part of it is the battle
for those who do not have a voice, which are the little babies.
You did not answer the question, but even one, even one
restriction on abortion? I did not get an answer.
Let me just throw one out there. How about a ban on the
legal discrimination in babies who are diagnosed with Down
syndrome?
Mr. Becerra. So, Senator, once again if I can simply say to
you that I respect the different views that are out there, but
what is important is that it makes sure that it is according to
the law.
Senator Daines. You have been a--if confirmed, you are
going to be the head of HHS. That is a huge organization that
has profound impact on our society. How about a ban on sex-
selective abortions? Whether the little baby is a male or a
female, would you say you cannot have a sex-selective abortion?
Mr. Becerra. And I respect those who take a particular
view. My job will be to make sure that I am following the law.
Senator Daines. There is a ban on partial-birth abortion. I
know that question came up yesterday. Is that yes or no? Would
you support a ban on partial-birth abortion?
Mr. Becerra. Again, Senator, you are asking questions which
will touch on aspects that I know have differing views, and
what I can say is that I will make sure that I am respecting
the law on those issues.
Senator Daines. You have repeatedly intervened in court to
revoke an important religious exemption to Obamacare's
contraception mandates from people like The Little Sisters of
the Poor, an order of Catholic nuns that serves the poor and
the most vulnerable. And they have won at the Supreme Court.
As HHS Secretary, would you commit to defending the
existing regulatory exemption to the contraceptive mandate? Or
would you seek to eliminate the exemption, protecting The
Little Sisters of the Poor from crippling government fines?
Mr. Becerra. Well, as you mentioned, the Supreme Court
issued a ruling. We will make sure, if I am fortunate to become
Secretary of HHS, that we will abide by the law as it stands.
And now with this ruling from the----
Senator Daines. You would defend the existing mandate,
then, per the Court?
Mr. Becerra. I will defend the law and support the law that
is in place.
Senator Daines. According to CDC data--they have been
comparing States and territories--Montana is ranked near the
top for administration of vaccine, but we fall near the bottom
for first doses allocated by the Federal Government. That is
why our congressional delegation wrote to President Biden
expressing frustration that Montana is not getting its fair
share of vaccines.
I am concerned that HHS is neglecting to reward States like
Montana that could administer at least three times the number
of doses being delivered currently. Do you believe HHS should
provide additional vaccines to States like Montanas that have
been able to quickly and efficiently get vaccines in the arms
of people who want them?
Mr. Becerra. Senator, we applaud States that are moving
forward and being diligent in getting their people protected.
And I know that President Biden has made the commitment to have
all the vaccines that we will need throughout the country. And
what I can commit to you is to make sure we are working with
you and the folks in Montana to make sure that the vaccines are
there for the people of your State when they need them, and
doing that the same way for all the people in this country.
We want to make sure we are not missing anyone, and that is
where this issue of pockets of population----
Senator Daines. Thank you for that. I appreciate that
answer.
Last question: you are on record for pushing for allowing
illegal immigrants to receive taxpayer-funded health care, and
for decriminalizing illegal entry into the United States.
This, coupled with President Biden's radical plan for
granting citizenship to those who are here illegally would
potentially lead to hundreds of thousands, if not potentially
millions more people flooding into our country.
As you know, in 2016 California passed a law requiring
covered Californians to apply for a section 1332 waiver to
allow illegal immigrants to purchase health insurance through
the marketplace. This waiver was withdrawn after President
Trump's election.
My question is this: will you attempt to use the waiver
authority contained in the Affordable Care Act to grant health-
care benefits to illegal immigrants?
Mr. Becerra. Senator, what I can tell you is that where the
law stands now, as I see it, it does not allow those who are
unauthorized in this country to receive taxpayer-paid benefits
except in very rare circumstances. And it will be my job to
make sure that we are following and enforcing the law. And I
can commit to you that that is what we will do.
Senator Daines. Thank you.
The Chairman. Senator Bennet?
Senator Bennet. Thank you, Mr. Chairman.
Let me turn to another--it is very nice to see you, Mr.
Attorney General. Welcome back to Washington. And I want to
turn to what was also called a radical point. And that was the
Affordable Care Act, which has made massive strides in
providing health care to 20 million Americans, protecting
people with preexisting conditions from discrimination, and a
lot of other things that have become the norm in this country,
like staying on your parent's health insurance until you are
26, something you could not do before the Affordable Care Act
was passed.
I think we need to build on the Affordable Care Act and use
the Medicare system to provide a true public option. And it is
something that the President has also talked about on his
campaign.
I believed in it when we passed the ACA to begin with. The
votes were not there to do it. I think it has become very clear
during the course of the pandemic that nobody is served by
having people who do not have access to primary health care.
Because you can see in the numbers in the pandemic what has
happened to this country versus some other places.
Last August, the President, then candidate Biden, was
speaking to one of my constituents from Colorado, Laura
Packard, who told the Vice President at the time that she was
literally receiving chemotherapy on the day that there were
some folks here trying to repeal the Affordable Care Act.
And she asked what he was going to do for people like her,
and for people in America. And he told her, quote, ``We're
going to provide a Medicare-like option as a public option.''
He went on, ``I'm going to protect you like I try and protect
my own family, and I promise you that.''
That was a powerful moment for all of us who were watching.
And yesterday Senator Tim Kaine and I and some of my colleagues
on this committee reintroduced the Medicare-X Choice Act to
create a true public option, increasing choice for consumers,
starting in rural areas, reducing health-care costs, and
increasing affordability and quality of health insurance.
We worked to ensure that our updated legislation aligns
with President Biden's plan, including plans offering primary
care services without cost-sharing, fixing the family glitch to
increase access to premium support, and ensuring that the cap
on premiums for everyone above 400 percent of the Federal
poverty level is 8.5 percent of their income.
Medicare-X both finishes the work of the ACA and aligns
with the President's objectives. You are uniquely situated,
having been both a lawmaker and the California Attorney
General, to help us get this across the finish line. And I just
want to ask what your thoughts are on the commitments the
President made on a public option during the campaign, and how
we can get it across the finish line so we can finally fulfill
the promise that every single American has access to health
care in this country.
Mr. Becerra. Senator, you pointed out where now-President
Biden stood as candidate Biden, and he was very strong about
this. He made it very clear that the Affordable Care Act is a
strong foundation from which we can build.
You have mentioned the public option. He made it very clear
he is a supporter of moving forward on a public option. My job
will be to try to implement the President's agenda on health
care. And so I will look forward to working with you and all of
your colleagues to try to make sure we can continue to see more
Americans access health care, whether through their employer,
or whether through Medicaid, or whether through the Affordable
Care Act's marketplaces.
We need to have those options, including the public option,
available. If States want to move in that direction, we will
try to be--we will work with them as best we can. But as you
have said, the goal here has to be to make things even better,
more affordable for Americans.
Senator Bennet. You know, Mr. Chairman, I came up with the
idea for this legislation after I was in a meeting in Jackson
County, CO. And to give you a sense of Jackson County--I just
saw my friend from Indiana--I had to start the meeting by
apologizing for how badly I had done in the election the last
time, because, you know, there are very few Democrats there.
And somebody actually said, ``Oh, you actually won a few more
Democrats than there actually are.'' But it was grim.
But I was there, and somebody said to me, ``You know,
Michael, I moved back to this town.'' It is a county with, I
think fewer than a thousand people in it. It is a huge space.
``I moved back to this town to take over the bowling alley that
I loved to go to as a kid. And I am working 50 hours a week. My
wife is working 50 hours a week. Neither of us has health
insurance.'' He said, ``I've got people I would want to hire,
but I can't hire people because they have to give up their
welfare to come work for me.''
I said, ``What do you mean `their welfare'?'' And he said,
``Their Medicaid.'' In other words, their health care. So here
in America--this is after the Affordable Care Act--here we have
a situation where a small business owner and his wife are
working 50 hours a week and they cannot afford health
insurance.
Folks who would want to come work, cannot come work because
they have to give up their insurance. How can we defend a
system like that? And we do not need to. And I think--I hope we
look back at the history of all of that and find a way to put
the partisanship aside and actually provide the American people
with just what this is, an option. They can choose. They can
choose all over rural and urban Colorado; it would be a choice.
If you want to stay with your private insurance, stay with it.
If you want a public option administered by Medicare, you can
have that too.
And I think that is going to be a powerful argument for the
American people who, coming out of this pandemic, want more
choices, not fewer.
So I am very glad you have been nominated, and I look
forward to supporting your nomination and working with you to
deliver this for the American people.
Thank you, Mr. Chairman.
The Chairman. Thank you, Senator Bennet.
Senator Young?
Senator Young. Mr. Becerra, there are all sorts of concerns
by my constituents--and I think every American--about getting
shots in the arms as quickly as possible. That is my foremost
objective in trying to support the administration in
furtherance of that goal.
The Biden administration just announced the launch of two
new Federal programs, the Federal Retail Pharmacy Program and
the Community Health Center vaccination program. This was an
effort to speed up vaccinations across the country. These
programs are in addition to an existing program, which is the
Pharmacy Partnership for Long-Term Care Program. Unfortunately,
these various programs are causing some confusion for the
States, as the States are not able to oversee and coordinate
distribution of our already limited supply of vaccine with
these various entities--long-term care facilities, community
health centers, retail pharmacies. And individual Hoosiers are
confused as well, because now they have to sign up in multiple
places in order to become vaccinated.
In fact, the National Governors Association recently wrote
to the administration highlighting this issue, indicating,
quote, ``if the Federal Government distributes independently of
the States to these same entities without State coordination
and consultation, redundancy and inefficiency may very well
follow,'' unquote.
I would like to submit two letters for the record, one from
the NGA and one from my home State of Indiana, further
detailing these concerns.
The Chairman. Without objection, so ordered.
[The letters appear in the appendix beginning on p. 226.]
Senator Young. So I bring this to your attention because,
until adequate supply is available, Mr. Becerra, the
administration should be working with States on vaccine
distribution, especially since retail pharmacies and Federally
Qualified Health Centers are already part of many States'
vaccine plans.
The State of Indiana has been making great strides with the
available vaccine to get it in the arms of Hoosiers. So do you
commit to working with the States before announcing major
program roll-outs, like the two I mentioned, in the future?
Mr. Becerra. And, Senator, you will understand why this is
close to my gut more than my heart, because I am a State
official right now. And we have had to administer a lot of
these programs. I have had to defend many of these programs at
our State level in court.
And what I will say to you is that, if we are not doing a
good job of coordinating with our State and local and tribal
and territorial partners, then we are not doing it as well as
we can. And so I am committed to working with you to make sure
that, as we get the product out--and, fortunately, President
Biden has made an aggressive effort to make sure we have enough
vaccines for everyone--that we are working with all those who
have to make sure that shot actually gets into the arm.
Senator Young. So that is an encouraging response. Let me
go further.
Mr. Becerra. Sure.
Senator Young. Would you allow States like Indiana that may
well find these programs counterproductive--as shared goals of
getting vaccine into arms--to opt out of these Federal programs
until a time where there is adequate supply available?
Mr. Becerra. So let me--I am not yet there, and I hope to
be confirmed, but it would be tough, Senator, to be honest with
you, to----
Senator Young. Would you consider it?
Mr. Becerra. Absolutely. We will sit down with you and
talk. The moment I am in that seat, I will make sure that we
are sitting together. We will go to your office, and we will
talk about this.
Senator Young. Can you conceive of a reason why you would
not allow a State like Indiana to opt out of these programs?
Mr. Becerra. I will tell you that the President's goals are
ambitious. We want to move quickly. I cannot understand why we
would not want to always coordinate, but I also want to make
sure it is clear that the President has been very transparent
in saying that we want to make sure we are reaching everyone,
we are doing it in a fair way, and we are doing it, you know,
so it makes sense.
Senator Young. I am going to cut you off, because you know
how this goes. I have limited time.
Mr. Becerra. Yes.
Senator Young. But I would hope you would allow States like
Indiana to opt out if that will help us get more vaccine in the
arms of Hoosiers.
So 33 Americans die every day waiting for a life-saving
organ transplant. We have an organ shortage in this country,
and it results from a severe lack of oversight and
accountability among government monopoly contracts that run our
organ donation system.
These are known as ``organ procurement organizations,'' or
OPOs. The Senate Finance Committee recently noted that our
organ donation system has been severely under-performing for
decades. The Department of Health and Human Services finalized
a rule last November that will allow HHS to hold OPOs
accountable for their performance for the first time in their
40-year history.
This rule is projected to save more than 7,000 additional
lives every year, and it is going to save money too: over a
billion dollars annually to Medicare. But because this rule was
finalized in the last 60 days of the previous administration--
you know where I am headed with this--it is currently being
subjected to the Biden administration's freeze on midnight
regulations.
So as HHS Secretary, will you commit to implementing and
enforcing the November 2020 OPO Final Rule swiftly and
forcefully as soon as the review period ends?
Mr. Becerra. Well, first I have to say ``thank you'' for
the role you played on organ donation. It is critical. It is
not a subject everyone wants to take on.
Secondly, there is--the pause the President put on a number
of these rules is something that most administrations do, but I
can guarantee you that the administration, if I am fortunate to
be confirmed to HHS, will work quickly to try to get back up to
speed on some of these different rules.
What I can commit to you is this. We all know we need to
increase the supply. We know we have to be fair. We have to
make sure we are doing this in a way that makes sense. And we
have to do the oversight.
And so I can commit to you to work with you to make sure
that, once I get in the chair, if I am fortunate to be
confirmed, that we will talk to you about how we move forward
with that rule, and of course your legislation as well.
The Chairman. Thank you, Mr. Attorney General. Let me also
say to my colleague, and to those following this, I think these
are very important issues. And we have had a bipartisan inquiry
going on in this committee where our colleague has been very
actively involved. We will be continuing that. It is a really
high-priority matter, and my colleague has laid out some of the
problems, and we are going to want to get into the details, I
believe, when the Attorney General is confirmed. And I was
appreciative of the positive answer, so I thank you.
Let us do this. If there are any Senators waiting in the
queue on the web, we will take one more before we go and vote.
And then otherwise, per an agreement with both sides, we will
take a 15-minute recess, Mr. Attorney General. Are any of my
colleagues waiting on the web to ask questions?
[No response.]
The Chairman. All right, I gather not. So we will take 15
minutes. We will have a recess, and we will be back at that
point.
Oh, Senator Casey? Okay. Senator Casey, you are out there
in cyberspace somewhere?
Senator Casey. I did not think I would have a chance.
The Chairman. Terrific, terrific. Okay, then we will revise
the state of play here, and we will hear from Senator Casey.
And after he has completed his questions, then we will take a
15-minute break, and that is in accord with the wishes of both
the majority and the minority.
Senator Casey?
Senator Casey. Thank you, Mr. Chairman. I think I may have
jumped ahead, so I just want the Attorney General to know this
has never happened before. [Laughter.]
So let me use my time wisely. Mr. Attorney General, thank
you again for your public service and your willingness to
continue public service on behalf of the Nation by running a
major agency of our government that is so important these days,
and that is the Department of Health and Human Services.
I also want to thank you for the commitment of your family,
which I know is a major commitment by any family when you are
in public service like you have been all these years. And yours
is a great American story.
I wanted to start with the issue of home- and community-
based services. We know that one of the real tragedies within
the larger tragedy of the pandemic, now that we have reached
that awful, awful number of 500,000 deaths, is a high
percentage of those deaths--at last count, more than 170,000--
were residents and workers dying of the virus who were in
nursing homes, living or working in nursing homes or other
long-term care settings.
One way to protect these populations is with a responsive
and robust support system that provides quality home- and
community-based services.
We know that those who do this work in the home or home- or
community-based services, as well as in the long-term care
setting, are front-line workers. They are heroic. And the folks
who do this work support older adults in our communities, and
they also support and provide care for folks with disabilities
who need that help.
They are often paid about $12 an hour for this essential
work. Most of them, a high percentage of them, are women of
color. And because these home- and community-based services are
not required under Medicaid under current law, there are over
800,000 people on waiting lists for these services, 16,000 of
those in Pennsylvania.
So we need to invest in this option that we have not really
made part of Medicaid in a substantial way other than the
waiver program. We need to invest now. The House legislation,
their COVID-19 bill, has over $9 billion. This is but a foot in
the door, but a very important, unprecedented foot in the door.
So I have two questions for you. First, upon the passage--
and I am being optimistic here, but I think it will happen--of
this emergency funding legislation, COVID-19 legislation, as
well as the funding for home- and community-based services,
will you work to distribute it to the States as quickly as
possible?
Mr. Becerra. You have my commitment, Senator.
Senator Casey. Thank you. And then secondly, as you know,
the next matter for President Biden and Vice President Harris
is to work on the Build Back Better plan. And that is another
opportunity I think for us to really focus on this issue, but
provide an even more substantial investment in home- and
community-based services. And I hope you would work with us to
secure that funding.
Mr. Becerra. You have my commitment, again, to work with
you on that.
Senator Casey. The last issue, in my remaining time, is
Medicaid. I do not have to tell you, because you have been a
strong supporter and a fighter to preserve Medicaid funding,
Medicaid, in so many ways, is not ``some program.'' It tells us
who we are. It tells us who we are, and it tells us whom we
value, whether it is kids or seniors or people with
disabilities. So many millions of Americans, 70 million-plus at
last count, have the benefit of Medicaid.
You were familiar, when we sat down most recently and in
our last hearing in the HELP Committee, with my agenda for
children, and the Five Freedoms for America's Children.
I believe every child at birth, if they do not have health-
care coverage, should be covered by Medicaid. And I just wanted
to ask you, how will you use your authority as HHS Secretary to
utilize waiver authority and other tools to strengthen Medicaid
and to help expand coverage to uninsured or under-insured
Americans?
Mr. Becerra. Senator, I know you know this, so I am just
repeating what you have already worked on so much, and that is:
Medicaid is the lifeline. It is what has kept so many American
families from losing all hope, and in many cases losing
respect.
And so I am absolutely prepared to work with you and many
of your colleagues to try to do what we can to strengthen
Medicaid for so many, including seniors who have Medicare who
oftentimes rely on Medicaid as well. We have to make sure that
we do not lose sight of how important Medicaid has become to
the entire population. And with the President's commitment to
continue to build on the Affordable Care Act, Medicaid, as you
know, is indispensable.
So we are ready to work with you on any issues, especially
for children. And I know my wife is applauding everything you
have just said to try to make sure our children have
opportunities from the get-go.
Senator Casey. Thanks so much. We look forward to your
confirmation.
The Chairman. Thank you, Senator Casey.
We are calling some audibles here and, with the consent of
both sides, we will have Senator Whitehouse, and then all other
Senators should know we are going to take a 15-minute break,
and then we will finish.
Senator Whitehouse?
Senator Whitehouse. Welcome, Attorney General. It is great
to see you, and I wish you every success in the remaining days
of your confirmation process.
I want to mention two things to you that I have put a lot
of work into over time. One is delivery system reform in our
health-care system. Macro, we hit the Medicare trust fund in
2024, and so we are going to have to deal with that issue
between now and then. Micro, Rhode Island has two of the best
Accountable Care Organizations in the country. These are
primary care provider groups, doctors' practices that have
gotten together early, signed up as ACOs under the Affordable
Care Act, and have changed the way they practice. And as a
result, their cost per patient is coming down. Their patient
satisfaction is through the roof. Their outcomes are improving,
and they are sending checks back to the Federal Government out
of the shared savings that they have been able to obtain.
My staff person will hand you a little graph that I have a
big copy of right here, which is something that I have worked
on for a while, as time has gone by. In the far left here
[indicating], time begins around the time we passed Obamacare.
At that point, CBO projected what Federal health-care spending
was going to look like. And their projection then is that top
line [indicating]. But in fact, with the Obamacare law, we did
not follow that trajectory. Costs were actually lower.
And as we have gone forward, we have experienced actual
costs that are that bottom line [indicating]. And the current
projection, matching that original one from 12 years ago I
guess now, pushes that from where we are now out 10 years. But
if you took that same projection and put it onto where we were
before, here is this gap between what was predicted and what we
have achieved.
And in the next 10 years, that gap is $6 trillion.
Something changed from what was anticipated at the time we
passed Obamacare. And the savings in the next decade are going
to be $6 trillion from whatever that thing was that changed.
I think that what changed was getting away from fee-for-
service, getting providers engaged in Accountable Care
Organizations and the emphasis on quality and reducing medical
errors, and dealing with patients better.
So I have had my rows with the Obama administration over
how they were doing ACOs, and I have had my rows with the Trump
administration. And I want to work with you to make sure that
these organizations that are basically breaking trails for the
rest of the health-care system, these leadership ACOs, are
getting the support and the encouragement that they need.
Because when they win, we win.
And with the Medicare trust fund starting to hit its limit
looming, we have to get serious about that. I do not need a
long response from you now, but I want to make sure you are
aware of the opportunities for delivery system reform. And I
know you have some very good ACOs in California as well.
Mr. Becerra. Yes. And, Senator, the response there is: I
look forward to working with you on it.
Senator Whitehouse. We will, because we have work to do. It
is also very likely a big political win/win. I do not know
anybody on any side of any aisle in Washington who does not
want better care, producing lower costs, with happier patients.
Last point; this is a bit of a personal thing. I have been
working for a long time on having us treat people at the end of
their lives better than we do, making sure that their choices
are respected, making sure that their capability to be at home
at that time is respected, making sure that they are pulled out
of the hospital treadmill and they are not dying in intensive
care units that they do not want to be in, and should not be
in.
We have worked with CMMI a lot on that, and I am hoping
that we can close out, under your leadership through the Center
for Medicare and Medicaid Innovation, a pilot program that will
show that when you treat people at the end of their lives with
more humanity, everybody is happier and it saves money. Will
you work with me on that?
Mr. Becerra. As someone who had his father live with him in
the last few years of his life, so that when he passed, he
passed in his bed in my home, I absolutely look forward to
working with you on that.
Senator Whitehouse. Thank you, sir. And Godspeed in your
confirmation.
Mr. Becerra. Thank you, Senator.
The Chairman. I thank my colleague.
Mr. Attorney General, we will take a 15-minute break.
Mr. Becerra. Thank you.
[Whereupon, at 4:15 p.m., the committee recessed,
reconvening at 4:30 p.m.]
The Chairman. The committee will come to order. The
tentative order of Senators will be: Senator Cortez Masto on
the web and Senator Warren in person. So that may be subject to
a change if someone who was here earlier did not come, but I
believe that is the case.
Senator Cortez Masto?
[No response.]
The Chairman. Are you out there in cyberspace?
[No response.]
The Chairman. Okay, we will go to Senator Warren, and then
we will go----
Senator Warren. Are you ready for me, Mr. Chairman?
The Chairman. Yes. Let me just--yes. Why don't you go, and
then we will sort out where we are after that.
Senator Warren?
Senator Warren. Thank you. Thank you, Mr. Chairman.
So, early in the pandemic, Representative Ayanna Pressley
and I, along with many of our colleagues, pushed the Trump
administration to collect and to publicly release demographic
information on who was getting tested for COVID-19, and who was
getting infected. Without this information, there would be no
way to know if black, brown, and indigenous communities had the
same access to tests as white communities. And it would be
impossible for the Federal Government to allocate resources
equitably.
Put plainly, you cannot fix what you cannot see.
Now, we kept pushing and mandated this data collection in
one of the COVID relief packages. And now we have begun to get
a fuller picture. We know that black, Latino, and indigenous
people are nearly two times as likely to contract COVID-19,
roughly four times more likely to be hospitalized when they get
sick, and more than twice as likely to die.
Those data are critical to setting policies to combat
racial inequality, but today, almost a year into the pandemic,
nearly half of all testing data collected by the CDC still does
not have associated race or ethnicity information.
As HHS Secretary, will you commit to prioritizing
collecting and reporting these critical data so that we get a
fuller picture of how the virus is affecting all Americans?
Mr. Becerra. Senator, first, thank you for making that
effort to secure that information. I can make this commitment
to you now that I will work with you to make sure we have all
of that type of information. We need that information to do a
good job.
Senator Warren. Good. I am glad to hear you say that.
Now on the vaccine front, we have administered over 64
million doses of the COVID-19 vaccine, but the CDC has race and
ethnicity information for just over half of those vaccines. So,
if confirmed, will you also commit to improving the collection
and publishing of the data on vaccines?
Mr. Becerra. I commit to work with you to make that happen.
Senator Warren. That is terrific. You know, there is more,
though. Racial equity should be a part of every public health
issue that you approach as HHS Secretary: chronic conditions,
infant mortality, addiction, police brutality. Racial health
disparities are not coincidences or aberrations in the data.
They result from structural racism, and it is time to start
treating structural racism like any other public health
problem: investing in research into its symptoms and its causes
and finding ways to mitigate its effects.
So let me ask you the third in this series. Will you commit
to collecting the data we need to see the racial disparities in
our health-care system, and to attacking those disparities
head-on?
Mr. Becerra. Senator, I am looking forward to working on
that with you, because it is time.
Senator Warren. Thank you very much. I am looking forward
to working with you, and I am going to support this nomination
all the way. Thank you.
Mr. Becerra. Thank you.
Senator Warren. Thank you, Mr. Chairman.
The Chairman. I thank our colleague.
Senator Cortez Masto, I believe, is next.
Senator Cortez Masto. Thank you. I am here.
Attorney General Becerra, congratulations on your
nomination. I am very excited for you and your family.
Let me start with an issue that I have been focused on for
the State of Nevada and that many of us really have been
talking about and putting in the most recent package. First, I
want to thank the administration for the work that went into
President Biden's American Rescue Plan to provide COVID-19
relief to millions of families across the country. There is
still a need for it out there, including in Nevada that has
been so hard-hit. So many of the provisions in the plan are
critical to getting Americans back on their feet.
But I would like to focus on the COBRA subsidies that will
be a lifeline to out-of-work Nevadans. Nevada's tourism-driven
economy was devastated by the coronavirus. The losses suffered
by our gaming and hospitality sectors have taken a toll on
hardworking families across the Silver State, as families have
experienced layoffs or seen their hours cut. They have lost
steady wages. They have experienced food and housing
insecurity. And they have lost their health care.
The Rescue Plan includes measures to address each one of
these issues, but COBRA subsidies are especially critical
because they are key to preserving the benefit that union
workers have fought for. They are central to protecting the
coverage of whole families and ensuring access to their doctors
and specialists.
So, Attorney General Becerra, I know you understand how
essential these benefits are to working families. Can we count
on you to help us protect these hard-fought benefits that will
help Nevada families and all families stay afloat through this
crisis and beyond?
Mr. Becerra. Senator, you have my commitment, because you
are talking about having a continuity of coverage for people
who were working, oftentimes had their coverage because of
their work, or through their union. Through no fault of their
own, now they find themselves in these conditions. And so
absolutely, you have my commitment to work with you on this.
Senator Cortez Masto. Thank you. And I want to touch on
another subject that my colleagues, Senators Wyden and
Stabenow, have talked about, which is mental health.
As we have seen, the pandemic has shone a new bright light
on the mental health needs of American families, from seniors
struggling with loneliness, to young students navigating an
online learning environment; from those with a history of
substance abuse or serious mental illness who have been thrown
off track by the radical change in our daily life, to families
facing the trauma of job loss and poverty--everyone is hurting.
We have had and made a huge effort last year to incorporate
funding for mental health support in the various coronavirus
relief packages. But let me just say this: block grants and
patchwork funding are no way to sustain the mental health
infrastructure that the Nation needs over the long term.
We should see the pandemic as an opportunity to build an
even stronger support system for American families. And that is
why I have been working on legislation that builds on Senator
Wyden's CAHOOTS Act to bolster behavioral health crisis
response services across the country. It integrates Senator
Stabenow's Certified Community Behavioral Health Services. And
so I look forward to working with you on this legislation that
will build on SAMHSA's guidelines to create a framework for
providing emergency mental health services to individuals in
crisis.
You know better than anyone, with your broad experience,
particularly as the most recent Attorney General of California,
that there is a need for this. We just have to get it right
moving forward.
So can I count on your support in working with us to
address metal health and behavioral health services in States
across the country?
Mr. Becerra. Senator, for the reasons you have just
articulated, I started a disability rights unit in the
Department of Justice in California, and I am absolutely
looking forward to working with you on these issues.
Senator Cortez Masto. Wonderful.
And then lastly, let me just put this on your radar. I
would like to underscore the imperative that HHS focus on
improvements to the Indian Health Service. We are in bipartisan
agreement here in Congress that the Service is in dire need of
additional, stable funding in order to meet the basic needs of
Indian country.
Many of us also sit on Senate Indian Affairs, and this is
crucial and critical that we have your support. You know, the
crisis at IHS was years in the making. And so, can I get a
commitment from you that we can work with you, that you are
willing even to come to the committee, Senate Indian Affairs,
and talk with us about how we address and improve upon the
Indian Health Service in this country?
Mr. Becerra. Absolutely; you have that commitment.
Senator Cortez Masto. Thank you. Congratulations, again.
Mr. Becerra. Thank you.
The Chairman. Thank you, Senator Cortez Masto.
Senator Cassidy is next.
Senator Cassidy. Hello, General Becerra. Again, it is good
to see you.
General Becerra, if I had to guess, if I was a betting man,
I would bet that you have the votes to be approved. As I
mentioned in the HELP Committee, my concern is that you will be
in charge of the largest domestic agency and you do not have
the background.
Now your answers have been typically general, and I have no
doubt that you will have good advisors. But as I said
yesterday, I am a physician. Should I be the Attorney General
of the United States? Obviously the answer is ``no.''
So--but, you know, there are three major buckets of HHS.
One bucket is the TANF or the social services; the other is the
finance in the Medicare and Medicaid; and the third is what we
discussed at HELP, those kind of FDA, NIH, and other buckets,
if you will. And those are the three big ones. And everything
else is far less.
So just to kind of explore, because, as Senator Burr said
yesterday, this is kind of your opportunity to introduce
yourself to the American people and to say, ``Nope, I've got
it. I'm ready. I don't know everything, but I know enough, and
you do not have somebody coming in who is unfamiliar with what
might be happening.''
So let me just ask you a couple of things. TANF is a
program that will be under your administration. And can you
just talk--and you have spoken about enforcing existing laws.
So knowing the goals of the TANF program, what could we do to
more specifically address those specific goals as laid out in
statute for TANF?
Mr. Becerra. So, Senator, thanks very much for the chance
to answer the question. And by the way, thank you very much for
the time you gave me to sit down and talk about a number of
issues.
What I can tell you is, if we are talking about children
and families, HHS can do a whole lot to make sure that, whether
it is nutritional goals, whether it is the health status, or
whether it is making sure that we are talking about wellness,
not just about remedying conditions, that we are working with
all of our sister agencies, and with our State and local
partners to make sure that we are trying to improve the
condition of life for these families--especially families----
Senator Cassidy. Let me, if I may, because I have limited
time. The statute says specifically that, among its four goals
are to reduce out-of-wedlock pregnancies; to promote the
formation and maintenance of two-parent families; to end the
dependence on government benefits through work, job
preparation, and marriage; and then to provide assistance to
needy families with children so they can live in their own
homes, or the homes of relatives.
So what specifically about those goals--because this is
part of one of those big three buckets that you will be
administering--would you bring to the table as sort of a policy
solution?
Mr. Becerra. Well, having been someone who had the benefit
of having two loving parents and who had a chance to be raised
by people who always worked hard and gave me the best example,
I certainly believe that one of the things that we can do is
continue to strive to give all of our children the opportunity
to be raised in a loving home, and with an opportunity to----
Senator Cassidy. So, General, that is the goal of the
program. That is the statute. I guess the question is, what
experience, or what specific programs, or what critique of
existing programs would you offer in order to better meet that
goal? Again, something that the HHS Secretary will be
responsible for.
Mr. Becerra. Well, certainly I think there is always a need
to try to improve on the different programs. We always learn
every year how we can make them better. We learn of
inefficiencies of bureaucracies that sometimes get in the way.
If I am fortunate to be confirmed, I certainly will take a
close look and, with your help and the oversight that you all
do, I hope what we can do is improve these programs and have in
place the road maps, whether it is through statute or through
regulation, that let us advance the interests of these
families.
Senator Cassidy. So then the second question is financing,
which is the Medicaid and Medicare programs. And we have talked
about a lot of things on this committee. You have been on Ways
and Means and were involved in the Medicare modernization, so
this might be more in your wheelhouse.
But one issue that we have discussed is, Medicare
beneficiaries and an increasing share of commercial enrollees
pay co-insurance based upon the list price of a drug. So if the
pharmaceutical company drives up the list price to give a
bigger rebate to a pharmacy benefit manager, the net price may
be lower for the PBM, but the patient is paying based on the
list price.
What steps could HHS take to protect the patient in this
situation?
Mr. Becerra. Well, here we have to look at this from the
perspective of the patient. And I know that there are a number
of things going on right now with the rebate program. And
rather than let patients, Medicare beneficiaries, get embroiled
in the food fight between PBMs and drug makers, we have to make
sure that we agree, all of us agree that whatever we are going
to do, whether it is on rebates or anything having to do with
prescription drugs, we are letting our seniors on Medicare know
that we are going to fight to lower the price.
And so without getting into the specifics of the different
fights that are going on between the different providers and
those that are involved as stakeholders, what I can tell you is
that we will do the oversight.
There are in some cases existing regulations that tell us
how to proceed with regard to the rebates. There is existing
authority. And what we can do is make sure that no one is
trying to game the system; that at the end of the day we are
looking for lower prices on the prescription drugs that our
seniors count on.
Senator Cassidy. Okay; thank you very much.
The Chairman. I thank my colleague, and I look forward to
working with him. The three remaining Senators that we have are
Senator Sasse, Senator Hassan, and Senator Portman.
Senator Sasse?
Senator Sasse. Thank you, Mr. Chairman.
Mr. Becerra, you said a little while ago that you never
sued the nuns, which is a pretty interesting way of reframing
your bullying. You actually sued the Federal Government who had
given an exemption to the nuns. Can you explain to us what The
Little Sisters of the Poor were doing wrong?
Mr. Becerra. So, Senator, as I tried to explain, my actions
were against the Federal Government. The Little Sisters of the
Poor, we never alleged that The Little Sisters of the Poor did
anything wrong. Our problem was that the Federal Government was
not abiding by the law as we saw it, and what we did is, we
took action against the Federal Government so California could
administer its programs to make sure that the Affordable Care
Act continued to work.
Senator Sasse. What were the nuns doing that made it
impossible for California to administer their program? That was
just a complete nonsense answer. What were the nuns doing that
would have made it difficult for California to administer your
program?
Mr. Becerra. Well, as I said, Senator, our action was
against the Federal Government----
Senator Sasse. No, no; you continued and you said ``so that
California could administer'' your program. What did the nuns
do that made it difficult for California to administer their
program?
Mr. Becerra. And, Senator, what I am trying to explain to
you is that we were not looking at the actions of The Little
Sisters or any other program. Our actions were against the
Federal Government in the way it was applying the law as it
existed to California.
Senator Sasse. But what did the Federal Government do? It
was about the nuns. This is nonsense. Like what you are saying
is not true. You say you did not sue the nuns, you sued the
Federal Government that was keeping you from making sure that
the nuns had to buy contraceptive insurance. Were the nuns
going to get pregnant?
Mr. Becerra. Senator, the actions of the State of
California--and I was defending the actions of our State and
the laws that were in place--the Federal Government took
actions, changed the way that we would administer the programs
that we had under the Affordable Care Act. Our actions related
to how providers are providing services to the people of
California.
When the Federal Government took action that we thought was
unlawful, we took action to protect the people of California.
Senator Sasse. So again, a whole bunch of words. But you
know well--you are an incredibly smart man--you know well that
what the Federal Government did was to make sure that you could
not target the nuns.
So you sued the Federal Government because the Federal
Government said the nuns did not have to buy contraceptive
insurance. You can put 17 layers of you were following the law
to go after the Federal Government for administering the
program, or doing X, or doing Y that made it difficult for
California to administer the program, but it was just about
nuns buying contraceptive coverage.
Was there something else the Federal Government did that
you were suing them for in the case called California versus
Little Sisters of the Poor?
Mr. Becerra. Senator, the case was not, again--that was not
the name of the case. And what I will tell you is that our
actions were based on trying to follow the law. When the
Federal Government took action, which we believe did not
comport with the law, at that point we took action. And our
action was based on the law.
And so as I have said, we may disagree on how we see this,
and I respect the differences that we may have, but my action
was to follow the law.
Senator Sasse. What about the law--as the Federal
Government's conscience exemptions applied in the case where
you sued the Federal Government--what about the law applied to
anybody except the nuns and other similarly situated religious
institutions?
You were targeting religious liberty.
Mr. Becerra. Senator, let me see if I can try to answer it.
The Affordable Care Act tried to make sure that we are
providing health care to all Americans. And we have to make
sure that we provide the services that Americans are entitled
to receive.
We tried to make sure that in California, under the
Affordable Care Act, every Californian received the benefit
they are entitled to under that Act. And so when we saw that
the Federal Government was taking actions which might abridge
those rights----
Senator Sasse. And I am going to ask the question again.
You said the Federal Government taking actions--this is the
third time you have not answered. Were any of those actions
about anything except nuns and religious liberty? Was the
Federal Government taking other actions that you were suing
about in that case? Or was it just because you wanted to target
the nuns and religious liberty?
Mr. Becerra. Senator, again I respect the way you view it,
but----
Senator Sasse. Because it is actually what happened.
Mr. Becerra. Senator, again I understand that we may view
it differently, but I was trying to protect access to care----
Senator Sasse. I am giving you the chance to explain what
you think it was about, if it was not this. And you have not
yet explained any part except ``the law as administered by the
Federal Government.'' But it was about the nuns.
Mr. Becerra. Senator, I will try once again to explain.
Californians are entitled under the Affordable Care Act to
access care.
Senator Sasse. And the nuns were keeping them from getting
care how?
Mr. Becerra. The Federal Government was changing the----
Senator Sasse. To make sure that the religious liberty
rights of the nuns were protected. Was there anything else the
Federal Government was doing, except making sure the nuns had
religious liberty?
Mr. Becerra. Senator, I respect the differences in the way
you pursue this----
Senator Sasse. For the fifth time, you have not answered
the question. I have asked you for any party, besides the nuns,
and you have just said you respect the diversity of opinion.
I will move on to another question. Former abortion
industry employees from your State have claimed on camera that
babies who survived abortions were left to die by Planned
Parenthood staff in your State, in clear violation of both
State and Federal law.
Instead of investigating these claims, you raided the
houses of the film makers who brought these atrocities to
light. Why did you do that?
Mr. Becerra. Senator, again I respect the way you framed
it. I would say to you that it is clear that we look at it
differently. California has privacy laws. We enforce privacy
laws. When we take action based on a violation of privacy laws,
it is because we have evidence that the rights of Californians
to their privacy have been violated.
You have described it differently, but what I will say to
you is, my job is to follow the law and make sure others do as
well.
Senator Sasse. I think what you are saying is, the baby
body parts were not interesting, but the filming of it was? But
in 2014 and 2015, at a California----
The Chairman. The Senator from Nebraska is over his time,
and his colleague, Senator Barrasso, is next, and two other----
Senator Sasse. Can I ask my colleague if he minds if I go
for 45 seconds?
The Chairman. Sure. Forty-five seconds, and that is it.
Senator Sasse. Thank you, Mr. Chairman. In 2014 and 2015,
California poultry farms were recorded secretly showing
inhumane treatment of animals in California. Did you
investigate the film makers of the poultry farm filmings?
Mr. Becerra. In what years?
Senator Sasse. 2014 and 2015.
Mr. Becerra. Senator, I was not the Attorney General at
that time.
The Chairman. The time of the gentleman has expired.
The Senator from Wyoming.
Senator Barrasso. Thank you, Mr. Chairman. Thank you for
taking time to visit by phone, and we all value your
willingness to serve our country.
You started the testimony referring to the painful impact
of coronavirus on all of us. Rural communities, as we talked
about, are facing significant challenges, especially as a
result of the pandemic. We talked about rural health needs and
getting physicians in training into rural communities. As a
doctor who practiced in Wyoming for over 2 decades, I am very
interested and focused on protecting and improving health care
in rural America.
The one aspect of health care that is often overlooked is
the many factors outside of direct patient care that impact the
health of individuals. According to the Centers for Disease
Control and Prevention, social determinants of health have a
major impact on people's health, well-being, and quality of
life. And when you were in the House of Representatives, you
actually helped draft legislation requiring the Secretary of
Health and Human Services, which you are now nominated to
serve, to conduct research on social determinants of health in
Medicare's value-based programs.
So then you agree that social determinants of health such
as employment, educational opportunity, all strongly impact the
health of individuals, that chronic unemployment is harmful at
a high rate. And that is why I am so bothered that one of the
first actions taken by the Biden administration was a ban on
oil and gas leasing. And the impact of that on jobs in my State
is just devastating.
It is killing jobs. It is killing hope in communities.
People are worried about rising unemployment rates and all of
the issues that come along with that. These industries create
thousands of jobs and contribute hundreds of millions of
dollars to States. And in the States, the money is used for
education, for schools, for students, and to help hospitals
stay open and stay viable in these communities.
The Biden administration's decisions are clearly going to
have a terrible impact, I believe, on the health and well-being
of communities in Wyoming and across rural America. And it is a
decision made by executive order, Day One.
Do you agree that cutting hundreds of millions of dollars
from hospitals and schools is going to have an impact on health
in rural communities?
Mr. Becerra. Well, Senator, first, thank you for the
question, and thank you for the chance to chat by phone. Any
time a community is impacted where it loses jobs, it loses
access to care and good schools, you are going to see impacts.
And so I think we all want to make sure that we are doing
everything possible to make sure that every family, wherever
they locate, has the opportunities that we expect in America.
Senator Barrasso. I want to talk about what is happening
also with the pandemic, especially how it has impacted seniors
and other vulnerable people living in nursing facilities. In
terms of my home State of Wyoming, a large proportion of people
who have lost their lives to coronavirus have been patients in
nursing homes. That is where it struck first within the State,
and continues.
From a public health perspective, I think it is important
for States and local governments to accurately report
information regarding the impact of coronavirus. And you know,
unfortunately it is clear now that the State of New York not
only failed to report accurate data regarding nursing home
deaths, but likely deliberately misled the public.
According to the Attorney General of New York--and I do not
know if that is someone you have worked with, because you are
still Attorney General of California--the Attorney General of
New York says the State under-counted deaths from coronavirus
in nursing homes by up to 50 percent.
Do you believe it is important for States to accurately
report public health data--especially deaths--from coronavirus?
Mr. Becerra. Senator, I think it is important that all of
us do the work to make sure that our data reflects the facts,
and that the data is used in appropriate ways so we can make
decisions on how to move forward.
Senator Barrasso. So, given this glaring evidence that is
presented by the New York Attorney General, as Secretary will
you advocate that the Biden administration fully investigate
what occurred in this situation?
Mr. Becerra. Senator, I know the Attorney General of New
York very, very well. AG James is a tremendous advocate for her
State. But I do not know the facts in that particular case, and
it would be difficult for me to comment.
Senator Barrasso. The other issue that you and I talked
about is graduate medical education, and you and I have similar
situations. You in California know that the majority of the
money goes to the big cities. Doctors train there. And we
talked about your wife, who is a physician. Most people
practice medicine within 50 miles of where they do their
training.
And so little of the money goes to the 26 States that have
the greatest needs in terms of under-served communities. I do
not know if you have had a chance to give additional thought to
that, but it is critical that we get a redistribution of the
money, if we are going to get a redistribution of where
physicians practice in America, because they tend to stay
pretty close to the area where they train.
Mr. Becerra. Senator, you brought up a very good point,
because I think the data will bear out what you said that
oftentimes, once you find yourself in a residency program, you
end up sticking around pretty close. You start to meet people.
Sometimes you meet your spouse and establish a family.
And so I think it is important that we make sure that no
community in the country is not considered when it comes to the
opportunity to have these tremendously important professionals
like you, like my wife, provide care to our families.
And so I am more than willing to work closely with you on
that, because I think it would be a mistake if we allow the
real professionals who have been champions in this COVID
pandemic to not be spread throughout the country.
Senator Barrasso. Thank you, Mr. Chairman.
The Chairman. I thank my colleague.
Senator Toomey is on the web. And then we will have Senator
Hassan and Portman, and that will be it. It has been a long
afternoon.
Senator Toomey. Thank you, Mr. Chairman. Can you hear me
okay?
The Chairman. Yes.
Senator Toomey. Thank you, Mr. Chairman.
Attorney General Becerra, welcome and thanks for your
willingness to serve.
I wanted to zero in on one particular health-care policy
that you have advocated for, and which I find very, very
disturbing. Specifically, I am referring to the use of the so-
called march-in rights by the Federal Government, to basically
confiscate the intellectual property of a private company. You
sent a letter to Dr. Francis Collins, the Director of the NIH,
and former Commissioner of the FDA Stephen Hahn, demanding that
the government use these so-called march-in rights to steal the
legal right to Gilead's product, in this case it was
remdesivir, and give it to a third party to manufacture.
The letter was sent just last August 4, 2020, so just a few
months ago. We are in the midst of a global pandemic, and just
a few months after this perhaps life-saving treatment was
approved by the FDA for emergency use in hospitalized patients
with COVID-19. And it was almost an entire month before the FDA
expanded the authorized use, no longer limiting it to nations
with severe disease. And the reason that you cited in the
letter was you did not think that the product was being
manufactured fast enough, and you did not like the price.
Well, I am not convinced that that comports with reality
here. Consumers were not being charged the full cost of the
drug, and separate co-pays are not paid on inpatient drugs.
Congress had already acted to protect uninsured patients from
any cost related to COVID-19 treatments. In fact, Congress went
a step further, increasing payments to hospitals that cared for
COVID-19 patients.
But this policy that you are recommending also seems to me
to betray a lack of understanding of the basic incentives, and
the science, and how drugs are made. Gilead was in the process
of finding other manufacturers at the time who could help them
expand the production, had there been a significant increase in
demand.
Also, you disregarded the opinions of legal and scientific
experts about this. Dr. Collins himself previously testified
that NIH legal experts do not believe that the law allows the
agency to intervene based on a drug's price, which was one of
the reasons you cited.
Here is what Dr. Collins said, and I quote: ``If you look
at the language of the bill, it really intends to cover a
circumstance where a drug is simply not available to the public
under any circumstances, and then NIH is entitled to step in.
This is a little different when it is available, but at a high
cost. Our legal experts do not feel that the law actually puts
us in a position to step in,'' end quote.
So, Mr. Becerra, I am not convinced that you fully
appreciate the downstream effects of socialist-type policies
such as those that you have advocated. So let me just ask this:
do you acknowledge that the administration does not actually
have the legal authority to use march-in rights as a mechanism
to try to lower drug prices?
Mr. Becerra. Senator, first, thank you for the question. It
is great to have an opportunity to have a dialogue with you
again after years of serving together, including on the Super
Committee.
What I will tell you is this: you have already raised the
subject of march-in rights. The letter that I was a part of was
a bipartisan letter. Attorney General Jeffrey Landry from
Louisiana and I put together that letter. And we had many, many
Attorneys General from both sides of the aisle who were part of
that. And if you remember, the date that you mentioned the
letter was issued, that was at the time, if you recall, when we
started to see the rapid increase in cases of COVID.
And what we know now is far more than what we knew then.
What we knew then was that many Americans were dying. And what
we knew then was that remdesivir was a drug that was keeping
people alive. And what we also knew then--and this was
bipartisan--at least back at the State level, maybe folks here
at the Federal level had more information, but at the State
level we were seeing our folks die. And we knew that there was
a drug that----
Senator Toomey. I am about to run out of time, and I just
have to say, we have very different understandings of this
history. There was not a shortage of remdesivir. There was not
a problem with people who could not afford it, because of other
steps that Congress had taken. But there is a big problem when
the government comes in and confiscates the intellectual
property that has led to a successful product. It creates a
chilling effect and seriously discourages future investment.
So I would--I am running out of time here--but I would
appreciate it and suggest you might want to reconsider whether
the Bayh Dole Act ever intended to act as a mechanism that
would undermine the incentive for the private sector to deliver
needed products.
The Chairman. I thank my colleagues. We have two Senators
who may join us momentarily, Mr. Attorney General, and what we
are going to do is just go through a couple of the formalities
and see if they are going to arrive, and we should be able to
wrap up.
First with respect to members, I would like to thank all
members for their participation. I would like to thank Attorney
General Becerra for a very long afternoon.
Regarding questions for the record, the deadline for
members to submit questions will be Friday, February 26th, at 5
p.m. That 5 p.m. deadline is firm. We want to thank everyone
for their cooperation.
I have a couple of other matters. Senator Crapo, is there
anything that you need to ask? Okay, then moving very quickly,
Mr. Attorney General, we wrote a law, a bipartisan law in this
committee--I think I mentioned this to you briefly in our
conversation--and it went into effect in 2018 to reflect the
transformation in the Medicare program. The Medicare program,
when I began the Gray Panthers in Oregon, we acknowledged that
it was an acute care program. Part A, Part B--if you broke your
ankle, you went to the hospital; if you had a bad case of the
flu, you went to the doctor. But it was acute care. That is not
Medicare today. Today Medicare is mostly chronic care--cancer
and diabetes and heart disease and strokes and the like.
This committee wrote a bipartisan law. I consider it one of
the most transformative health initiatives in many years, and
the Trump people basically said it was a wonderful idea and
never did anything about it in terms of moving it forward.
My question to you is, when you are confirmed--and I will
use that, ``when'' you are confirmed--will you assign several
people of your staff to work with the bipartisan leadership on
this committee? Senator Crapo and I have talked about these
issues before with Senator Hatch and others, and we would like
to have a chance to work with you after the Senate votes on
your confirmation.
Mr. Becerra. Senator, I look forward to that, and I can
certainly confirm that.
The Chairman. Very good. One last point. And that is, at
today's hearing it was clear there were stark differences of
opinion when it comes to women's health care. And, Mr. Attorney
General, you have made it clear that you respect those
differences.
And I want to emphasize this point now. If confirmed, you
will follow the law on women's health and all other issues that
you will be responsible for as Health and Human Services
Secretary.
So, given those commitments that you have made, Mr.
Attorney General, today, in my view the differences of opinion
should not be used as a rationale to prevent confirmation of a
person like yourself who is qualified. And I just wanted to set
that out for the record.
I want to make sure that Senator Hassan and Senator Portman
are not waiting. I see no evidence that they are.
And with that, the Finance Committee is adjourned.
[Whereupon, at 5:14 p.m., the hearing was concluded.]
A P P E N D I X
Additional Material Submitted for the Record
----------
Prepared Statement of Hon. Xavier Becerra, Nominated to be
Secretary, Department of Health and Human Services
Thank you, Mr. Chairman, Ranking Member Crapo, members of the
committee. I'm grateful for the opportunity to speak with you. And a
sincere ``thank you'' to Senators Feinstein and Padilla for their kind
introduction.
I also want to thank my family: my wife, Dr. Carolina Reyes, who is
here with me, and my daughters Clarisa--along with her husband Ivan--
Olivia, and Natalia, for their constant love and support.
I am here because my parents Manuel and Maria Teresa--who had only
their health and hope when they settled in Sacramento--were tireless
believers in earning the American Dream. A construction worker with a
sixth-grade education and a clerical worker who arrived in her teens
from Guadalajara, Jalisco, Mexico, they never saw the inside of a
college classroom, but they sent all their kids to one, or to the
military.
We lost my dad last year on New Year's Day. When the end came, my
dad knew we were there with him--at his side, in our home. Sadly,
hundreds of thousands of Americans haven't had that closure this past
year. That, Senators, is why I'm here today.
The COVID pandemic has killed 500,000 Americans, many of them alone
without their families. Millions more have lost their jobs and health
care. That is not the America my parents would believe possible.
To meet this moment, we need strong Federal leadership. That's what
President Biden is demonstrating. If I'm fortunate to be confirmed, I
look forward to joining the President in this critical mission.
I understand the enormous challenges before us and our solemn
responsibility to be faithful stewards of an agency that touches almost
every aspect of our lives. I'm humbled by the task. And I'm ready for
it.
The mission of HHS--to enhance the health and well-being of all
Americans--is core to who I am. When I was a child, my mom had a health
scare: she was rushed to the hospital after hemorrhaging at home. The
image is seared in my memory.
We were lucky. My mom is now 87 years old. Better put, we were
blessed: my dad had insurance--through his union, Laborers' Local 185.
We didn't have much, but we didn't have to face the threat of unpaid
medical bills or even bankruptcy.
Over 2 decades in Congress, I worked to ensure every family had the
assurance of care that mine had. I helped expand the Children's Health
Insurance Program. I helped write the Affordable Care Act. From the
Ways and Means Committee, I fought to strengthen and modernize Medicare
and how we finance it.
As California's Attorney General, I created a health-care rights
and access unit and cracked down on Medicare and Medicaid fraud. I
worked to protect people's health--holding opioid manufacturers
accountable for the addiction crisis and successfully taking on
hospitals and drugmakers who unfairly jacked up prices on patients. I
protected patients' privacy. If confirmed, I'll work with you to
continue this type of work, and to address HHS's biggest challenges.
First, COVID. The President has ambitious goals: 100 million
vaccine shots in arms in his first 100 days, increasing access to
testing, sequencing the virus so we're prepared for the variants, and
reopening schools and businesses. HHS has a central role in meeting
these goals--safely and equitably.
As Attorney General, I saw the importance of this on the front
lines. I worked with colleagues in other States--both Republicans and
Democrats--to make COVID treatments more readily available. I am ready
to work with you, our State and local partners, and across government,
to get this right.
Second, we must ensure people have access to quality, affordable
health care. If confirmed, I will work with you to strengthen our
Medicare and Medicaid lifelines; reduce the cost of health care and
prescription drugs; and ensure we are accountable, spending resources
wisely and effectively.
I won't forget the other ``H'' in HHS: human services. I want to
work with you supporting our vulnerable kids, those in foster care,
strengthening Head Start, and expanding access to child care.
Third, we must restore faith in our public health institutions.
That starts with putting science and facts first and showing respect
for our career workforce.
No one understands your States and communities better than you. We
may not always agree, but if I'm fortunate enough to be confirmed, I
will always listen to you and keep an open mind, find common cause, and
work with you to improve the health and dignity of the American people.
Thank you for the opportunity to share my vision.
______
SENATE FINANCE COMMITTEE
STATEMENT OF INFORMATION REQUESTED
OF NOMINEE
A. BIOGRAPHICAL INFORMATION
1. Name (include any former names used): Xavier Becerra.
2. Position to which nominated: Secretary of Health and Human
Services.
3. Date of nomination: The President-elect announced his intent to
nominate me on December 7, 2020.
4. Address (list current residence, office, and mailing addresses):
5. Date and place of birth: January 26, 1958; Sacramento, CA.
6. Marital status (include maiden name of wife or husband's name):
7. Names and ages of children:
8. Education (list all secondary and higher education institutions,
dates attended, degree received, and date degree granted):
Stanford Law School.
Dates attended: September, 1981-June, 1984.
Degree received: JD.
Degree granted: June, 1984.
Stanford University.
Dates attended: September, 1976-June, 1980.
Degree received: Bachelor's Degree.
Degree granted: June, 1980.
C.K. McClatchy High School.
Dates attended: September, 1973-June 1976.
Degree received: High School Diploma.
Degree granted: June, 1976.
9. Employment record (list all jobs held since college, including the
title or description of job, name of employer, location of work, and
dates of employment for each job):
Attorney General (January 2017 to present).
State of California.
Sacramento, CA.
Member of Congress (January 1993-January 2017).
U.S. House of Representatives.
Washington, DC.
Assemblymember (December 1990-November 1992).
Assembly, State of California.
Sacramento, CA.
Deputy Attorney General (January 1987-November 1990).
State of California.
Los Angeles, CA.
Acting District Director (January 1986-December 1986).
State Senator Art Torres, Senate, State of California.
Los Angeles, CA.
Reginald Heber Smith Community Lawyer Fellowship/``Reggie
Fellow'': (September 1984-September 1985).
Legal Services Corporation of Central Massachusetts.
Worchester, MA.
Summer Law Clerk (June 1983-August 1983).
Mexican American Legal Defense and Education Fund (MALDEF).
San Francisco, CA.
Summer Law Clerk (June 1982-September 1982).
Legal Aid Foundation of Los Angeles.
Los Angeles, CA.
California State Legislature Fellow (September 1980-September
1981).
State Senate and Assemblymember Art Torres, State of
California.
Sacramento, CA.
10. Government experience (list any current and former advisory,
consultative, honorary, or other part-time service or position with
Federal, State, or local governments held since college, including
dates, other than those listed above):
Hispanic Employee Advisory Committee to the State Attorney
General, Chair, 1989.
National Commission on Fiscal Responsibility and Reform
(Simpson-Bowles), Commission Member, 2010.
11. Business relationships (list all current and former positions held
as an officer, director, trustee, partner (e.g., limited partner, non-
voting, etc.), proprietor, agent, representative, or consultant of any
corporation, company, firm, partnership, other business enterprise, or
educational or other institution):
The following are all former positions: Smithsonian
Institution, Board of Regents; National Museum of African
American History and Culture, Council; Smithsonian National
Latino Board; Pitzer College, Board of Trustees; Congressional
Hispanic Caucus Institute, Board (and Advisory Council); Center
for the Advancement of Hispanics in Science and Engineering
Education, Board; Close up Foundation--Board of Advisors;
National Association of Latino Elected and Appointed Officials,
Board; and the Los Angeles Annenberg Metropolitical Project
(LAAMP)/Families in Schools, Board.
12. Memberships (list all current and former memberships, as well as
any current and former offices held in professional, fraternal,
scholarly, civic, business, charitable, and other organizations dating
back to college, including dates for these memberships and offices):
To the best of my knowledge, I've included a list of my current
and former memberships.
Memberships and Boards
Courts and Legal Organizations
------------------------------------------------------------------------
Year Organization Role
------------------------------------------------------------------------
2020-Present U.S. Supreme Court Bar Member
------------------------------------------------------------------------
2017-Present Ninth Circuit Court of Appeals Bar Member
------------------------------------------------------------------------
2017-Present U.S. District Court, Eastern Member
District of California Bar
------------------------------------------------------------------------
2017-Present U.S. District Court, Northern Member
District of California Bar
------------------------------------------------------------------------
2017-Present U.S. District Court, Southern Member
District of California Bar
------------------------------------------------------------------------
1987-Present U.S. District Court, Central Member
District of California Bar
------------------------------------------------------------------------
1987-1990 Mexican American Bar Association of Member
(Estimate) Los Angeles County
------------------------------------------------------------------------
1985-present State Bar of California Member
------------------------------------------------------------------------
Attorney General Memberships
------------------------------------------------------------------------
Year Organization Role
------------------------------------------------------------------------
2017-Present National Association of Attorneys Member
General
------------------------------------------------------------------------
2017-Present Democratic Attorneys General Member
Association
------------------------------------------------------------------------
2017-Present Conference of Western Attorneys Member
General
------------------------------------------------------------------------
Congressional Memberships
------------------------------------------------------------------------
Year Organization Role
------------------------------------------------------------------------
1993-2016 United States-Korea Inter- Vice Chair
(Estimate) Parliamentary Exchange
------------------------------------------------------------------------
1993-2016 Congressional Progressive Caucus Member
------------------------------------------------------------------------
2013-2016 Democratic Caucus Chair
------------------------------------------------------------------------
2011-2012 Joint Select Committee on Deficit Member
Reduction
------------------------------------------------------------------------
2009-2010 National Commission on Fiscal Member
Responsibility and Reform
------------------------------------------------------------------------
2009-2013 Democratic Caucus Vice Chair
------------------------------------------------------------------------
2008 (Estimate) Congressional Friends of Spain Co-Chair
------------------------------------------------------------------------
1994-2016 Congressional Asian Pacific Executive
American Caucus (CAPAC) Committee
Member, Member
------------------------------------------------------------------------
1993-2016 Congressional Hispanic Caucus Board Member,
Advisory Council
Member,
Chair 1997-1998
------------------------------------------------------------------------
Organizations
------------------------------------------------------------------------
Year Organization Role
------------------------------------------------------------------------
1993-2016 ** Inter-American Dialogue Member
------------------------------------------------------------------------
2011-2016 National Museum of African American Museum Council
History Member
------------------------------------------------------------------------
1994-2015 Close up Foundation Board of
(Estimate) Advisors
------------------------------------------------------------------------
2008-2016 Smithsonian Institution Regent
------------------------------------------------------------------------
2008-2016 Smithsonian Institution National Board Member
Latino Board
------------------------------------------------------------------------
2008-2015 Center for the Advancement of Board Member
(Estimate) Hispanics in Science and
Engineering Education
------------------------------------------------------------------------
1993-1996 National Student Leadership Honorary Board
(Estimate) Conference of Advisors
------------------------------------------------------------------------
1993-1996 Hispanic Outreach Advisory Board, Member
(Estimate) National Parent Teacher
Association
------------------------------------------------------------------------
2001-2016 BOLD PAC Member, Chair
2007-2008
------------------------------------------------------------------------
2001-2007 Families in Schools Founding Board
Member
------------------------------------------------------------------------
1995-2003 Pitzer College Board of
Trustees Member
------------------------------------------------------------------------
1995-2001 Los Angeles Annenberg Metropolitan
Project (LAMP)
Board Member
------------------------------------------------------------------------
**** Mexican American State Legislators Member
Policy Institute
------------------------------------------------------------------------
**** Greater Eastside Voter Registration Member
Project
------------------------------------------------------------------------
1993-2016 Congressional Hispanic Caucus Chair 1997-1998,
Institute Board of
Directors,
Advisory Council
Member, Member
------------------------------------------------------------------------
1991-2005 National Association of Latino Board Member
(Estimate) Elected and Appointed Officials
(NALEO)
------------------------------------------------------------------------
1987-1990 Association of California State Member
Attorneys and Administrative Law
Judges
------------------------------------------------------------------------
1977-1978 Northern CA District Council of Member
Laborers, Laborers' Local 185
------------------------------------------------------------------------
1976-1980 MEChA (Stanford University) Member
------------------------------------------------------------------------
** When I became Attorney General, my office requested that all outside
organizations in which I had an affiliation end any role I might have
and remove my name from their materials. However, during this process,
it came to our attention that I was still listed on this
organization's website as a member. We have asked that my name be
removed.
**** This organization was listed in a previous biography. However, we
have not been able to determine the dates of participation.
13. Political affiliations and activities:
a. List all public offices for which you have been a candidate
dating back to the age of 18.
California State Assembly: 1990.
U.S. House of Representatives: 1992-2016 elections.
Los Angeles Mayor: 2001.
Attorney General of California: 2018 (appointed first in 2017)
b. List all memberships and offices held in and services
rendered to all political parties or election committees,
currently and during the last 10 years prior to the date of
your nomination.
During the last 10 years, I've had the following campaign
committees: Becerra for Congress and Becerra for Attorney General. I
also had a Leadership PAC, Leadership for Today and Tomorrow, which has
been terminated.
c. Itemize all political contributions to any individual,
campaign organization, political party, political action
committee, or similar entity of $50 or more for the past 10
years prior to the date of your nomination.
To the best of my knowledge, I have not made any personal
contributions of more than $50 during the past 10 years, other than a
$60 contribution to ActBlue in 2015. However, as with many members of
Congress, my Leadership PAC and campaign committees did make political
donations.
14. Honors and awards (list all scholarships, fellowships, honorary
degrees, honorary society memberships, military medals, and any other
special recognitions for outstanding service or achievement received
since the age of 18):
California Legislature Fellowship: 1980-1981.
Reginald Heber Smith Community Lawyer Fellowship (``Reggie
Fellow''): 1984-1985.
During my 30 years in public service, I have received numerous
awards and other special recognitions--and those that I could
locate, I have listed below by year.
Awards Received by the Attorney General
------------------------------------------------------------------------
Year Organization Award
------------------------------------------------------------------------
2020 National Health Law Program Henry Waxman Award for
Health Care Advocacy
------------------------------------------------------------------------
2020 Lawyers' Committee for LCCR's Living the Dream
Civil Rights of the San Award
Francisco Bay Area
------------------------------------------------------------------------
2020 UnidosUS Public Service Award
------------------------------------------------------------------------
2020 Consumer Federation of Lifetime Achievement Award
America
------------------------------------------------------------------------
2020 Friends of the River Mark Dubois Award
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2019 Mexican American Bar Precursor de Justicia/
Foundation Pioneer of Justice Award
------------------------------------------------------------------------
2019 California Rural Legal Cruz Reynoso-Ralph Abascal
Assistance, Inc. Don Quixote Award
------------------------------------------------------------------------
2019 California ChangeLawyers ChangeLawyer Leadership
Award
------------------------------------------------------------------------
2019 Coalition for Clean Air Air Quality Award for
Leadership in Government
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2018 United Nations Association Eleanor Roosevelt Human
of San Diego Rights Award
------------------------------------------------------------------------
2018 California Reinvestment Community Hero Award
Coalition
------------------------------------------------------------------------
2018 Adventist Health--White Man of the Year Award
Memorial Charitable
Foundation
------------------------------------------------------------------------
2018 American Public Health Paul Wellstone Award
Association
------------------------------------------------------------------------
2018 Equality California Nancy McFadden Ally
Leadership Award
------------------------------------------------------------------------
2018 Mexican Bar Association of Benito Juarez Attorney of
Los Angeles County the Year Award
------------------------------------------------------------------------
2018 Instituto Laboral de La California Visionary Award
Raza
------------------------------------------------------------------------
2018 Breathe California of Los Civic Leader Award
Angeles County
------------------------------------------------------------------------
2018 TELACU Creo Award
------------------------------------------------------------------------
2018 Metro Los Angeles--Metro Visionary Award
Latino Association
------------------------------------------------------------------------
2018 NAACP--San Diego Chapter Honoree for Community
Service
------------------------------------------------------------------------
2018 Essential Access Health Family Planning Champion
Award
------------------------------------------------------------------------
2018 The Campaign for College Change Maker Award
Opportunity
------------------------------------------------------------------------
2018 Coalition for Humane Honored for Leadership of
Immigrant Rights of Los the Immigrant Rights
Angeles Movement
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2017 Cesar Chavez Foundation Cesar Chavez Legacy Award
------------------------------------------------------------------------
2017 The Women's Foundation of Visionary Award
California--Women's Policy
Institute
------------------------------------------------------------------------
2017 Black Prosecutors Black Prosecutors
Association of Los Angeles Association of Los
Angeles Champion of
Justice Award
------------------------------------------------------------------------
2017 Conference of California John Van de Kamp Justice
Bar Association Through Laws Award
------------------------------------------------------------------------
2017 Cruz Reynoso Bar Community Service Award
Association
------------------------------------------------------------------------
2017 California Hispanic Hispanic Appointee of the
Chambers of Commerce Year
------------------------------------------------------------------------
2017 Equality California Vanguard Leadership Award
------------------------------------------------------------------------
Congressional Awards
------------------------------------------------------------------------
Year Organization Award
------------------------------------------------------------------------
2016 League of United Latin Recognition
American Citizens (LULAC)
------------------------------------------------------------------------
2016 Asian Pacific American Lifetime Achievement Award
Institute for
Congressional Studies
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2015 Health Access Health Care Champion Award
------------------------------------------------------------------------
2015 California Retired Teachers Friend of CalRTA Award
Association
------------------------------------------------------------------------
2015 The National Association of Edward R. Roybal Award for
Latino Elected and Public Service
Appointed Officials
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2014 National Association of Leadership Award
Community Health Centers
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2013 National Association of Founders Award
Hispanic Real Estate
Professionals
------------------------------------------------------------------------
2013 Clinica Romero Spirit Award
------------------------------------------------------------------------
2013 Los Angeles United Outstanding Achievement
Methodist Museum of Social
Justice
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2012 California Alliance of Retiree Hero Award
Retired Americans
------------------------------------------------------------------------
2012 A Community of Friends Leadership Award
------------------------------------------------------------------------
2012 Alta Med Thank You For Outstanding
Support
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2011 Enterprise Foundation Visionary of the Year
------------------------------------------------------------------------
2011 California Council for Appreciation Certificate
Adult Education
------------------------------------------------------------------------
2011 Arroyo Vista Family Health Recognition
Center
------------------------------------------------------------------------
2011 Hollywood Freeway Central A Real Star of Hollywood
Park
------------------------------------------------------------------------
2011 South Central Family Health Appreciation of Public
Center Service
------------------------------------------------------------------------
2011 CARA Award
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2010 The Muniz Family Foundation Distinguished Community
Leadership Award
------------------------------------------------------------------------
2010 Los Angeles Community Visionary Leadership Award
College Foundation
------------------------------------------------------------------------
2010 The American Physical Public Service Award
Therapy Association
------------------------------------------------------------------------
2010 California Hospital Health Care Champion Award
Association
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2009 American Society of Legislative Advocacy Award
Radiologic Technologists
------------------------------------------------------------------------
2009 City of El Paso Key to the City
------------------------------------------------------------------------
2009 FASGI Leader of the Year Award
------------------------------------------------------------------------
2009 Esperanza Community Housing 20th Anniversary Builder
Corporation of Hope Award
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2008 AARP Legislative Achievement
Award
------------------------------------------------------------------------
2008 ACLU Legislator of the Year
Award
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2007 Armenian Assembly 2007 Honor
------------------------------------------------------------------------
2007 Hispanic Heritage Education Award
Foundation
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2006 Congressional Management Gold Mouse Award
Foundation
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2005 The Word--Pastor Castro Recognition
------------------------------------------------------------------------
2005 Normandie Residents Recognition
------------------------------------------------------------------------
2005 Career Opportunities for Recognition
Youth
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2004 Mobility 21--Los Angeles Julian Dixon Award
County Moving Together
------------------------------------------------------------------------
2004 Los Angeles City College Outstanding Support
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2003 Eastside Democratic Club Legislator of the Year
------------------------------------------------------------------------
2003 Santa Monica College Appreciation Award
------------------------------------------------------------------------
2003 Baptist Church Partners in Progress Award
------------------------------------------------------------------------
2003 Arroyo Vista Family Health Recognition
Center
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2002 National Hispanic Medical Recognition
Association
------------------------------------------------------------------------
2002 San Francisco Board of Recognition
Supervisors
------------------------------------------------------------------------
2002 Indo American Award Recognition
------------------------------------------------------------------------
2002 Urban Issues Breakfast Recognition
Forum
------------------------------------------------------------------------
2002 UPS Plaque for Years of
Service
------------------------------------------------------------------------
2002 Barrio Planners Appreciation Award
------------------------------------------------------------------------
2002 Farmers Insurance Star Award--Support of
Bronze Screen
------------------------------------------------------------------------
2002 City of Pontiac, Michigan Key to the City
------------------------------------------------------------------------
2002 Korean American Democratic Appreciation Award
Committee
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2001 LAUSD--District F Appreciation Award
------------------------------------------------------------------------
2001 HACU Appreciation Award
------------------------------------------------------------------------
2001 ICT College Appreciation Award
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
2000 NCLR Graciela Olivarez La Raza
Award
------------------------------------------------------------------------
2000 Filipino American Senior Appreciation Award
Citizens Association
------------------------------------------------------------------------
2000 The New Leaders Appreciation Award
------------------------------------------------------------------------
2000 Parents of BBAC Appreciation Award
------------------------------------------------------------------------
2000 Cal State La Raza Appreciation Award
Graduation
------------------------------------------------------------------------
2000 KAC Award of Appreciation
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
1999 Los Angeles Unified School Recognition
District
------------------------------------------------------------------------
1999 USC Cuahtemoc Award Recognition
------------------------------------------------------------------------
1999 Filipino American Service Recognition
Group, Inc. FASGI
------------------------------------------------------------------------
1999 Hollywood Chamber of Appreciation Award
Commerce
------------------------------------------------------------------------
1999 Korean American Coalition Appreciation Award
(KAC)
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
1997 NABE Recognition
------------------------------------------------------------------------
1997 Koreatown Youth and Recognition
Community Center
------------------------------------------------------------------------
1997 Northeast Trees Recognition
------------------------------------------------------------------------
1997 Pakistan Golden Jubilee Appreciation Award
Celebration
------------------------------------------------------------------------
1997 Asian Pacific American Appreciation Award
Legal Center
------------------------------------------------------------------------
1997 Franciscans of California Appreciation Award
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
1996 CA Hispanic American Recognition
Medical Association
------------------------------------------------------------------------
1996 Latino Coalition Healthy CA Appreciation Award
------------------------------------------------------------------------
1996 Alta Med Appreciation Award
------------------------------------------------------------------------
1996 Covenant House California Appreciation Award
------------------------------------------------------------------------
1996 AARP Recognition
------------------------------------------------------------------------
1996 St. John's Well Child & Advocate Award
Family Center
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
1995 Korean American Coalition Recognition
------------------------------------------------------------------------
1995 National Compadres Network Recognition
------------------------------------------------------------------------
1995 California Association of Appreciation Award
Bilingual Education
------------------------------------------------------------------------
1995 Society of Hispanic Appreciation Award
Professional Engineers
------------------------------------------------------------------------
1995 Bilingual Foundation of the El Angel Community Award
Arts
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
1994 Association of Community Recognition Award
Health Agencies
------------------------------------------------------------------------
1994 City Terrace Community Public Service Award
Council
------------------------------------------------------------------------
1994 State of California Migrant Appreciation
Education
------------------------------------------------------------------------
1994 Career Opportunities for Award of Appreciation
Youth, Inc.
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
1993 Gay and Lesbian Latinos Community Member Award
Unidos
------------------------------------------------------------------------
1993 DWP Latin American Appreciation Award
Employees Association
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
1992 Chicano/Latino Medical Leadership Award
Association
------------------------------------------------------------------------
15. Published writings (list the titles, publishers, dates, and
hyperlinks (as applicable) of all books, articles, reports, blog posts,
or other published materials you have written):
OP-EDS AND LETTERS TO THE EDITOR
September 19, 2018: USA Today: California Focuses on Taking
Guns From Criminals, https://www.usatoday.com/story/opinion/
2018/09/19/california-attorney-general-we-take-guns-criminals-
editorials-debates/1362407002/.
March 26, 2018: San Francisco Chronicle: Citizenship Question
on 2020 Census May Result in Undercount, https://
www.sfchronicle.com/opinion/openforum/article/Citizenship-
question-on-2020-census-may-result-in-12783055.php.
March 14, 2018: Washington Post: Message to Trump: California
Isn't in the Deportation Business, https://
www.washingtonpost.com/opinions/message-to-trump-california-
isnt-in-the-deportation-business/2018/03/14/0a48d250-2701-11e8-
bc72-077aa4dab9ef_story.html.
February 22, 2018: San Diego Union Tribune: Why Supreme Court
Case Critical to Future Health of California, https://
www.sandiegouniontribune.com/opinion/commentary/sd-oe-unions-
california-janus-workers-20180222-story.ht
ml.
February 18, 2018: San Jose Mercury News: Letter: State AG
Becerra Vows to Protect Patient Drug Data, https://
www.mercurynews.com/2018/02/18/letter-state-ag-becerra-vows-to-
protect-patient-drug-data/.
January 16, 2018: New York Times: Florida Isn't the Only State
That Will Be Hurt By Offshore Drilling, https://
www.nytimes.com/2018/01/16/opinion/florida-offshore-
drilling.html.
September 1, 2017: HuffPost: DACA Is Lawful and Making America
Stronger, https://www.huffpost.com/entry/daca-is-lawful-and-
making-america-stronger_b_59a9c6a4e4b0b5e530febdb9.
December 16, 2013: USA Today: Honor Our Heritage and Our
Values, https://www.usatoday.com/story/opinion/2013/12/15/
immigration-reform-citizenship-editorials-debates/4034153/.
February 25, 2012: Arizona Republic: Fixing Middle Class,
https://drive.
google.com/file/d/1Ssxb32rKyKFnwZCq8QXzVVjXvtMXDv3r/view.
September 7, 2010: Let's Make It in America Again, https://
www.politico.com/story/2010/09/lets-make-it-in-america-again-
041842.
June 1, 2010: Becerra Responds, https://www.politico.com/story/
2010/06/letter-to-the-editor-becerra-responds-037979.
November 3, 2008: Wall Street Journal: Real Charities Deserve
Deductions, https://www.wsj.com/articles/SB122568104723692401.
February 24, 2007: Myrtle Beach Sun: Amends Still Needed for
WWII Detentions, https://drive.google.com/file/d/
1UVvhnr4y1QW1p5y1b-T61xmSo9HXnC5
M/view.
August 9, 1998: New York Times: Letter to the Editor:
Prosecutor Is Qualified, https://www.nytimes.com/1998/08/09/
opinion/l-prosecutor-is-qualified-2697
51.html.
BLOG POSTS
October 15, 2019: Medium: Liberty and Justice Under Law--A Look
at Legislation Sponsored by the California Department of
Justice, https://medium.com/@AGBecerra/liberty-and-justice-
under-law-d85c3762d7c.
June 30, 2019: Medium: Reasons to Smile: Immigrant Heritage
Month, https://medium.com/@AGBecerra/reasons-to-smile-
immigrant-heritage-month-289f8928
f747.
June 20, 2019: Medium: Protecting California's Oceans During
World Oceans Month, https://medium.com/@AGBecerra/protecting-
californias-oceans-during-world-oceans-month-f345c4e46f2f.
October 26, 2018: Medium: Saving the Clean Car Standards and
the Clean Power Plan, https://medium.com/@AGBecerra/saving-the-
clean-car-standards-and-clean-power-plan-5fa4a1532aa8.
September 13, 2018: Medium: California's Roadmap to Building a
More Just World Through Climate Action, https://medium.com/
@AGBecerra/californias-roadmap-to-building-a-more-just-world-
through-climate-action-6e61ee867b4c.
January 16, 2018: HuffPost: DACA Is Lawful and Making America
Stronger, https://www.huffpost.com/entry/daca-is-lawful-and-
making-america-stronger_
b_59a9c6a4e4b0b5e530febdb9.
January 9, 2018: Medium: In His Own Words: Why EPA
Administrator Pruitt Should Have Nothing To Do With the Clean
Power Plan, https://medium.com/@AGBecerra/in-his-own-words-why-
epa-administrator-pruitt-should-have-nothing-to-do-with-the-
clean-power-plan-9f7be3fbb44d.
December 22, 2017: SCOTUS Blog: Symposium: Agency Fees Benefit
the Workplace--Just Ask the States, https://www.scotusblog.com/
2017/12/symposium-agency-fees-benefit-workplace-just-ask-
states/.
June 8, 2017: Medium: Trump Administration Threatens
Protections for California's Cherished National Monuments,
https://medium.com/@AGBecerra/trump-administration-threatens-
protections-for-californias-cherished-national-monuments-
22dcf519975e.
May 31, 2017: Medium: Clean Air Month: Breathing Easier in
California, https://medium.com/@AGBecerra/clean-air-month-
breathing-easier-in-califor
nia-490fcae03834.
March 26, 2016: HuffPost: 20 Pictures of Cuba Through My Lens,
https://www.huffpost.com/entry/20-pictures-of-cuba-
throu_b_9550660.
November 3, 2016: Daily Kos: GOP Incumbent in CO-06, Who Tries
to Run and Hide From Trump, Supports Deportation Force
Policies, https://www.
dailykos.com/stories/2016/11/3/1590541/-CO-06-Republican-
Incumbent-Who-Tries-to-Run-Hide-From-Trump-Supports-
Deportation-Force-Policies.
October 27, 2016: Daily Kos: Republicans Are Down on America as
Democrats Build It Up, https://www.dailykos.com/stories/2015/
10/27/1441533/-Republicans-Are-Down-On-America-As-Democrats-
Build-It-Up.
October 27, 2016: Daily Kos: Grassroots Momentum for Zephyr
Teachout's Congressional Bid Grows in NY-19, https://
www.dailykos.com/stories/2016/10/27/1587741/-Grassroots-
Momentum-for-Zephyr-Teachout-s-Campaign-for-Congress-Grows-in-
NY-10.
October 26, 2016: Only One Candidate Knows How to Protect
Social Security and Medicare in NJ-05, https://
www.dailykos.com/stories/2016/10/26/1461678/-Only-One-
Congressional-Candidate-Knows-How-to-Protect-Social-Security-
and-Medicare-in-NJ-05.
October 26, 2016: Why Many Texans Aren't Enamored By Trump's
Border Wall, https://www.dailykos.com/stories/2016/10/26/
1587021/-Why-Many-Texans-Aren-t-Enamored-By-Trump-s-Border-
Wall.
October 21 2016: In NV-4, House Race Polls, Premised on Likely
Voters, Fail to Account for Many Latinos Who Will Vote, https:/
/www.dailykos.com/stories/2016/10/21/1585068/-In-NV-4-House-
Race-Polls-Premised-on-Likely-Voters-Fail-to-Account-For-Many-
Latinos-Who-Will-Vote.
December 18, 2015: Daily Kos: Congress Is Broken and It's Not
Working for Working Families, https://www.dailykos.com/stories/
2015/12/18/1461680/-Congress-is-Broken-and-It-s-Not-Working-
for-Working-Families.
October 15, 2007: Daily Kos: Three Weeks of War or One Week of
Health Coverage for Kids?, https://www.dailykos.com/stories/
2007/10/15/398228/-Three-Weeks-of-War-or-One-Year-of-Health-
Coverage-for-Kids.
February 20, 2007: Daily Kos: The Forgotten Internees, https://
www.daily
kos.com/stories/2007/2/20/303962/-.
January 27, 2007: Daily Kos: Justice for Japan Latin American
Internees, https://www.dailykos.com/stories/2007/1/26/295189/-
Justice-for-Japanese-Latin-American-Internees.
September 21, 2006: Daily Kos: H.R. 4844: A 21st Century Poll
Tax, https://www.dailykos.com/stories/2006/9/21/248521/-H-R-
4844-A-21st-Century-Poll-Tax.
September 19, 2006: Daily Kos: Voters Need to Feel Confident,
https://www.dailykos.com/stories/2006/9/19/247832/-.
LAW REVIEWS
1994: ``Reinventing Asylum: A Challenge to America.'' American
University International Law Review 9, no. 4 (1994): 39-42,
https://digitalcommons.wcl.
american.edu/cgi/viewcontent.cgi?article=1482&context=auilr.
BOOK CHAPTERS
2004: ``Policymaking in a Diverse America'' (pages 29-39), as
part of the book: Strengthening Community: Social Insurance in
a Diverse America, by Kathleen Buto, https://www.jstor.org/
stable/10.7864/j.ctt1gpccpf.
1995: ``Beyond Ideology: Educating Language-Minority Children
Through the ESEA,'' as part of the book: National Issues in
Education: Elementary and Secondary Education Act, by John F.
Jennings, https://eric.ed.gov/?id=ED386803.
Supplemental information: As Attorney General, my name and/or
office also appear on a large number of reports.
16. Speeches (list all formal speeches and presentations (e.g.,
PowerPoint) you have delivered during the past 5 years which are on
topics relevant to the position for which you have been nominated,
including dates):
October 15, 2020--Remarks at Health Access California Forum:
``Still Fighting for Our Health!'', https://drive.google.com/
file/d/11xzQLtDejajiI5CKCGZWpeye
KvANlWAK/view.
August 17, 2020--Remarks at Protect Our Care's Town Hall During
Democratic National Convention Week, https://drive.google.com/
file/d/1MSnHDne_mlkt
GSVenYIJPSF2ld8Vq8Ij/view.
May 7, 2020--Remarks at Annual Consumer Federation of America
Conference: ``Stepping in and Protecting the Health, Safety and
Welfare of Consumers and the Environment When the Federal
Government Fails to,'' https://vimeo.com/417955875.
January 28, 2020--Remarks at the National Health Law Program's
50th Anniversary Celebration (remarks as prepared), https://
drive.google.com/file/d/15ffRTL44zBm5I2DVJyFuudpzOSAxijul/view.
March 5, 2020--Remarks on the 25-Year Anniversary of The
Children's Partnership: ``State of the Child 2020,'' https://
drive.google.com/file/d/1EzXCk
7chcLPc7hyfml39rr3rtg0Sgv8M/view.
January 21, 2020--Keynoting the Annual Families USA Conference:
``Health Action 2020,'' https://drive.google.com/file/d/
1oDDu2MWiuXkWVUSQuAbQM
MJzRvMBYz0n/view.
December 4, 2019--Remarks at Essential Access Health's Title X
Business Meeting and Awards Luncheon (remarks as prepared),
https://drive.
google.com/file/d/19g3nZ6AJRDGL6sz4LrgeXZ1-ktyleIz8/view.
September 26, 2019--Keynoting the USC Schaeffer Center ``Moving
Towards Universal Coverage'' Conference, https://
drive.google.com/file/d/1BGn5F
FrMI34X0--2ZfTnTfjAKyI6ySpob/view.
February 5, 2019--Remarks at the Annual Insure the Uninsured
Project Conference: ``Mapping the Future of Health Reform''
(remarks as prepared), https://drive.google.com/file/d/
1YKmJNB_4XxPdQIWgu2rG6ahvnNf335MZ/view.
November 11, 2018--Remarks at the American Public Health
Association's Annual Health Advocate Dinner (remarks as
prepared), https://drive.google.com/file/d/
1ZXBSM3HlC5kgfD6Jv7PBRd9Qi91wBFDZ/view.
September 27, 2018--Keynoting the Community Health
Association's Inland Southern Region Biennial Symposium
(remarks as prepared), https://drive.google.com/file/d/
1RgS5Uq_Q_NhOAMnyhLS41smwuvg6SSNI/view.
February 15, 2018--Remarks at Regional Planned Parenthood
Inaugural Leadership Council Symposium (remarks as prepared),
https://drive.google.com/file/d/15J9kI7S7A5_n6vRMX_SVFALRv-
s70k84/view.
January 12, 2018--Keynoting My Sister's House Conference: ``A
Trauma-
Informed Response to Human Trafficking Victims'' (remarks as
prepared), https://drive.google.com/file/d/
1_zC9sNuMyj0aAlkEh0I0CraWV6nz6TA2/view.
June 19, 2017--Remarks at the Public Law Center Volunteers for
Justice Dinner (remarks as prepared), https://drive.google.com/
file/d/17LFQ-5FWfBO--Vnx6BV3EdT33DbDUY4ZE/view.
March 23, 2016--Marking the Six-Year ACA Anniversary on Capitol
Hill, https://www.c-span.org/video/?c4938115/user-clip-xavier-
becerra-remarks-acas
-6th-year-anniversary.
17. Qualifications (state what, in your opinion, qualifies you to
serve in the position to which you have been nominated):
The mission of the Department of Health and Human Services--to
protect people's health and dignity--has been central to my
life's work. I worked early on as a legal aid lawyer helping
people struggling with mental health challenges. Since then,
during more than 30 years in public service, I have focused on
getting people the best health care at the best possible price,
from my decades on the House Ways and Means Committee to the
last 4 years serving as Attorney General of the largest State
Department of Justice in the country.
As a 12-term member of Congress, I fought to give people access
to quality, affordable health care. I served on the Ways and
Means Committee for 2 decades, where I focused on protecting
and strengthening Medicare, Medicaid, and health-care payments
and program financing, and where, in 2015, I led efforts to
successfully stave off roughly 20-percent cuts in Social
Security Disability Insurance.
I helped write and pass the Affordable Care Act, including the
provision addressing Medicare benefits and reimbursements. I
helped expand the Children's Health Insurance Program and
introduced legislation--the Medicare Savings Programs
Improvement Act of 2007--that passed to expand cost-sharing
subsidies for low-income seniors who receive both Medicare and
Medicaid benefits by increasing the amount of resources they
could receive. Several of these provisions were included in the
Medicare Improvements for Patients and Providers Act of 2008
and the Medicare Access and CHIP Reauthorization Act of 2015.
I also championed provisions of the Medicare Improvements for
Patients and Providers Act of 2008 that required physicians who
perform imaging to be accredited and trained to ensure patient
safety. I introduced legislation in 2007 to raise the cap on
the benefits of patients receiving Medicare physical therapy,
as well as the E-Centives Act of 2009, which provided
incentives for Medicaid providers to implement electronic
health records. A version of this legislation was included in
the American Recovery and Reinvestment Act of 2009. I
introduced the Medical Anesthesiology Teaching Funding
Restoration Act of 2007 to improve anesthesiologists' teaching
payments, and it passed in 2008.
I helped draft the Improving Medicare Post-Acute Care
Transformation (IMPACT) Act of 2014, requiring the HHS
Secretary to conduct research on the social determinants of
health in Medicare's value-based programs, so we could use good
data to improve outcomes and save costs. In 2016, I helped
launch a House Affordable Drug Pricing Task Force to tackle
rising prescription drug costs.
As Attorney General, I have taken on powerful interests to make
sure Americans have the best and most affordable health care,
managing a large, complex agency to get results for
Californians. I created a special Health Care Rights and Access
Unit, with 55 attorneys uniquely focused on health-care
antitrust and consumer protection. Our team has cracked down on
Medicare and Medicaid fraud to protect these lifelines,
recovering almost $1 billion in just the last 3 years from
defendants that defrauded California's State Medicaid program
with false claims for payment. I also launched a Disability
Rights Unit to investigate discrimination against people with
disabilities. This unit has successfully investigated and
negotiated agreements with several school districts to ensure
that students with disabilities have received their legally
entitled quality education.
I have overseen the maintenance and regulation of our State
prescription drug monitoring program called the Controlled
Substance Utilization Review and Evaluation System (CURES)--a
required database for prescribers, devised to stop people from
``doctor shopping'' and receiving multiple opioids
prescriptions. I have worked with a bipartisan group of
Attorneys General to prevent youth and children from using
tobacco products and taken on the opioid epidemic, working to
hold drug makers and distributors, including Purdue Pharma,
responsible for the addiction crisis. I have used my authority
as Attorney General to tackle skyrocketing prescription drug
prices by helping pass State laws to deter ``pay for delay''
deals and ensure transparency in prescription drug pricing.
Moreover, my office settled a $69-million lawsuit against Teva
Pharmaceutical Industries for its illegal pay for delay
activities.
We have prioritized protecting patients' privacy--securing
settlements against Cottage Health System for failing to
protect patient medical records, Aetna over exposing HIV
patient statuses in mailers, Anthem for its violation of
privacy laws resulting from a 2014 data breach, Glow, Inc. for
their privacy and security failures that put women's sensitive
personal information at risk, and Premera Blue Cross over their
breaches of patient privacy.
I worked with the Republican Attorney General of Louisiana to
lead a bipartisan, multistate coalition urging HHS, NIH, and
FDA to use their legal authority to increase the availability
and affordability of Remdesivir. In California, I used my
authority to protect workers from exposure to COVID-19, take on
fraudsters trying to take advantage of people during the
pandemic, and press the Federal Government to do more to
produce PPE and boost reporting by nursing homes.
With the responsibility for reviewing non-profit health-care
mergers in the State, I have fought to ensure that hospitals
benefiting from nonprofit status give back appropriately to the
communities they serve. For example, in 2018, my office
approved the biggest merger in our State history, the Dignity-
Catholic Health Initiative Merger, and along with it, secured a
grant program between the hospital system and local governments
to better support the delivery of treatment and services to
hospitalized individuals experiencing homelessness. I also
secured a half-billion-dollar settlement from Sutter Health,
one of our country's largest hospital systems, for unfairly
sucking up hospitals and doctors and using their market power
to jack up costs for patients.
As part of our efforts to ensure integrity among health-care
providers and vigorously protect patients, the California DoJ
won a $344-million verdict against Johnson & Johnson for its
deceptive marketing arising from sale of pelvic mesh. The
pelvic mesh implants, which were advertised to treat a
condition called organ prolapse, caused severe bleeding and
searing pain in these female patients. The award was more than
twice the size of the $117-million settlement J&J reached to
resolve claims by 41 States and the District of Columbia for
similar deceptive marketing accusations arising from the sale
of pelvic mesh products.
Finally, over 3 years, I led the national defense of the
Affordable Care Act in court, going all the way to the Supreme
Court to ensure that the American people don't lose their
health care or see their coverage denied just because they have
a pre-existing condition, which is especially critical as we
address the twin public health and economic crises caused by
the pandemic.
The mission of the Department of Health and Human Services has
never been more important than right now. I believe my
experiences and background qualify me for this role, and I am
humbled by and ready for this responsibility of leading HHS
during this consequential time for the agency--and for our
country.
B. FUTURE EMPLOYMENT RELATIONSHIPS
1. Will you sever all connections (including participation in future
benefit arrangements) with your present employers, business firms,
associations, or organizations if you are confirmed by the Senate? If
not, provide details.
Upon consultation with and approval by my agency ethics
officials, I will continue to participate in the State of
California's 401(k) and 457(b) retirement plans and the CalPERS
pension plan. The State of California will not make any
contributions after my resignation.
2. Do you have any plans, commitments, or agreements to pursue
outside employment, with or without compensation, during your service
with the government? If so, provide details.
No.
3. Has any person or entity made a commitment or agreement to employ
your services in any capacity after you leave government service? If
so, provide details.
No.
4. If you are confirmed by the Senate, do you expect to serve out
your full term or until the next presidential election, whichever is
applicable? If not, explain.
Yes.
C. POTENTIAL CONFLICTS OF INTEREST
1. Indicate any current and former investments, obligations,
liabilities, or other personal relationships, including spousal or
family employment, which could involve potential conflicts of interest
in the position to which you have been nominated.
I have consulted with agency ethics officials to determine
what, if any, steps I must take to avoid conflicts of interest
and appearance issues in carrying out my duties as the
Secretary of Health and Human Services. My wife is a practicing
physician. In connection with her work, I will comply with all
applicable ethics laws and regulations and with the provisions
of my ethics agreement, which spells out my recusal obligations
with respect to her employment.
My financial holdings consist largely of diversified mutual
funds, real property, cash and cash equivalents, which do not
present significant potential for conflicts of interest in
carrying out my anticipated official duties.
2. Describe any business relationship, dealing, or financial
transaction which you have had during the last 10 years (prior to the
date of your nomination), whether for yourself, on behalf of a client,
or acting as an agent, that could in any way constitute or result in a
possible conflict of interest in the position to which you have been
nominated.
None. My financial interests consist largely of diversified
mutual funds, real property, and cash or cash equivalents,
which do not present a conflict of interest with my anticipated
official duties. However, I will consult with agency ethics
officials and comply with the ethics laws and regulations.
3. Describe any activity during the past 10 years (prior to the date
of your nomination) in which you have engaged for the purpose of
directly or indirectly influencing the passage, defeat, or modification
of any legislation or affecting the administration and execution of law
or public policy. Activities performed as an employee of the Federal
government need not be listed.
Since becoming Attorney General, I have testified twice before
Congress.
On September 19, 2017, I testified before the Senate Commerce
Committee regarding sex trafficking. The title of the hearing
was ``S. 1693, The Stop Enabling Sex Traffickers Act of 2017.''
The press release below includes my testimony submitted to the
committee.
https://oag.ca.gov/news/press-releases/attorney-general-
becerra-testifies-us-senate-support-protecting-children-sex
On September 23, 2020, I testified before the Senate Commerce
Committee regarding California's privacy laws. The title of the
hearing was ``Revisiting the Need for Data Privacy
Legislation.'' The press release below includes my testimony
submitted to the committee.
https://oag.ca.gov/news/press-releases/attorney-general-
becerra-testifies-us-senate-cormnittee-commerce-science-and
As Attorney General, I have also written to Congress on a
variety of issues. Most of these letters have been sent with
other Attorneys General. To the best of my knowledge, the
topics and dates of all such letters sent are listed below:
------------------------------------------------------------------------
Legislation Date Comments
------------------------------------------------------------------------
S. 168, The Commercial Vessel February 15, 2017 Multistate
Incidental Discharge Act. Opposition Letter
from AG Becerra
and nine AGs to
Majority Leader
McConnell and
Minority Leader
Schumer.
------------------------------------------------------------------------
S. 118, Reinforcing American- March 15, 2017 Opposition Letter
Made Products Act of 2017. from AG Becerra to
Senate Commerce
Chairman Thune and
Ranking Member
Nelson.
------------------------------------------------------------------------
S.J. Res. 19, H.J. Res. 62, and April 5, 2017 Multistate
H.J. Res. 73 (bills that would Opposition Letter
eradicate protections for from AG Becerra
consumers who use prepaid and 18 AGs to
cards to receive wages or make Majority Leader
purchases). McConnell,
Minority Leader
Schumer, Speaker
Ryan, House
Majority Leader
McCarthy, and
House Minority
Leader Pelosi.
------------------------------------------------------------------------
Federal funding for the Legal May 22, 2017 Bipartisan
Services Corporation. Multistate
Opposition Letter
opposing reduction
in funds to Legal
Services
Corporation from
AG Becerra and 31
AGs to House
Appropriations
Chairman
Frelinghuysen,
House
Appropriations
Ranking Member
Lowey, House
Appropriations
Subcommittee
Chairman
Culberson, and
House
Appropriations
Subcommittee
Ranking Member
Serrano.
------------------------------------------------------------------------
The Financial CHOICE Act of June 7, 2017 Multistate
2017 (H.R. 10) (bill would Opposition Letter
eliminate consumer protections from AG Becerra
from Dodd-Frank Wall Street and 20 AGs to
Reform and Consumer Protection Speaker Ryan,
Act). Majority Leader
McCarthy, Minority
Leader Pelosi, and
Minority Whip
Hoyer.
------------------------------------------------------------------------
H.R. 23 (bill would exempt July 11, 2017 Opposition Letter
California from longstanding from AG Becerra to
principle that Congress should Speaker Ryan and
defer to States in managing Minority Leader
water resources). Pelosi.
------------------------------------------------------------------------
S. 1693, Stop Enabling Sex 2017 AG Becerra's
Traffickers Act of 2017. Responses to
Questions for the
Record from
Senator Cortez
Masto from
September 2017
Senate Commerce
Committee Hearing.
------------------------------------------------------------------------
Safe Banking Act (legislation January 16, 2018 Bipartisan
to provide a safe harbor for Multistate Support
depository institutions that Letter for the
service marijuana-related Safe Harbor
business). Legislation from
AG Becerra and 19
AGs to Senate and
House Leadership.
------------------------------------------------------------------------
Legislation to protect the February 12, 2018 Bipartisan
victims of sexual harassment Multistate Support
in the workplace. Letter from AG
Becerra and 55 AGs
to Leaders of
Congress.
------------------------------------------------------------------------
S. 2152, Amy and Vicky Child March 6, 2018 Bipartisan
Pornography Victim Assistance Multistate Support
Act of 2017. Letter from AG
Becerra and 54 AGs
to Speaker Ryan,
Minority Leader
Pelosi, Judiciary
Committee Chairman
Goodlatte, and
Judiciary
Committee Ranking
Member Nadler.
------------------------------------------------------------------------
Protection for Eligible March 13, 2018 Multistate Support
Refugees with Established Letter from AG
Residency Act of 2017 (ESPERER Becerra and 18 AGs
Act of 2017), H.R. 4184, and to Majority Leader
the Safe Environment from McConnell,
Countries Under Repression and Minority Leader
Emergency Act (SECURE Act), S. Schumer, Speaker
2144. Ryan, Majority
Leader McCarthy,
and Minority
Leader Pelosi.
------------------------------------------------------------------------
Legislation to safeguard the March 15, 2018 Bipartisan
rights of States to protect Multistate Support
their residents from student Letter from AG
loan-related abuses. Becerra and 32 AGs
to Speaker Ryan,
Senate Majority
Leader McConnell,
House Minority
Leader Pelosi,
Senate Minority
Leader Schumer,
House Education
Committee
Chairwoman Foxx,
Ranking Member
Scott, Senate HELP
Committee Chairman
Alexander, and
Ranking Member
Murray.
------------------------------------------------------------------------
Data Acquisition and Technology March 19, 2018 Bipartisan
Accountability and Security Multistate
Act. Opposition Letter
from AG Becerra
and 31 AGs to the
House Committee on
Financial
Services.
------------------------------------------------------------------------
H.R. 3891 (bill would expand March 28,2018 Bipartisan
the authority of Medicaid Multistate Support
Fraud Control Units to Letter from AG
prosecute Medicaid patient Becerra and 48 AGs
abuse). to Representatives
Walberg and Welch.
------------------------------------------------------------------------
H.R. 3299 (Protecting June 27, 2018 Bipartisan
Consumers' Access to Credit Multistate
Act of 2017) and H.R. 4439 Opposition Letter
(Modernizing Credit from AG Becerra
Opportunities Act). Bills and 20 AGs to
would allow non-bank lenders Majority Leader
to sidestep State usury laws McConnell,
and charge excessive interest Minority Leader
rates.. Schumer, Senate
Banking Chairman
Crapo, and Ranking
Member Brown.
------------------------------------------------------------------------
Legislation to improve July 27, 2018 Multistate Support
corporate transparency by Letter from AG
requiring companies to Becerra and 23 AGs
disclose the identities of to House Financial
individuals who control and Services Chairman
profit from the company at the Hensarling, and
time of its incorporation. Ranking Member
Waters.
------------------------------------------------------------------------
H.R. 6147 (bill that would bar July 31, 2018 Opposition Letter
Californians from using State from AG Becerra to
courts to challenge Majority Leader
construction of State and McConnell,
Federal water projects in Minority Leader
California). Schumer, Speaker
Ryan, and Minority
Leader Pelosi.
------------------------------------------------------------------------
Legislation to reauthorize the September 17, 2018 Bipartisan
Violence Against Women Act Multistate Letter
(VAWA). from AG Becerra
and 55 AGs to
Leaders of
Congress.
------------------------------------------------------------------------
First Step Act (bill to provide December 20, 2018 Bipartisan
tools to the Federal Bureau of Multistate Support
Prisons). Letter from AG
Becerra and 37 AGs
to Majority Leader
McConnell,
Minority Leader
Schumer, Speaker
Ryan, and Minority
Leader Pelosi.
------------------------------------------------------------------------
Telephone Robocall Abuse March 5, 2019 Bipartisan
Criminal Enforcement and Multistate Support
Deterrence (TRACED) Act. Letter from AG
Becerra and 53 AGs
to Senate
Committee on
Commerce, Science,
and Transportation
Chairman Wicker
and Ranking Member
Cantwell.
------------------------------------------------------------------------
Request funding for the Legal May 1, 2019 Bipartisan
Services Corporation (LSC) in Multistate Support
Fiscal Year 2020. Letter from AG
Becerra and 41 AGs
to the House
Committee on
Appropriations.
------------------------------------------------------------------------
Request funding for the Legal May 1, 2019 Bipartisan
Services Corporation (LSC) in Multistate Support
Fiscal Year 2020. Letter from AG
Becerra and 41 AGs
to the Senate
Committee on
Appropriations.
------------------------------------------------------------------------
Legislation that would allow May 8, 2019 Bipartisan
States and territories that Multistate Support
have legalized certain use of Letter from AG
marijuana to bring that Becerra and 37 AGs
commerce into the banking to Leaders of
system. Congress.
------------------------------------------------------------------------
Urge Congress to take action to June 13, 2019 Support Letter from
protect the integrity of our AG Becerra to the
election infrastructure. Senate Committee
on Appropriations
and Senate Rules
Committee.
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H.R. 1603, the Alan Reinstein July 12, 2019 Multistate Support
Ban Asbestos Now Act of 2019. Letter from AG
Becerra and 17 AGs
to the House
Committee on
Energy and
Commerce.
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H.R. 1705, Jaime's Law (bill September 23, 2019 Multistate Support
would require background Letter from AG
checks for ammunition Becerra and 20 AGs
purchases). to Leaders of
Congress.
------------------------------------------------------------------------
Resolution of Disapproval for January 14, 2020 Multistate Support
the U.S. Department of Letter for
Education's ``Borrower resolution of
Defense'' regulation. disapproval of the
Borrower Defense
Rule from AG
Becerra and 19 AGs
to Senator Durbin
and Representative
Lee.
------------------------------------------------------------------------
Urge Congress to take action to February 5, 2020 Support Letter from
rein in predatory lending AG Becerra to
practices. House Financial
Services
Chairwoman Waters
and Ranking Member
McHenry.
------------------------------------------------------------------------
H.R. 4421, Bankruptcy Venue February 20, 2020 Bipartisan
Reform Act of 2019. Multistate Support
Letter from AG
Becerra and 39 AGs
to House
Congressional
Sponsors of H.R.
4421.
------------------------------------------------------------------------
California Consumer Privacy Act February 25, 2020 Letter from AG
and Federal Privacy Becerra providing
Legislation. support for the
California
Consumer Privacy
Act to Senate
Commerce Committee
Chairman Wicker
and Ranking Member
Cantwell, and
House Energy and
Commerce Chairman
Pallone and
Ranking Member
Walden.
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Concern over the proposed March 26, 2020 Bipartisan
allocation of funding for the Multistate Letter
District of Columbia in the from AG Becerra
Coronavirus Relief Fund. and 38 AGs to
President Trump,
Speaker Pelosi,
Minority Leader
McCarthy, Majority
Leader McConnell,
and Minority
Leader Schumer.
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Concerns about the ongoing May 6, 2020 Multistate Letter
implementation of the Paycheck from AG Becerra
Protection Program of the and 23 AGs to
CARES Act. Majority Leader
McConnell,
Minority Leader
Schumer, Speaker
Pelosi, and
Minority Leader
McCarthy.
------------------------------------------------------------------------
Legislation to impose remote May 18, 2020 Opposition Letter
online notarization on from AG Becerra to
California residents. Senate Judiciary
Chairman Graham
and Ranking Member
Feinstein.
------------------------------------------------------------------------
Safe Banking Act (legislation May 19, 2020 Bipartisan
to provide a safe harbor for Multistate Support
depository institutions that Letter from AG
service marijuana-related Becerra and 33 AGs
business). to Leaders in
Congress.
------------------------------------------------------------------------
S. 3607, Safeguarding America's May 21, 2020 Bipartisan
First Responders Act of 2020. Multistate Support
Letter from AG
Becerra and 51 AGs
to Speaker Pelosi,
Minority Leader
McCarthy, Majority
Leader McConnell,
Minority Leader
Schumer, House
Judiciary
Committee Chairman
Nadler, and House
Judiciary
Committee Ranking
Member Jordan.
------------------------------------------------------------------------
Legislation to provide State June 4, 2020 Multistate Support
AGs clear authority under Letter from AG
Federal law to investigate Becerra and 17 AGs
unconstitutional policing by to Speaker Pelosi,
local police departments. Minority Leader
McCarthy, Majority
Leader McConnell,
and Minority
Leader Schumer.
------------------------------------------------------------------------
Legislation to provide State June 5, 2020 Support Letter from
AGs clear authority under AG Becerra to
Federal law to investigate Speaker Pelosi,
unconstitutional policing by Minority Leader
local police departments. McCarthy, Majority
Leader McConnell,
and Minority
Leader Schumer.
------------------------------------------------------------------------
Urge Congress to address the July 14, 2020 Multistate Letter
crisis in our childcare to Congress from
systems by providing funding AG Becerra and 21
in the next Federal stimulus AGs to Majority
package. Leader McConnell
and Minority
Leader Schumer.
------------------------------------------------------------------------
Driving for Opportunity Act of August 3, 2020 Bipartisan
2020 (legislation to end the Multistate Support
practice of license suspension Letter from AG
for unpaid fines and fees). Becerra and 23 AGs
to Senate
Committee on
Environment and
Public Works
Chairman Barrasso
and Ranking Member
Carper.
------------------------------------------------------------------------
Student Loan Fairness Act of August 5, 2020 Bipartisan
2020, S. 4237. Multistate Support
Letter from AG
Becerra and 29 AGs
to Senators
McConnell,
Schumer,
Alexander, Murray,
Durbin, Duckworth,
Murkowski, and
Sullivan.
------------------------------------------------------------------------
Questions for the Record September 23, 2020 Letter from AG
following AG Becerra's Becerra to the
testimony at Senate Commerce U.S. Senate
Committee Hearing, Committee on
``Revisiting the Need for Data Commerce, Science,
Privacy Legislation''. and Transportation
in response to
Senator Schatz's
Questions for the
Record.
------------------------------------------------------------------------
Request that Congress extend November 30, 2020 Bipartisan
the spending-related deadline Multistate Support
for relief funding so Letter from AG
Americans can receive the full Becerra and 48 AGs
benefits of the CARES Act. to Speaker Pelosi,
Minority Leader
McCarthy, Majority
Leader McConnell,
Minority Leader
Schumer, and Ways
and Means
Committee Chairman
Neal and Ranking
Member Brady.
------------------------------------------------------------------------
Request to allow for free and December 3, 2020 Multistate Letter
fast access to a COVID-19 from AG Becerra
vaccine to every person. and 12 AGs to
Speaker Pelosi,
Minority Leader
McCarthy, Majority
Leader McConnell,
Minority Leader
Schumer
------------------------------------------------------------------------
Supplemental Information: In addition, as the Attorney General of
California, our department has weighed in on Federal rulemaking and
legislation in California and across the country.
4. Explain how you will resolve any potential conflict of interest,
including any that are disclosed by your responses to the above items.
(Provide the committee with two copies of any trust or other
agreements.)
I have consulted with agency ethics officials and will sign an
ethics agreement that sets forth my ethics obligations. I will
receive initial and annual ethics training as required by the
Ethics in Government Act. I will comply with my ethics
agreement and with all applicable ethics laws and regulations,
and I will rely on the advice of my agency ethics officials,
whom I will consult regularly.
5. Two copies of written opinions should be provided directly to the
committee by the designated agency ethics officer of the agency to
which you have been nominated and by the Office of Government Ethics
concerning potential conflicts of interest or any legal impediments to
your serving in this position.
D. LEGAL AND OTHER MATTERS
1. Have you ever been the subject of a complaint or been
investigated, disciplined, or otherwise cited for a breach of ethics
for unprofessional conduct before any court, administrative agency
(e.g., an Inspector General's office), professional association,
disciplinary committee, or other ethics enforcement entity at any time?
Have you ever been interviewed regarding your own conduct as part of
any such inquiry or investigation? If so, provide details, regardless
of the outcome.
I have never been disciplined or cited for a breach of ethics
or unprofessional conduct.
In 2011, the Office of Congressional Ethics looked into an
allegation that my wife and I had improperly received a
homestead exemption for our residence in Maryland, interviewed
me, and found that the allegation lacked merit. The Office of
Congressional Ethics unanimously recommended to the House
Committee on Ethics that the matter be dismissed, which the
Committee on Ethics did without any further investigation.
2. Have you ever been investigated, arrested, charged, or held by any
Federal, State, or other law enforcement authority for a violation of
any Federal, State, county, or municipal law, regulation, or ordinance,
other than a minor traffic offense? Have you ever been interviewed
regarding your own conduct as part of any such inquiry or
investigation? If so, provide details.
No.
3. Have you ever been involved as a party in interest in any
administrative agency proceeding or civil litigation? If so, provide
details.
I have not been involved in any administrative proceedings or
civil litigation in my personal capacity.
Supplemental Information: As Attorney General representing the
State of California, I am sometimes named in litigation. In
addition, during my 30-year tenure as an elected official, my
campaign committees have been the subject of very few
complaints. To the best of my knowledge, here is a list of all
administrative complaints and civil litigation involving my
campaign committees.
Federal Election Commission
In 2015, the Foundation for Accountability and Civic Trust
filed a complaint against the DNC and every Democratic
congressional campaign committee alleging that they had
received prohibited in-kind contributions from Catalist and NGP
VAN. The FEC rejected those claims by a vote of 6-0 and closed
the matter without taking any action.
In 2001, the company Mattel filed a self-referral complaint
with the FEC voluntarily disclosing that a former executive had
used corporate funds to make political contributions through
Mattel employees to a number of congressional campaign
committees, including Becerra for Congress. Becerra for
Congress was unaware of any improper contributions, and
voluntarily returned the contributions to the U.S. Treasury
after the allegations came to light. The FEC voted unanimously
that there was no violation of the Act by Becerra for Congress
or any other campaign committees, and the matter was closed.
California Fair Political Practices Commission (FPPC)
My Democratic opponent in the 2018 primary campaign for
Attorney General, Dave Jones, filed a complaint with the State
of California Fair Political Practices Commission (FPPC),
regarding a television advertisement paid for by my committee,
Becerra for Attorney General. The Fair Political Practices
Commission found there were no violations and closed the file
immediately without any further investigation. Days before the
primary election, Dave Jones for Attorney General held a press
conference announcing that he had also filed a civil lawsuit
against Becerra for Attorney General about the same issue.
However, he never served the lawsuit, and dismissed it shortly
after the election without taking any further action.
L.A. City Ethics Commission
Following a mandatory audit of all the campaign committees
involved in the 2001 mayoral election, the Commission found
that five of the leading mayoral committees, including the
Becerra for Mayor committee, made technical administrative
errors during the campaign. Becerra for Mayor agreed to pay
$11,089.99 to resolve issues regarding six mailers that weren't
filed with the Commission and the receipt of surplus matching
funds. The committee also refunded $7,089.99 to the city for
the surplus matching funds it received.
Sacramento County Superior Court
In 2018, Eric Early, a candidate for Attorney General, filed a
Petition for Writ of Mandate and Complaint for Declaratory
Relief to remove Xavier Becerra's name from the November 2018
statewide general election ballot, alleging that he was
ineligible to serve as Attorney General because he was an
inactive member of the California State Bar for the 5-year
period preceding his appointment or election to office.
The trial court judge denied the Petition for Writ of Mandate
and ruled in favor of Becerra, declaring that the law only
required Becerra to be admitted to practice law in the State of
California to be eligible to run for the office of Attorney
General, not to be an ``active'' member of the State Bar.
Following the entry of judgment, the court awarded Becerra his
attorneys' fees for defending the lawsuit. Plaintiff appealed
the trial court ruling and the Court of Appeal upheld the trial
court ruling in favor of Becerra, issuing a published decision
(Early v. Becerra (2020) 47 Cal. App. 5th 325.) Plaintiff then
filed a separate appeal of the trial court's award of
attorneys' fees to Becerra. Oral argument was heard by the
court on November 16, 2020, and a decision is pending.
4. Have you ever been convicted (including pleas of guilty or nolo
contendere) of any criminal violation other than a minor traffic
offense? If so, provide details.
No.
5. Please advise the committee of any additional information,
favorable or unfavorable, which you feel should be considered in
connection with your nomination.
None.
E. TESTIFYING BEFORE CONGRESS
1. If you are confirmed by the Senate, are you willing to appear and
testify before any duly constituted committee of the Congress on such
occasions as you may be reasonably requested to do so?
Yes.
2. If you are confirmed by the Senate, are you willing to provide
such information as is requested by such committees?
Yes.
______
Questions Submitted for the Record to Hon. Xavier Becerra
Questions Submitted by Hon. Ron Wyden
nursing homes
Question. The COVID-19 pandemic has taken an outsize toll on our
Nation's 1.3 million seniors living in nursing homes. As of early
February, more than 160,000 long-term care workers and residents have
died. While long-term care residents represent roughly 5 percent of the
U.S. COVID-19 cases, they represent about one-third of total U.S.
COVID-19 deaths.
Throughout the pandemic, nursing homes have faced chronic shortages
of PPE, staffing, and testing. HHS has allocated roughly $10 billion to
nursing homes from the Provider Relief Fund, but with essential
resources like staff and PPE in short supply for much of the last year,
it is not clear whether those dollars have always translated to an
improved response on the ground. Nursing homes where black and Latino
residents make up a higher percentage of their population have faced
the worst outcomes. The failure to control the spread of the virus in
communities across the country resulted in nursing homes in majority-
minority communities bearing at disproportionate risk, compared to
mostly white communities.
I've worked closely with Senator Casey over the last year to push
and prod HHS to collect and make public information about COVID-19's
impact on Medicare and Medicaid certified nursing homes. The weekly
nursing home data required and posted by CMS has provides families,
policymakers and heath care experts with timely information about how
COVID-19 is affecting nursing home residents and workers.
Broadly speaking, if confirmed as Secretary of HHS, will you
support efforts to improve transparency relating to COVID-19 in nursing
homes and address the disproportionate impacts of COVID-19 on nursing
home residents of color?
And specifically in regard to vaccinations, will you support
efforts to provide consumers and Congress facility-level data about the
rate of COVID-19 vaccinations in nursing homes?
Answer. Thank you for your leadership on this important issue. If I
am fortunate enough to be confirmed, it will be a top priority for the
U.S. Department of Health and Human Services (HHS) to protect our most
vulnerable Americans by addressing the disproportionate impact of the
novel coronavirus of 2019 (COVID-19) pandemic on nursing home
residents, especially people of color. As you and I have discussed,
making data-driven decisions will be critical to addressing racial and
ethnic health disparities not just at the Nation's nursing homes but
across the health-care system. If confirmed, I will make transparency
and data collection regarding the impacts of COVID-19 and vaccination a
priority because good data is essential to good policy.
family separation and treatment of unaccompanied noncitizen minors
Question. Policies promoting the forced separation of children from
their families at the border has led to serious trauma for noncitizen
children and their families.
If confirmed, how do you plan to support the health and well-being
of noncitizen children and ensure their safe and timely reunification
with family members or sponsors?
Answer. If confirmed, I will ensure HHS is making the safety and
well being of vulnerable children in the care and custody of the Office
of Refugee Resettlement (ORR) a priority. Ensuring these children's
safety and well-being is both our legal duty and our moral obligation--
I take both seriously. Providing such care includes complying with all
legally mandated services required by the terms of the Flores
Settlement Agreement, the Homeland Security Act of 2002, and the
Trafficking Victims Protection Reauthorization Act of 2008. As you
know, HHS is required to release children to an appropriate sponsor
without unnecessary delay. When a child enters ORR care, ORR aims to
put every child safely in contact with their parents, guardians, or
relatives as soon as possible. We are committed to continued
improvement in the program's discharge rate.
Question. Will you commit to providing members of Congress timely
updates and details on the changes the Office of Refugee and
Resettlement makes to meet the physical and mental health needs of
children its care at all placement types?
Answer. Yes.
Question. Will you commit to soliciting the input of child welfare
experts, in addition to comments from the general public before
implementing significant policy changes?
Answer. Yes.
Question. Lastly, will you commit to working with the Secretary of
the Department of Homeland Security to uphold the Flores Settlement and
the Trafficking Victims Protection Reauthorization Act?
Answer. Yes.
______
Question Submitted by Hon. Debbie Stabenow
Question. I'm a strong supporter of Medicare's home health benefit,
and it's a really important option, particularly during the pandemic.
What improvements and modernizations would you like to see made to the
home health benefit?
Answer. As you mention, the Medicare home health benefit allows
beneficiaries to receive care from their home, which is a much needed
lifeline for our Nation's seniors. I believe the home health benefit is
necessary to ensuring quality health care. I also understand this issue
personally. As I discussed briefly in our hearing, I was fortunate
enough to care for my father at home, prior to his passing. I
understand that in response to the COVID-19 Public Health Emergency,
the Centers for Medicare and Medicaid Services provided flexibilities
to home health agencies, giving them tools to help ensure beneficiaries
maintain access to care. If confirmed, I will work with you and other
members of Congress to ensure that our Nation's seniors are able to
utilize home health care and to continue to improve the benefit.
______
Question Submitted by Hon. Maria Cantwell
lymphedema treatment act
Question. Lymphedema is an incurable but treatable medical
condition caused by injury, trauma or congenital defects. One of the
most common causes of Lymphedema is cancer treatments that remove or
damage lymph nodes and vessels, or cause blockages in the lymphatic
system. The disease is effectively managed through prescription medical
compression garments, which are highly specialized compression
stockings, sleeves, gloves, and other items, all of which must be
custom-fit by trained providers. In the case of more advanced disease
or complex cases, these garments must be custom-made.
Medically necessary supplies such as these should be covered by
insurance. Moreover, by not treating the condition with compression
garments, patients are more likely to enter hospitals and doctors'
offices during the current COVID-19 pandemic, which is not helpful to
our efforts to combat the spread of the virus.
Unfortunately, Medicare does not currently provide coverage for
lymphedema compression supplies, which must be replaced about every six
months, because the Centers for Medicare and Medicaid Services (CMS)
claim they do not fit into an existing benefit category.
I have been leading the effort in Congress to correct this problem
and have sponsored the Lymphedema Treatment Act (LTA) to direct CMS to
cover prescribed medical compression garments.
If confirmed as Secretary, are you willing to endorse this
legislation and recommend President Biden sign it into law if passed by
the Congress, unless you are able to fix this administratively?
Answer. Thank you for your leadership on behalf of Lymphedema
patients. I agree that we must ensure Medicare beneficiaries have
access to medically necessary health-care items and services. If
confirmed, I will work with you to identify solutions to this issue.
______
Question Submitted by Hon. Benjamin L. Cardin
medicaid and covid-19
Question. Last year, at the beginning of the COVID-19 pandemic, the
country saw a dramatic decline in the utilization of health-care
services as individuals sought to limit their risk and exposure to
contracting the coronavirus. Almost a year later, many States have
lifted restrictions on medical procedures, begun reopening schools, and
relaxed other restrictions. As a result, utilization of non-urgent care
has returned to or trended near normal utilization levels, pre-
pandemic.
Capitated managed care is the dominant way in which States deliver
services to Medicaid enrollees. States pay Medicaid managed care
organizations (MCOs) a set per member per month payment for the
Medicaid services specified in their contracts. During the pandemic,
States were making payments to plans, but those payments were not
necessarily flowing to providers where utilization had decreased. As a
result, many Medicaid providers faced substantial losses in revenue,
while many health insurers reported record earnings.
In the waning days of the Trump administration, many States sought
approval from CMS to implement a risk corridor financing mechanism for
their respective Medicaid programs. This allowed States to recoup
monies that were paid to Medicaid MCOs prior to the pandemic and the
Public Health Emergency Declaration.
Now that utilization patterns in the Medicaid program are returning
to normal, when would it be appropriate for CMS to review State risk
corridor arrangements?
Answer. The COVID-19 public health emergency (PHE) disrupted all
aspects of our lives, including our use of routine and urgent health
services, presenting unique and unanticipated circumstances. Over the
past year, there have been different patterns in health care
utilization. If confirmed, I look forward to working with you to
support State efforts to respond to COVID-19, including regarding
payment to the managed care plans and providers to ensure Medicaid
beneficiaries have continued access to care.
______
Questions Submitted by Hon. Sherrod Brown
child abuse fatalities
Question. In my State, there have been a number of tragic child
abuse-related deaths, which is unacceptable. It is critical that we do
more to support at risk children and families and ensure States have
the resources to prevent these tragedies. Right now, the National Child
Abuse and Neglect Data System (NCANDS) fails to capture the entire
number of child abuse fatalities. Like almost every other aspect of the
child welfare system, child abuse deaths disproportionately affect
black families. The Federal Commission to Eliminate Child Abuse and
Neglect Fatalities recommended significant reforms, including increased
funding to child welfare programs and the development of a standard
definition of ``child maltreatment fatality.''
Will you commit to working with members of Congress to advocate for
funding to ensure States and community partners have the resources to
support families and prevent child abuse-related deaths? Will you
commit to incorporating the voices and lived experiences of young
people and families to root out factors that lead to this tragedy
having a disparate impact on black families? If confirmed, what initial
steps would you take to strengthen Federal data systems and encourage
cross agency collaboration to ensure policymakers and practitioners
have the information necessary to prevent child abuse-related
fatalities?
Answer. Federal data systems are critically important to ensuring
child safety and must be inclusive so that they capture all relevant
information that States, policymakers, and practitioners need to
prevent child abuse-related fatalities. Working with Congress to
support States and community partners will be an important part of our
broader efforts to reduce child abuse-related fatalities, including by
strengthening Federal data systems. President Biden has been
unequivocal that equity issues will be and will remain at the forefront
of his administration. If confirmed, I will ensure that the experiences
and perspectives of all children and families will inform my work.
family first implementation
Question. COVID-19 has devastated State budgets, particularly
systems that were already underfunded, such as the child welfare
system. As States like Ohio, work to implement provisions from the
Family First Act, it is critical to ensure they have adequate and clear
guidance and support to be successful under the new system.
Will you commit to providing States and child welfare providers
with the tools, resources, and information necessary to implement
Family First? Will you commit to working with county-administered child
welfare systems in States like Ohio to promote equitable access to
Family First support services across jurisdictions?
Answer. The Family First Prevention Services Act is an important
law that seeks to transform child welfare services by increasing
support for prevention services to strengthen families and keep
children safely at home and in their communities with their parents, or
other family members whenever possible. When children must come into
foster care, the law seeks to limit the use of institutional care and
encourage family-based placements. If confirmed, I commit to ensuring
HHS takes every available step to support vulnerable children and
families, and makes available needed guidance and technical assistance
so that all States, including those with county-administered child
welfare systems like Ohio, can effectively implement the law and ensure
equitable access to needed services.
social determinants of health
Question. As was discussed during Wednesday's hearing, entities
across the health-care and political spectrum are increasingly focused
on ways to address the social determinants of health. The Department of
HHS--as both a payer and a policy driver--has many tools at its
disposal to improve health and drive value by addressing social
determinants.
If confirmed, how will you use Federal payment policy--across
Medicare and Medicaid and through the Center for Medicare and Medicaid
Innovation (CMMI)--to address the social determinants of health, ensure
our Federal programs and models address health-related social needs of
patients, and support upstream investments in the social determinants
of health?
Answer. The COVID-19 pandemic has further exposed the disparities
that exist in our society. I understand the CMS Innovation Center is
currently testing the Accountable Health Communities Model, which
evaluates whether systematically identifying and addressing the health-
related social needs of Medicare and Medicaid beneficiaries through
screening, referral, and community navigation services will impact
health-care costs and reduce health-care utilization. In addition, if
confirmed, I intend to take a department-wide approach to the
advancement of equity, consistent with President Biden's charge to
Federal departments and agencies, and this would include examination of
ways to address the social determinants of health.
covid-19 vaccine disparities and data
Question. A recent Washington Post \1\ article gave examples of
States that have managed the COVID vaccination process well, while
others have had a more challenging time navigating the complex process.
All States, however, have failed to distribute vaccines equitably \2\--
we are failing our communities of color.
---------------------------------------------------------------------------
\1\ https://www.washingtonpost.com/national/states-vaccine-rollout/
2021/02/03/eae671a0-656f-11eb-886d-5264d4ceb46d_story.html.
\2\ https://www.kff.org/coronavirus-covid-19/issue-brief/latest-
data-on-covid-19-vaccinations-race-ethnicity/.
Many States, including Ohio, are working to develop a vaccine
appointment finder tool to increase resident participation and aid in
the State's vaccination campaign. Some localities have made use of
online platforms that help collect data on the root causes of vaccine
hesitancy, providing public health and community leaders with
additional information on actions they can take to improve the vaccine
distribution process, particularly for communities of color and
---------------------------------------------------------------------------
underserved communities.
If confirmed, will you commit to getting States the complete set of
data and information they need to populate their vaccine finder tools,
and ensure States have the tools to build and leverage their platforms
to accelerate the vaccine distribution process and reduce disparities
in access to vaccine?
Answer. I am acutely aware of the disparities faced by communities
of color and other underserved communities. If confirmed, I will ensure
that we are partnering with States on data and vaccine information so
that Americans, especially communities of color, can more easily access
vaccination. I will also endeavor to work with States on other options
for those who may not have access to a computer as well. It is critical
that Federal and State governments are closely coordinated and sharing
information to best serve the needs of the American people.
direct and indirect remuneration fees
Question. Community pharmacists are a critical player in our
Nation's health-care workforce, extending essential services to
underserved and disproportionately at-risk communities. Especially
during the COVID-19 pandemic, pharmacists have been critical in our
efforts to expand access to testing and vaccination services, including
long-term care residents and other seniors and Part D beneficiaries.
Unfortunately, the rapid growth of pharmacy direct and indirect
remuneration (DIR) fees continues to create uncertainty for the
community pharmacies Ohioans rely on for essential services. The use of
DIR fees in Medicare Part D has exploded over the past several years,
threatening the financial viability of pharmacies across Ohio and the
health of the patients they serve. The Centers for Medicare and
Medicaid Services (CMS) has estimated that pharmacy DIR fee reform
could result in saving Medicare beneficiaries between $7.1 and $9.2
billion in cost-sharing burden over the next decade.
If confirmed, will you commit to working with Congress on solutions
to address the explosion of DIR fees and support stability for
community pharmacies, while ensuring quality and low costs for Medicare
beneficiaries?
Answer. I agree that community pharmacists are critical to our
Nation's health-care system. We must do all we can to ensure that
Americans can access important health-care services, including from
local pharmacies in their communities. If confirmed, I look forward to
working with Congress to ensure that community pharmacists have
predictability.
preventive/primary care/screenings during covid-19
Question. COVID-19 has been a threat to our health in more ways
than one. Not only has the virus stolen the lives of more than 500,000
Americans, it has drastically reduced other vital health-care services
that are essential to keeping Americans healthy. COVID-19 has had a
significant negative impact on primary care visits, childhood
vaccination rates, and cancer screening rates.
The Centers for Disease Control and Prevention (CDC) issued a
Morbidity and Mortality Weekly Report (MMWR) in September 2020 that
found that ``because of concerns about COVID-19, an estimated 41
percent of U.S. adults had delayed or avoided medical care including
urgent or emergency care (12 percent) and routine care (32 percent).
Avoidance of urgent or emergency care was more prevalent among unpaid
caregivers for adults, persons with underlying medical conditions,
black adults, Hispanic adults, young adults, and persons with
disabilities.''
It is essential that we both work to reduce the backlog in
screenings and vaccinations and other primary health-care services, and
to better understand factors associated with medical care avoidance
to--as the CDC MMWR says--``inform targeted care delivery approaches
and communication efforts encouraging persons to safely seek timely
routine, urgent, and emergency care.''
If confirmed, what will you do to ensure that we make up for the
lost progress (as a result of the pandemic) in our rates of childhood
vaccinations and cancer screening efforts, as well as in our work to
reduce the prevalence and severity of other chronic conditions and to
improve public health outcomes?
Answer. We know the COVID-19 pandemic caused Americans--adults and
children--to delay routine care, including important preventive
measures like vaccinations and cancer screenings. If confirmed, I look
forward to working across the Department to address lost progress and
the looming effects of unaddressed chronic conditions.
medicare advantage/prior authorization
Question. Thank you for your commitment to working with me to equal
the playing field between traditional Medicare and the Medicare
Advantage program. I look forward to collaborating on this effort.
One area where we can create some parity lies in the prior
authorization process. Last Congress, I introduced legislation with
Senator Thune to establish an electronic prior authorization program in
Medicare Advantage (MA) to better facilitate the prior authorization
process in MA and improve the timeliness and efficacy of care delivery
for beneficiaries and their providers. CMS has issued a notice of
proposed rulemaking to establish similar programs in Medicaid, the
Children's Health Insurance Program (CHIP), and insurers operating
qualified health plans on the federally facilitated exchange under the
Affordable Care Act (ACA). Beneficiaries and their providers should not
have to jump through hoops in order to access medically necessary
services.
If confirmed, will you work with Senator Thune and me to provide
additional technical assistance on our legislation so that we can
advance improved prior authorization processes that put the patient
back at the center of care and reduce barrier to timely access to
essential services?
Answer. I believe that ensuring Americans have timely access to
health care is critical, and I agree with you that providers and
individuals should not have to jump through unnecessary hoops for
access to medically appropriate care. If confirmed, I look forward to
working with you, Senator Thune, and other members of Congress on these
important issues.
biosimilars
Question. Thank you for your commitment to lowering the high cost
of prescription drugs. The robust uptake of biosimilars represents an
opportunity to increase competition in the prescription drug
marketplace and reduce costs for patients and taxpayers. I'd like to
work with you on ways to maximize the uptake of biosimilars as they
enter the market to ensure competition and reduce patient out of pocket
cost.
If confirmed, what additional steps should and will you take to
build out a robust biosimilars market and ensure all patients who
require treatment have immediate access to high-quality, affordable
biosimilar biologic medicines?
Answer. Competition in the market has helped control the growth in
spending on prescription drugs. Biosimilars have a role to play in
containing the cost of innovative yet expensive biologic treatments by
creating competition. As Attorney General, I helped to promote
competition by taking on a number of pharmaceutical companies that
restricted competition through ``pay-for-delay'' schemes, which delayed
putting a generic product on the market to compete with the brand-name
product, therefore keeping the price of that brand-name product high.
In addition, I sponsored a law in California that made it more
difficult for pharmaceutical companies to enter into anti-competitive
``pay-for-delay'' agreements. If confirmed, I will continue to work on
finding ways to lower drug costs and ensuring Americans have access to
prescription drugs.
antibiotic resistance
Question. From the CDC to the World Health Organization, public
health experts consider antibiotic resistance to be one of the top
threats to global health security. The threat posed by superbugs
demands swift action and a robust response.
I urge you to commit to building on the National Action Plan for
Combating
Antibiotic-Resistance Bacteria (CARB) and follow through on
coordinated, strategic actions to address antibiotic resistance.
What actions will you take, amidst and after this pandemic, to
prioritize our Nation's fight against antibiotic resistance in addition
to building out our antibiotic stewardship programs and curbing the
overuse of antibiotics?
Answer. It is clear that antimicrobial resistance (AMR) must be a
top public health priority, not only for the United States but around
the world. Even during this time, AMR remains a top CDC priority, and
if confirmed, we will continue investing in key prevention strategies
like early detection and containment, infection prevention, and
ensuring the appropriate use of antibiotics in the U.S. and around the
world. I will also support efforts to develop new antibiotics to treat
infections that are becoming untreatable.
______
Questions Submitted by Hon. Michael F. Bennet
rural health
Question. According to the Brookings Institute, rural communities
had not yet recovered from the recession when COVID-19 hit. Farm
workers and packing plant workers have experienced particular hardship
over the past year. I recently finished a tour of all 64 counties in
Colorado and I often visited with hospital leaders in the rural parts
of the State. In the past 10 years, 135 rural hospitals have shut down,
including 19 in 2020. I heard the same refrains throughout: that
Medicare reimbursement wasn't adequate, that they needed infrastructure
support, and that they were afraid that one more thing could shut them
down. I have worked with my colleagues, Senators Murkowski and Barrasso
and many others, on legislation to support our rural providers and
public health, often the bedrock of their communities.
Will you commit to working with me on rural health? What can you do
to support rural hospitals and providers to ensure they can recover
more quickly than they did in the last recession?
Answer. I believe it is HHS's role to support programs and advance
policies that promote access to high-quality care in rural and other
underserved areas. If confirmed, I look forward to working with you and
other Members of Congress to advance rural health through the work of
the Health Resources and Services Administration, Centers for Medicare
and Medicaid Services, and other parts of the Department, and to
support efforts that put rural hospitals in a better financial position
to deliver needed care in their communities.
surprise medical billing
Question. In December, Congress passed the No Surprises Act, which
will end the practice of surprise billing. I think this was a major
step to protect patients who were often taken advantage of in their
most vulnerable state. I had been working on that effort for years with
Senators Cassidy and Hassan and others on the committee, and I am
grateful it was signed into law. Now you have the responsibility to
implement the legislation before it goes into effect next year.
Can you highlight your thoughts on surprise billing and your
commitment to implement the legislation over the next year should you
be confirmed?
Answer. This law is important to so many. I want to thank you and
your colleagues for the good work that went into getting this
legislation enacted. If confirmed, I will work to ensure that this
critical legislation is implemented effectively and in a timely manner.
I look forward to working with you and other members of Congress on
this shared goal.
public health jobs
Question. In Colorado, the public health infrastructure has been
underfunded by up to 40 percent. Our national public health
infrastructure has been in a similar place. I believe that this
underinvestment, on top of a total lack of leadership from the previous
administration, is a huge reason why the response in the United States
compared to other countries was so poor. The American Rescue Plan has a
public health jobs program, which looks very similar to the Health
force proposal that I put together with Senator Gillibrand, and would
provide 100,000 public health jobs to do everything from contact
tracing to vaccine administration through and beyond the COVID-19
pandemic. This proposal would create jobs for people in the communities
they serve, which I believe can make a massive difference to help
reduce racial and ethnic disparities, which this pandemic has only
highlighted.
Do you agree that public health workers should come from the local
communities they serve? How can the Public Health Jobs program improve
case in underserved, black, indigenous, and Latino communities?
Answer. I am deeply committed to bolstering the Nation's public
health infrastructure. Like you, I believe that equity must be central
to all aspects of our COVID-19 response and how we prepare for future
public health challenges. It is also important that our health
workforce is representative of the communities they serve. As you know,
the President's American Rescue Plan calls for 100,000 public health
workers who will work in their local communities. The President has
stated that these public health workers will perform critical near-term
tasks, including vaccine outreach and contact tracing, and ultimately
transition into long-term roles in low-income and underserved
communities. If confirmed, I would look forward to the opportunity to
work with you on this program and other initiatives to promote health
equity and strengthen the country's public health workforce.
Question. Will you work to ensure that the formula for the Public
Health Jobs Program funding includes a percentage of funding that would
go directly to local public health agencies and not fully through the
State health agencies?
Answer. If confirmed, I commit to work with you to ensure that
support reaches local public health agencies.
opo regulations
Question. Colorado is consistently among the top performing States
for organ donation in the country: last year, in Colorado, 215 heroic
organ donors saved a record-setting 622 lives. This marked a 45-percent
growth in the last 5 years. New organ procurement organization (OPO)
performance regulations that the Trump administration created were long
awaited to reform the current organ donation and transplantation
system. Unfortunately, the age only adjustment for organs transplanted
metric could unintentionally place the Colorado OPOs in a lower,
inappropriate tier due to the State's young population.
As the Centers for Medicare and Medicaid Services may review and
update the OPO, will you work with me to ensure that such updates take
into account Colorado's unique situation? For example, will you include
a medical adjustment in the metric to take into account health
characteristics that may affect the eligibility for donation, such as
diabetes or hypertension?
Answer. I share your desire to ensure OPOs are held to high, fair
standards using appropriate metrics that account for high-performing
OPOs. If confirmed, I look forward to working with you to increase the
organ supply and hold OPOs accountable for their performance.
equity in policy decisions
Question. Many of the efforts surrounding health equity address
issues among the private sector among the health-care industry, but
often overlook bias among policy-makers and their staff in both the
executive and legislative branches. Your nomination as the first Latino
to lead HHS would be historic and provides you with a unique lens and
prerogative to create lasting change in the agency.
Would you work to use all available tools to hire diverse staff
specifically assigned to reviewing policy and communications (e.g.,
regulations, legislation, technical assistance for legislation,
guidance, press releases, etc.) and, as appropriate, embed policy and
feedback that would help reduce disparities among agencies and the
industries they regulate under your purview?
Answer. I am committed to a diverse workforce within HHS including,
but not limited to, policy and communications staff. I agree with
Office of Personnel Management tenets that workforce diversity benefits
organizations' ability to effectively serve our increasingly diverse
Nation and address disparities. A diverse workforce also can ignite
innovation in policies, programs and processes. If confirmed, I will
champion diversity, equity, and inclusion across HHS.
public health leader safety
Question. Over the past year, public health leaders at local public
health agencies (LPHA) in Colorado and across the country have
experienced a great deal of stress responding to the pandemic,
including threats to their personal lives and families. This has led to
a significant amount of turnover, including 21 LPHA directors in
Colorado alone leaving their posts.
Should you be confirmed, will you work with the Department of
Justice to provide guidance to State, local, territorial, and tribal
governments on how to best support LPHA and other health agency
leaders, including their physical safety?
Answer. If confirmed, I commit to working to address the physical
safety and behavioral health concerns of our Nation's public health
leaders and consulting with the Department of Justice, as appropriate,
on these efforts.
______
Question Submitted by Hon. Michael F. Bennet and Hon. Todd Young
antimicrobial resistance
Question. Antibiotic resistance and the broken antibiotic
marketplace complicate our response to public health emergencies, may
lead to a public health crisis that is worse than the COVID-19
pandemic, and threaten the very foundation of modern medicine. It has
been over 30 years, since the late 80s, since a new class of
antibiotics has entered the market. Small biotech firms are keeping
this industry alive, but in the past few years there have been a number
of casualties and these companies have shuttered. Without better
preparation and investment in novel antibiotics, some have projected up
to 10 million deaths globally per year by 2030 if we don't invest now.
Procedures including cancer chemotherapy, surgery, transplants,
treatments of wounds and burns, and care of medically complex patients
all rely upon safe and effective antibiotics.
We have developed legislation--the PASTEUR Act--to establish a
subscription model for new, critically needed antibiotics. Under
PASTEUR, the Federal Government would enter into contracts with
antibiotic developers to provide set payments for new antibiotics that
are delinked from the volume of antibiotics used. In exchange, they
will provide a reliable supply of antibiotics. The PASTEUR Act would
also provide support for antibiotic stewardship programs in health care
facilities--which are proven to reduce inappropriate antibiotic use and
improve patient outcomes.
Will you commit to working with us on legislation to prepare for
the threat that resistant infections pose, including the PASTEUR Act,
which both incents antibiotic development and supports the appropriate
use of antibiotics?
Answer. It is clear that antimicrobial resistance (AMR) must be a
top public health priority, not only for the United States but around
the world. Even during this time, AMR remains a top CDC priority, and
if confirmed, we will continue investing in key prevention strategies
like early detection and containment, infection prevention, and
ensuring the appropriate use of antibiotics. I agree that it is
important to encourage the industry to develop innovative therapies
that improve health outcomes. I also believe it is important to ensure
access to and appropriate use of crucial therapies such as antibiotics.
If confirmed, I am committed to working with you to achieve these
important goals.
______
Questions Submitted by Hon. Mark R. Warner
medicare diabetes prevention program
Question. According to the Centers for Disease Control and
Prevention (CDC), 88 million Americans--more than 1 in 3--have
prediabetes while another 34 million--just over 1 in 10--have diabetes.
Those rates hold true in my home State where over 631,000 Virginians
suffer from diabetes. Fortunately, there is a proven and innovative
CDC-recognized lifestyle change program to help prevent or delay type 2
diabetes, the National Diabetes Prevention Program (DPP).
In recent years Congress and CMS have recognized the benefits of
this program for Medicare beneficiaries by ensuring patients have
access to DPP. However, despite the increased demand and need for
accessing health care virtually, current CMS rules do not ensure
comprehensive access to virtual DPP. To address this gap, I introduced
bipartisan legislation, the PREVENT DIABETES Act, with Senator Tim
Scott. HHS has temporarily allowed individuals to access the DPP via a
virtual platform during the COVID-19 pandemic, but this administrative
change still excludes a number of providers and does not ensure long-
term access to a virtual benefit. Our legislation will improve access
to the program by ensuring individuals can access the DPP Expanded
Model via virtual suppliers.
As Secretary, will you work with CMS and Congress to ensure the DPP
services can be offered to Medicare beneficiaries via a virtual
platform?
Answer. Innovation is important to advancing the administration's
goals in health care, and the CMS Innovation Center is integral to the
administration's efforts to promote high-value care and encourage
health care provider innovation, including virtual and digital health
innovation. With respect to the Medicare Diabetes Prevention Program
(MDPP) expanded model, I understand that CMS issued regulatory
flexibilities in response to the COVID-19 pandemic, including waiving
the limit on virtual sessions that can be provided by MDPP suppliers.
If confirmed as Secretary, I commit to working with you on this and
other models to reduce health disparities and prevent chronic diseases
such as diabetes.
rural health/area wage index
Question. Over the past decade, well over 100 rural hospitals have
closed, and over the past year, the COVID-19 pandemic has made this
rural health-care crisis significantly worse. It is no coincidence that
the vast majority of these hospital closures have occurred in areas
with the lowest Medicare Area Wage Index rates. To help solve this
problem, I have previously introduced the Save Rural Hospitals Act of
2020 and plan to introduce similar legislation this year.
This legislation that would establish a reasonable national minimum
Medicare Area Wage Index of 0.85, and as a result, would increase
Medicare payments for rural hospitals in 22 States. The previous
administration took several administrative steps to help solve the
numerous problems with the Medicare Area Wage System, but much more
needs to be done.
If confirmed, would you pledge to work with Congress, and take
additional administrative steps as needed, to support rural hospitals
by addressing the problems in the Medicare Area Wage System?
Answer. The Biden administration believes that all Americans should
receive quality health care. Rural hospitals provide critical access to
care in communities that have unique needs and challenges. While many
requirements for Medicare payment to hospitals are defined in statute,
I look forward to working with Congress to help rural hospitals serve
their communities.
health data privacy
Question. I recently worked with Senator Blumenthal, as well as
with Representatives Eshoo, Schakowsky, and Delbene to introduce the
Public Health Emergency Privacy Act, which would set strong and
enforceable privacy and data security rights for health information.
After decades of data misuse, breaches, and privacy intrusions,
Americans are reluctant to trust tech firms to protect their sensitive
health information--according to a recent poll, more than half of
Americans would not use a contact tracing app and similar tools from
Google and Apple over privacy concerns.
Our health privacy laws have not kept pace with what Americans have
come to expect for their sensitive health data; HIPAA was passed by
Congress at a time when heath data looked very different than it does
today. Health data collected by health technology companies, apps, and
other entities--whether for public health emergency purposes or in
general--is not protected in the same way as health data collected by
providers, exposing patients to potential harm.
The previous administration recently released rules that would
further reduce privacy protections and lead to an expanded role for
third party apps and other entities not subject to health privacy laws.
Strong protections created through the patient authorization process
have been eroded, and apps are given the same right to access data as
patients. These rules appear to be moving forward under the new
administration.
Will you commit to curtailing data abuses by third parties who seek
to monetize valuable health data as HHS secretary? How else do you plan
to address this important issue and protect patient privacy?
Answer. As California Attorney General, I held several companies
accountable for legal violations for not protecting patients' health
information. Patients have a legal, enforceable right to request a copy
of and access to their health information under the HIPAA Privacy Rule
and may use a variety of means to do so. As technology has changed, so,
too, have the ways in which that access can be provided. HHS is aware
and sensitive to the importance of protecting patient privacy and
continues to work collaboratively with partner agencies across the
Executive Branch. If confirmed, I look forward to a collaborative
relationship with Congress on this evolving issue.
Question. How will you ensure that companies with documented
privacy lapses and anti- competitive behavior will not benefit from
HHS's efforts to enable third-party access to sensitive and valuable
health data?
Answer. The issue of data privacy and ensuring the security of
valuable health data is constantly evolving. If confirmed, I commit to
working with Congress on this important issue.
telehealth
Question. In recent years, I have worked with a bipartisan group of
Senators to advance common-sense telehealth reform in the Medicare
program. Specifically, our previously introduced and soon-to- be
reintroduced CONNECT for Health Act provides targeted reforms to the
Social Security Act to ensure access to telehealth for Medicare
beneficiaries. Telehealth use and popularity--including among the
Medicare population--has increased significantly during the COVID-19
Public Health Emergency. However, these services will go away with the
PHE. Now more than ever, we must work with the administration to
support policies like those in CONNECT.
What role do you see telehealth playing post-pandemic?
Do you think Congress should restrict access to telehealth after
the end of the PHE based on a patient's geographic or physical
location?
How would you, as Secretary, work to ensure patients have the
choice to access care via telehealth?
Answer. Telehealth is an important tool to improve health equity
and improve access to health care. Health care should be accessible, no
matter where you live. If confirmed, I will look at the telehealth
flexibilities developed for the current public health emergency and
determine how we can build on this work to improve health equity and
improve access to health care.
pre-existing conditions
Question. To date, the COVID-19 pandemic has taken the lives of
more than half a million Americans and infected millions more across
our country. Those who have been infected with the diseases have
suffered with the short-term health implications of the virus, but the
long-term health impacts are still poorly understood. As a result, more
Americans than ever will now have a pre-existing condition.
Junk insurance plans, such as short-term limited-duration plans and
association health plans, are allowed to discriminate against people
with pre-existing conditions, charge them more based on their health
status, and rescind or deny coverage altogether. In the wake of the
pandemic, it is critically important that the administration move
quickly and decisively to limit the availability of substandard
insurance products that undercut the health and well-being of
Americans.
Will you commit to taking immediate action to reign in these
harmful products and if so can you commit to working with me and my
office on this issue?
Answer. Making sure that all Americans have access to quality,
affordable health care is one of the Biden administration's top
priorities. If confirmed, I will examine rules and other policies, to
ensure that plans provide Americans access to the care that they need.
I look forward to working with you and your office on this important
issue.
foster youth
Question. Almost everyone living in the United States has had to
make significant adjustments in the wake of the COVID-19 pandemic, but
it has greatly worsened existing challenges for foster youth across the
Nation. Even before the public health emergency, only about half of
youth aging out of the foster care system each year were anticipated to
have some form of gainful employment by the age of 24. Studies show
that foster youth have and will continue to feel the brunt of the
pandemic's economic impact and the growing digital divide. A survey
conducted by FosterClub found that 65 percent of transition-age foster
youth who were employed before the pandemic lost their jobs by May
2020. According to a report conducted by iFoster, only about 5 percent
of youth in foster care in rural settings and 21 percent of youth in
foster care in urban settings have regular access to a computer. I am
concerned that foster youth will continue to be harmed if changes are
not made to strengthen support and resources. Therefore, I would
appreciate a response to the following questions.
In light of the challenges faced by foster youth during the
pandemic, how would you use your role as HHS Secretary to support
foster youth and ensure they receive the support and resources
necessary to enter the workforce and accomplish their personal and
professional goals?
What specific steps do you plan to take to ensure stability for
foster youth, both in the short-term and long-term, during the pandemic
and its aftermath?
Answer. I share your concern that young people aging out of the
foster care system too often lack access to stable housing, income, and
other resources, and the pandemic has made these challenges even more
pronounced. The Supporting Youth and Families Through the Pandemic Act,
passed as part of the Consolidated Appropriations Act of 2021 contained
critical provisions to prevent youth from aging out of foster care and
to allow voluntary re-entry into foster care. It also contained
expanded flexible funding that States may use to provide direct
financial assistance or housing assistance, or to assist with other
needs, whether that be purchasing food, cell phones and laptops, or
gaining Internet access. It is essential that States reach out to and
listen to the diverse populations of youth with lived experience in the
foster care system to guide their implementation of these provisions
and to lay the groundwork for stronger supports for youth moving
forward. I appreciate your thoughtful leadership on this issue, and, if
confirmed, look forward to working with you on it.
protections for coal workers
Question. As you well know, the U.S. passed a grim milestone last
week: more than 500,000 Americans have died after contracting COVID-19.
Coal miners living with coal workers' pneumoconiosis (black lung
disease) are particularly at risk for suffering severe consequences of
the disease. Many miners receive diagnostic, treatment, and
rehabilitation services at black lung clinics funded through the
Department of Health and Human Services' (HHS) Health Resources and
Services Administration (HRSA). Given that these clinics are under your
authority, I would appreciate your response to the following questions.
Do you believe that further guidance is needed to ensure that
miners' treatment is not compromised during the pandemic and their
needs are best served? If so, what step do you plan to take?
Moving forward, what specific steps do you plan to take, in
coordination with the Department of Labor, to ensure that coal miners
receive the appropriate health screenings, preventive care, and
treatment necessary for their well-being?
Answer. It is important to protect the most vulnerable in our
communities, especially during a global pandemic. If confirmed, I will
work across the Federal Government to ensure all people with chronic
conditions are able to access the health care they need, and I will
support robust oversight of HRSA's black lung clinic program.
______
Questions Submitted by Hon. Sheldon Whitehouse
substance use and opioid use disorder treatment
Question. Access to evidence-based substance use disorder treatment
including medication-assisted treatments (MAT) is limited in the U.S.
due to restrictive Federal laws and regulations. For example, providers
are limited in the number of patients they can see and are required to
obtain an additional ``X waiver'' from the DEA to provide this type of
treatment. In addition, people incarcerated in U.S. jails and prisons
often are denied access to these effective treatments and the rate of
overdose death for individuals who recently have reentered the
community from incarceration is very high. My legislation the TREATS
Act would provide providers with flexibility and improve access to MAT.
Will you work with Congress to eliminate the X waiver and lift the
patient caps that artificially limit how many patients providers can
serve?
Answer. If confirmed, I will work with Congress to expand
availability of and access to substance use disorder prevention,
treatment, and recovery services. There are a number of measures that
HHS can consider implementing. If confirmed, I will work with you
toward these goals.
Question. Will you work with SAMHSA and the DEA to make permanent
the current temporary waivers for methadone and buprenorphine that
enable more stable patients to take home medications (allowing 14-28
days to be taken home) and enable buprenorphine induction to happen via
telehealth?
Answer. I am committed to reducing barriers to medication-assisted
treatment and will work with SAMHSA and the DEA to do so.
behavioral health it
Question. I authored a provision in the SUPPORT Act to create a
CMMI demonstration program that furnishes financial incentives to help
Community Mental Health Centers, psychiatric hospitals and other
behavioral health providers obtain Electronic Health Record systems.
The prior administration did not implement the demonstration, which is
critical to helping mental health and addiction treatment providers
communicate with hospitals, primary care doctors and medical
specialists through Health Information Exchanges (HIEs) and Health
Information Technology (HIT).
Will you commit to exploring ways to generate CMMI funding to
implement this authorized demonstration?
Answer. Innovation is critically important to advancing goals in
health care, and the CMS Innovation Center is integral to the
administration's efforts to improve behavioral health. I know CMS is
always looking for ways to incorporate payment incentives for improved
behavioral health into its models, and if confirmed as Secretary, I
look forward to working with you to find ways to better support our
Nation's mental health and addiction treatment providers.
______
Questions Submitted by Hon. Maggie Hassan
gun purchaser safety education
Question. The Gun Shop Project was started in New Hampshire as a
suicide prevention program that encourages gun stores and firing ranges
to display and distribute suicide prevention materials, as well as
trains gun dealers on how to look for customers who may be in crisis or
at risk for suicide.
Today, more than half of all gun stores in New Hampshire are
disseminating materials about the risk of suicide, and the program has
expanded to more than 21 States. The Gun Shop Project is a proven
example of a successful partnership between gun owner groups and
suicide prevention advocates.
The Federal Government can build on the success of the Gun Shop
Project by providing funding for similar programs. A recent study that
interviewed leaders from State-level and national-level Gun Shop
Projects found that funding was the primary challenge to implementing
these programs.
Do you support funding and support for public awareness campaigns
that provide gun purchasers with safety information about the risks
associated with guns, best practices for responsible gun storage, and
suicide prevention information?
Answer. We certainly should be funding innovative and collaborative
strategies for suicide prevention and reducing gun violence. Providing
gun purchasers with safety information and information on suicide
prevention seems like a commonsense way to help protect Americans, and
if confirmed, I hope to work with you on this issue to keep people
safe.
direct distribution of covid-19 vaccines to health centers
Question. As COVID-19 vaccination continues across the United
States, the data is showing that people of color, people with low
incomes or limited English proficiency, and people in rural areas are
much less likely to get a vaccine. One way to address these disparities
is to rely on the Nation's system of community health centers.
To date, many health centers are completely unable to receive
vaccine allocations. Will you commit to working with States and
providers to ensure that future vaccine distribution plans incorporate
the inclusion of community health centers?
Answer. Yes, if I am confirmed, I will aim to strengthen our
community health center vaccination program to reduce barriers and
increase access to the COVID-19 vaccine for people of color, people
with low incomes or limited English proficiency, and hard-to-reach
communities in rural areas.
grant funding to health centers to support vaccine administration
Question. When health centers have access to COVID-19 vaccines,
they will need financial support to administer the vaccine. Health
centers in my State estimate that it costs around $100 per dose to
administer a vaccine. This reflects the cost of freezers, staff,
supplies, and scheduling work. If confirmed, how will you work to
provide health centers with the funding they need so they can be able
to vaccinate our most vulnerable populations?
Answer. The Biden administration's program to distribute vaccines
directly to community health centers is intended to increase access to
the COVID-19 vaccine. The health centers invited for participation in
the initial phase of the program serve a significant number of
vulnerable populations, including those experiencing homelessness,
migrant/seasonal agricultural workers, residents of public housing,
seniors, and those with limited English proficiency, and include at
least one health center in each State or territory. In order to ensure
that health centers have the support they need to succeed, if
confirmed, I will work with HRSA to ensure each health center that is
part of the program has the ability to participate, readiness to
receive doses, and staff capacity to distribute vaccines.
national suicide hotline
Question. For individuals in a mental health crisis, a law
enforcement response, rather than a mental health response, can lead to
negative outcomes, including jail or death. Last year, Congress
unanimously passed the National Suicide Hotline Designation Act to
provide a national, easy-to-remember 3-digit number, 988, for
individuals in crisis to reach trained counselors 24/7. HHS will play a
vital role in the success of the new, 3-digit dialing code, 988. Should
you be confirmed, how will you work with the Substance Abuse and Mental
Health Services Administration to ensure the public is aware of this
service and improve the outcomes for individuals in crisis?
Answer. If confirmed, I will work closely with the Assistant
Secretary for Mental Health and Substance Use and the Substance Abuse
and Mental Health Services Administration and other Federal partners to
ensure the American people are aware of the availability of 988 once it
becomes universally available across the country. We will work to
improve outcomes for those in a mental health or suicidal crisis, this
includes pursuing improvements in the crisis response infrastructure in
order to reduce unnecessary police involvement. HHS will continue to
work with the FCC, with VA, and with the Office of Emergency Medical
Services in the Department of Transportation to implement 988.
strategic national stockpile
Question. The COVID-19 pandemic has revealed vulnerabilities and
shortfalls within our existing Strategic National Stockpile (SNS).
Since then, the SNS has entered into short-term public-private
partnership contracts to leverage the capabilities of the distribution
industry to ensure a continuously replenishing inventory system. As SNS
continues to reassess and restructure its operations, will you commit
to working with Congress to improve our Nation's preparedness for
future shortages caused by pandemics and other national emergencies?
Answer. Yes, I will work with Congress to improve the SNS in order
to increase our overall readiness for future public health emergencies.
substance misuse
Question. You were among a bipartisan group of Attorneys General
that sent a letter to former FDA Commissioner Hahn requesting an update
on what actions the Food and Drug Administration has taken under the
SUPPORT Act to address the Nation's devastating opioid epidemic, and
what actions are proposed for the future. If confirmed, how will you
work with FDA and SAMHSA to better address the ongoing opioid crisis by
improving efforts around prevention, including improvements to
education and awareness campaigns and access to non-opioid therapies,
and increasing access to medication-assisted treatment?
Answer. The opioid crisis demands a multifaceted approach to
include prevention, intervention, treatment, and recovery support
services. We will continue to fund training, educational resources and
materials for providers, and technical assistance for professional
organizations to support these efforts. And we will explore
opportunities for additional education and awareness activities.
Moreover, we will work with the FDA in their efforts to approve novel
therapeutics and devices for the treatment of opioid use disorder.
perinatal vaccinations
Question. Too many women--particularly women of color--in this
country are dying. Greater attention and efforts are needed to ensure
that women are receiving necessary preventive care during their
pregnancies, including recommended immunizations that not only protect
them but also protect their babies from vaccine preventable illness.
Senator Cassidy and I have introduced bipartisan legislation to
help ensure that pregnant women have access to these vital services. If
confirmed, will you work with us to improve maternal access to care and
preventive services such as immunizations?
Answer. Thank you for your leadership on this important issue. If
confirmed, I look forward to working with you and Senator Cassidy and
others to improve maternal health in our country, including access to
preventive services like immunizations and other recommended care.
access to items and services for vulnerable populations
Question. HHS and CMS have significant regulatory authority to
ensure that vulnerable populations have access to items and services.
This is particularly true during the pandemic, in rural an underserved
areas where individuals struggle to access care. What steps will you
take to ensure that seniors and individuals experiencing disabilities
are able to access health-care services and essential equipment,
particularly in rural areas?
Answer. Individuals dually eligible for Medicare and Medicaid,
including seniors and people experiencing disabilities, are some of the
most vulnerable Americans. Many of these individuals have complex
health care needs with multiple chronic conditions. Medicare and
Medicaid provide indispensable access to care for this vulnerable
population. These programs have kept many families from losing hope,
particularly in rural parts of the country. If confirmed,
I am prepared to work with you and your colleagues in Congress to
strengthen these valuable programs and ensure vulnerable populations
have access to the quality, affordable health care that they need.
______
Questions Submitted by Hon. Elizabeth Warren
otc hearing aids
Question. In 2017, President Trump signed into law the Over-the-
Counter Hearing Aid Act, a bill that I introduced with Senator
Grassley, Senator Hassan, and Senator Isakson. The bill requires the
FDA to categorize certain hearing aids as over the counter (OTC). Under
law, the FDA was required to issue regulations regarding OTC hearing
aid safety and manufacturing by August 18, 2020--but the agency failed
to issue the rules on time. As HHS Secretary, will you commit to
ensuring that the FDA releases these statutorily required regulations
as soon as possible?
Answer. Thank you for your leadership on this issue. I commit that,
if confirmed, I will support FDA in its work to ensure availability of
over-the-counter hearing aids. I recognize this as a public health
priority as hearing loss can have a negative effect on communication,
relationships, and other important aspects of life.
drug pricing authorities
Question. The Federal Government has the power to step in and
rectify the market failures that have allowed drug prices to skyrocket.
Using its compulsory licensing authority, the Federal Government can
use patented products without the permission of the patent holder.
Codified at 28 U.S.C. Sec. 1498, this authority allows the government
to ``manufacture, import, and use'' products protected by active
patents, as long as it provides patent holders with ``reasonable and
entire compensation for such use and manufacture.'' Meanwhile, using
the march-in rights established under the Bayh-Dole Act, the Federal
Government can require the re-licensing of certain patents. Bayh-Dole
gives Federal contractors the right to exclusively manufacture and sell
products developed with Federal support. However, Bayh-Dole allowed the
Federal Government to retain ``nonexclusive, nontransferable,
irrevocable, paid-up'' licenses for products developed with government
funds. In certain cases, such as when health or safety needs have not
been reasonably satisfied by the original licensee, the Federal
Government can ``march-in'' and direct other licensees to produce
products. As HHS Secretary, will you commit to conducting a review of
the Department's pre-existing executive authorities to determine how
they can be used to lower the prices of critical drugs--like insulin
and naloxone--that millions of Americans rely on?
Answer. If I am fortunate to be confirmed, we will conduct a
thorough review to identify and analyze the tools at our disposal to
reduce the price of drugs and make treatments more affordable for the
American people. President Biden has been clear that reducing costs is
a top priority for this administration.
nursing homes and private equity firms
Question. The National Bureau of Economic Research recently
released a study showing that private equity (PE) ownership of nursing
homes ``increases the short-term mortality of Medicare patients by 10
percent, implying 20,150 lives lost due to PE ownership over [a] 12-
year sample period.'' Meanwhile, PE-owned nursing homes also saw
``declines in other measures of patient well-being, such as lower
mobility, while taxpayer spending per patient episode increases by 11
percent.'' As HHS Secretary, will you commit to working with me and my
colleagues to review, reduce, and mitigate the negative impacts of
private equity ownership of health-care facilities, including but not
limited to nursing homes?
Answer. I agree that we must ensure nursing homes provide high-
quality care to their residents. Nursing homes' first obligation should
be to their patients, no matter what kind of ownership arrangements
they have, and nursing homes participating in Medicare and Medicaid
programs should meet required Federal health and safety standards. If
confirmed, I am committed to working with you and your colleagues to
ensure nursing homes provide high-quality care to their residents.
assisted living facilities and congregate care settings
Question. Congregate settings like nursing homes, assisted living
facilities, and prisons and jails have been epicenters of the COVID-19
pandemic since the virus began to spread. My oversight has revealed the
extent of these problems, and the gaps that are making outbreaks in
these facilities so frequent and so severe. Assisted living facilities,
for example, have high rates of COVID-19 infections, hospitalizations,
and deaths, but report limited COVID-19 data when compared to more
heavily regulated nursing homes. Meanwhile, Federal correctional
facilities and State and local prisons and jails are not required to
report sufficient demographic data to adequately track the spread of
COVID-19, and behavioral health facilities have limited resources to
prevent outbreaks. As HHS Secretary, will you commit to expanding
COVID-19 demographic data collection at congregate care facilities,
including but not limited to assisted living facilities, residential
behavioral health facilities, and correctional facilities? After the
pandemic subsides, will you commit to examining the regulations that
currently apply to congregate care facilities to determine if more
routine data collection and standards could improve patient safety?
Answer. If confirmed, I am committed to expanding the scope of data
collection in congregate settings, such as assisted living facilities
and correctional facilities, in order to better track demographic and
other relevant trends associated with the spread of COVID-19. If
confirmed, I will work with various HHS agencies, including the CDC, as
well as States, tribal, local, and territorial partners on ways to
improve data collection and the quality of data in such settings.
supply chain
Question. The United States is heavily dependent on foreign sources
of pharmaceutical products such as active pharmaceutical ingredients
(API) and their raw materials. Only 28 percent of facilities
manufacturing APIs used in drugs and 47 percent of facilities
manufacturing finished dosage forms of drugs for the U.S. market are
located in the United States. The COVID-19 pandemic revealed the extent
and the dangers of this overreliance, as materials needed for
diagnostic testing, PPE, and other pharmaceutical products have been in
chronically short supply, marring the Nation's response to the
pandemic. An interruption to the supply of APIs and other
pharmaceutical products could have severe public health and national
security implications, and there is an urgent need for the Biden
administration to take action. As HHS Secretary, what steps will you
take to address this overreliance?
How will you work alongside other Federal agencies like the
Department of Defense, the Food and Drug Administration, and other drug
procuring agencies to create a unified Federal response to this
overreliance?
Answer. The global pandemic has highlighted the vulnerabilities of
the global supply chain for many products. I am aware that BARDA has
invested in and is working to expand pharmaceutical manufacturing in
the United States for use in producing medicines needed during the
COVID-19 response and future public health emergencies. This work will
expand domestic manufacturing of raw materials and active
pharmaceutical ingredients for drugs. If confirmed, I will continue to
support ongoing efforts in this area, as well as support the
department's work with the FDA and other Federal agencies to expand
domestic capacity for supplies needed in the ongoing COVID-19 response.
medication abortion
Answer. Last year, you led 21 Democratic Attorneys General in a
letter to then-HHS Secretary Alex Azar and FDA Commissioner Stephen
Hahn, urging them to waive the Risk Evaluation and Mitigation Strategy
(REMS), or use FDA enforcement discretion, to allow certified
prescribers to use telehealth for Mifepristone, the prescription drug
used to provide medication abortion care. As you noted in your letter,
the REMS requirements on mifepristone create unnecessary delays for
women who need access to time-sensitive health care and force them to
travel unnecessarily during the COVID-19 public health emergency.
Furthermore, your letter noted that mifepristone is extremely safe and
effective. Mifepristone was approved by the FDA over 20 years ago and
about 3 million women in the United States have used the drug. On April
14, 2020, Senators Murray, Baldwin, and I sent a similar letter to
then-Commissioner Hahn regarding the REMS imposed on mifepristone by
the FDA and our concerns that FDA is not following the science by
allowing these restrictions to remain in place. However, we have not
received a written response or staff briefing from FDA, which we
requested. Can you commit that the FDA will respond to our request
within 30 days and will clarify what scientific evidence the FDA is
currently using to justify that the REMS for mifepristone remains in
place?
Answer. Thank you for raising this important issue. I strongly
believe women should not be put through unnecessary hurdles to receive
access to health care. Further, I believe FDA should be empowered to
make regulatory decisions based on the available science. If confirmed,
it would be a priority to make sure the Congress is provided
information when requested.
title x
Question. The Title X Family Planning Program (the title X program)
is the only Federal program dedicated to providing family planning
services to people with low incomes. In 2016, title X supported nearly
4,000 health centers providing basic primary and preventive health-care
services--including contraception, Pap tests, breast exams, and STI and
HIV testing--to more than 4 million Americans. But in 2019, the Trump
administration finalized a rule that gutted the title X program,
causing family planning providers in 34 States to leave the program and
at least 1.5 million people to lose access to care. On January 28,
2021, President Biden issued a Presidential Memorandum on Protecting
Women's Health at Home and Abroad, which directed HHS to ``consider, as
soon as practicable, whether to suspend, revise or rescind, or publish
for notice and comment proposed rules, suspending, revising, or
rescinding those regulations, consistent with applicable law, including
the Administrative Procedure Act.'' I believe this review will make
clear the numerous harms patients and community health faced as a
result of the rule. For example, in Massachusetts, only one title X
grantee remains in the State. Will you commit to complete the review of
the title X rule, as directed by President Biden, no later than March
29, 60 days after the president issued the presidential memorandum?
Answer. If confirmed, it will be a priority to review the title X
regulation as quickly as possible.
child care assistance
Question. The COVID-19 pandemic has severely damaged the child care
sector, with many providers struggling to keep their doors open and
parents missing work or leaving the workforce altogether because of the
lack of affordable care. Even before the pandemic, quality, affordable
child care was much too difficult to find, despite extensive research
showing that Federal investment in child care and early childhood
education pays off in increased earnings for families, higher levels of
parental employment, and improved health development of children. The
Child Care and Development Fund is the primary source of Federal
funding dedicated to helping low-income families afford child care. Yet
national figures show that five out of six children who are eligible
for help and who need that help aren't receiving a subsidy. According
to a GAO report, many States manage demand by setting their eligibility
limits very low, preventing many families from being able to
participate. In administering the supplemental funds provided under the
Child Care Development Block Grant (CCDBG) and other child care
programs for COVID-19 relief, how will you promote the stabilizing the
child care sector and sharing best practices between States?
Answer. The COVID-19 pandemic has highlighted the many gaps in
child care in this country. Important investments have been made, but
even with these efforts, additional investments are necessary to
stabilize the child care sector, which is why the Biden administration
has proposed additional funding for CCDBG as well as new child care
stabilization grants for child care providers. If confirmed, I look
forward to working with you on these efforts and appreciate your
leadership on this important issue.
______
Questions Submitted by Hon. Mike Crapo
covid-19 pandemic
Question. I appreciate your comments throughout the nomination
process regarding the importance of good data and following science in
making decisions. As we approach the first anniversary of the COVID-19
pandemic lockdowns, many Americans are wondering how long they will
have to endure the restrictions fighting the pandemic has required.
How long do you anticipate that the COVID-19 Public Health
Emergency will last, and what specific criteria would you and the other
advisors to President Biden use to assess an appropriate public health
response?
Answer. Americans' frustrations and exhaustion with this pandemic
are understandable. We all want to get back to our lives, see our
friends and families, be able to visit loved ones or go to work or
school without fear of contracting or spreading the virus. We need to
approach this crisis with urgency, and if we all do our part, we can
finally end this pandemic. If confirmed, I would work closely with the
medical doctors, scientists, and other public health experts at HHS to
make determinations about the Public Health Emergency and would utilize
the criteria set forth by experts to ensure that HHS's response to the
pandemic is driven by the science and relies on the most recent data
available, such as infection and mortality rates.
Question. How does the HHS Secretary fit into the larger Biden
administration COVID-19 response team structure?
Answer. As the head of the Department tasked with executing so much
of the Federal Government's public health response to the pandemic, if
confirmed as the HHS Secretary, I would lead the HHS COVID-19 response
efforts--everything from ASPR's efforts to expand testing and
diagnostics, to OASH's deployment of vaccinators and ongoing minority
outreach efforts, to the development, procurement, and distribution of
the vaccines--and work in close collaboration with the White House
COVID-19 Coordinator and the White House COVID-19 Response Team. This
is a whole-of-government effort, and if confirmed I am committed to
ensuring HHS is leading the implementation of President Biden's
national strategy and executing the programs that deliver Americans the
aid they need.
Question. What have you learned from your experience with the
California COVID-19 response, and how would you apply those lessons if
you are confirmed as HHS Secretary?
Answer. This has been a dynamic and evolving virus, which has posed
constant challenges for the American people. In my State, I took action
as Attorney General early in the pandemic to keep Californians safe. I
used my authority to protect workers from exposure to COVID-19, secure
key safeguards for front-line health-care workers' rights, take on
fraudsters trying to take advantage of people during the pandemic, and
stand up for homeowners trying to make their mortgage payments during
the downturn. I also worked with a Republican colleague from Louisiana,
Attorney General Jeff Landry, to try to make COVID-19 treatments more
available for the American people. I have seen the importance of
working together--with urgency--to tackle this crisis, with the
constant goal of protecting Americans.
Question. Congressional Democrats are moving swiftly to use budget
reconciliation to advance President Biden's $1.9 trillion COVID-19
response plan. The planned increase in spending through reconciliation
would trigger automatic spending reductions to Medicare and other
programs.
Considering that bipartisan support is needed for Congress to waive
its budget rule to prevent those reductions, would it be more prudent
for the administration to work with Congress to negotiate another
bipartisan COVID-19 relief bill?
Answer. I agree that we must work together to tackle this crisis.
This pandemic is a threat to us all, and we have to find common ground
to get the American people the help they need. Urgency is critical: the
public needs help and they need it now. President Biden has been very
clear that he agrees and believes bipartisan agreement on this front is
achievable. If I am confirmed, I will commit to working with you to
both address this crisis and strengthen our health care lifelines like
Medicare.
Question. During the COVID-19 Public Health Emergency, HHS has
provided flexibility to providers to better furnish care to patients,
including through telehealth and access to innovative treatments. As we
begin to consider the end of the pandemic, we must carefully evaluate
our response to the pandemic, and implement appropriate reforms based
on the data and lessons learned.
Which policies do you believe have been most successful for
patients and providers, and how would you work with Congress to make
appropriate improvements to our Federal health-care programs?
Answer. Telehealth is an important tool to improve health equity
and improve access to health care. Health care should be accessible, no
matter where you live. If confirmed, I will look at the telehealth
flexibilities developed for the current public health emergency and
determine how we can build on this work to improve health equity and
improve access to health care.
Question. It was reported on February 14, 2021 that Vice President
Harris said, with respect to COVID-19 vaccinations and the state of
preparedness when the Biden administration began, that ``there was no
stockpile . . . of vaccines; there was not a national strategy or plan
for vaccinations. We were leaving it to the States and local leaders to
try and figure it out. And so, in many ways we're starting from scratch
on something that's been raging for almost an entire year.'' Earlier,
in a January 21, 2021 White House press briefing, medical adviser Dr.
Anthony Fauci said during a White House press briefing that, ``We
certainly are not starting from scratch because there is activity going
on in the distribution.'' Do you believe that Vice President Harris's
characterization that in many ways the Biden administration was
starting from scratch and there was not a national strategy or plan for
vaccinations, or Dr. Fauci's characterization that the Biden
administration was certainly not starting from scratch?
Answer. If I am fortunate to be confirmed, I promise I will work
with you and your colleagues in the Senate, as well as my colleagues in
the administration, to ensure our plans for addressing this crisis are
collaborative and meet the needs of the moment. It is no secret that
this crisis has carried on for far too long, in no small part because
of deficiencies in our earlier Federal response efforts, and as HHS
Secretary, I would work to strengthen our efforts to increase
vaccinations, expand testing, and ensure that there is a clear, strong,
and well-executed Federal plan to tackle COVID-19.
medicare
Medicare Hospital Insurance Trust Fund Insolvency
Question. The most recent Medicare trustees report projected that
the Hospital Insurance (HI) trust fund would be officially bankrupt in
2026, at which time it would no longer be able to pay full benefits for
our Nation's seniors and the disabled. That report failed to include
any analysis showing the fiscal impact of the COVID-19 pandemic on the
trust fund. Earlier this month, the Congressional Budget Office (CBO)
released its updated winter baseline. The new baseline takes into
account increased tax revenue due to a stronger economic forecast.
While CBO now also predicts that the HI trust fund will be insolvent in
2026, there is substantial uncertainty behind their projections. Given
recent Medicare spending trends, it seems unlikely that the trust fund
could remain solvent through 2025.
Will you commit, if you are confirmed, to immediately direct the
Centers for Medicare and Medicaid Services (CMS) Chief Actuary to
provide an update to me, in writing, that shows the current status of
the Medicare HI insolvency date that takes into account the fiscal
impact of the COVID-19 pandemic?
Answer. If confirmed as Secretary, I can commit to you that we will
work with you to give you and this committee the information you need
to make the right decisions with respect to Medicare.
Question. Congress has historically looked to reform and adjust
Medicare payments to providers in order to extend the life of the HI
trust fund. However, the last time Congress enacted significant
Medicare savings the money was used to finance spending on the 2010
health-care law.
As a member of the House, you voted for the law that raided over
$700 billion from a financially strapped Medicare program and spent it.
Now, a decade later, those savings are not available to protect
Medicare. What policies do you now think Congress should consider to
extend the life of the HI trust fund?
Answer. If confirmed, my team and I will be ready to sit down with
you and other members of Congress to discuss both short- and long-term
solutions to guarantee Medicare's future.
Question. Medicare is on a near-term path toward bankruptcy. The HI
trust fund could be insolvent in anywhere from 4 to 5 years. Other than
during the first few years of the Medicare program's existence,
Congress has never allowed the HI trust fund to project less than 4
years of solvency without acting in order to minimize the impact on
beneficiaries, health-care providers, and taxpayers.
Given the looming fiscal crisis, how soon would you provide a
comprehensive legislative proposal that extends the life of the HI
trust fund?
Answer. If confirmed, my team and I will be ready to sit down with
you to discuss short and long-term solutions to guarantee Medicare's
future.
prescription drugs
Question. Modernizing the successful Medicare Part D program has
been a feature of numerous recent proposals to address prescription
drug issues from Republicans and Democrats, including a comprehensive
bill that I introduced last Congress. The different proposals involve
many of the same common elements, such as improving incentives to
increase competition and establishing a cap on patient out-of-pocket
spending. Making these improvements to a program that serves over 45
million beneficiaries would be a momentous, bipartisan accomplishment.
Some, however, have suggested that Part D modernization is insufficient
and that it should not happen without other major changes. While other
changes may be worthy of debate, there have been few major reforms that
have broad bipartisan support. Would you oppose legislating a Part D
modernization that includes a first-time patient out-of-pocket cap on
spending as a stand-alone policy?
Answer. If I am fortunate to be confirmed, we will conduct a
thorough review to identify and analyze the tools at our disposal to
reduce the price of drugs and make treatments more affordable for the
American people. President Biden has been clear that reducing costs is
a top priority for this administration, and I hope we can work together
on finding solutions.
Question. You have consistently advocated for the Federal
Government to negotiate prescription drug prices in Medicare Part D. If
confirmed as Secretary, you would be the one in charge of negotiating
those prices. Barring some type of artificial price ceiling, the
Congressional Budget Office has consistently maintained that the
Federal Government would not be able to secure lower prices than those
established through negotiation between private entities, unless the
government used a national drug formulary list. Are you prepared to
determine which prescription drugs over 45 million beneficiaries can
access, knowing this would inherently involve denying medications that
physicians prescribe as the best course of treatment for patients?
Answer. If I am fortunate to be confirmed, we will conduct a
thorough review to identify and analyze the tools at our disposal to
reduce the price of drugs and make treatments more affordable and
accessible for the American people. President Biden has been clear that
reducing costs is a top priority for this administration, and I hope we
can work together on finding solution.
Question. There is broad concern that establishing Medicare (or
other) prescription drug payment amounts using foreign reference prices
will harm patient access and stifle innovation. Do you support the use
of foreign reference prices in Medicare? Do you view the use of a
foreign reference price to set payment amounts as price setting or a
form of negotiation?
Answer. If I am fortunate to be confirmed, we will conduct a
thorough review to identify and analyze the tools at our disposal to
reduce the price of drugs and make treatments more affordable and
accessible for the American people. President Biden has been clear that
reducing costs is a top priority for this administration, and I hope we
can work together on finding solution.
other
Question. You have highlighted the settlement you secured with a
large California hospital system related to the charge that it acquired
hospitals and physician practices to unfairly increase market power and
increase costs for consumers. The Medicare Payment Advisory Commission
and other experts have determined that Medicare payment systems
incentivize provider consolidation. Do you believe that some Medicare
payment policies incent consolidation and increase costs for
beneficiaries and the program?
Answer. Thank you for this question. This has been a significant
focus of my tenure as Attorney General, and if I am confirmed, I will
continue to focus on preventing consolidation that increases prices on
consumers and patients. Like President Biden, I believe that all
Americans should be able to access affordable health care, and part of
that is identifying solutions to hospital over-consolidation. I hope I
have the opportunity to work with you to tackle this issue and pursue
solutions that strengthen our Federal programs and protect patients and
consumers.
Question. You have highlighted that you authored Medicare
provisions included in the Affordable Care Act. Can you describe those
policies and note those of which you are most proud?
Answer. As a member of the Ways and Means Committee for 2 decades,
I have a lot of experience on Medicare legislation. I introduced
legislation--the Medicare Savings Programs Improvement Act of 2007--
that expanded cost-sharing subsidies for low-income seniors who receive
both Medicare and Medicaid benefits by increasing the amount of
resources they could receive. Several of these provisions were included
in the Medicare Improvements for Patients and Providers Act of 2008 and
the Medicare Access and CHIP Reauthorization Act of 2015. I also
championed provisions of the Medicare Improvements for Patients and
Providers Act of 2008 that required physicians who perform imaging to
be accredited and trained to ensure patient safety. I introduced
legislation in 2007 to raise the cap on the benefits of patients
receiving Medicare physical therapy, as well as the E-Centives Act of
2009, which provided incentives for Medicaid providers to implement
electronic health records. A version of this legislation was included
in the American Recovery and Reinvestment Act of 2009. I introduced the
Medical Anesthesiology Teaching Funding Restoration Act of 2007 to
improve anesthesiologists' teaching payments, and it passed in 2008. I
helped draft the Improving Medicare Post-Acute Care Transformation Act
(IMPACT) of 2014, requiring the HHS Secretary to conduct research on
the social determinants of health in Medicare's value-based programs,
so we could use good data to improve outcomes and save costs. And as
you mentioned, I worked on the Affordable Care Act which strengthened
Medicare and lowered costs for seniors. As a member of the Ways and
Means Committee and House leadership, I led successful discussions on
the design of the health-care exchanges and Medicare reimbursement
payments. The ACA added years of solvency to the Medicare Trust Funds,
closed the prescription drug ``donut hole,'' and provided free
preventive care to all Medicare beneficiaries. I am proud of all this
work to protect and strengthen health care for our seniors.
Question. The Affordable Care Act established the Center for
Medicare and Medicaid Innovation (CMMI). There is significant
bipartisan support for testing different ways to pay for services to
figure out how patients can get better care at a lower cost. However,
there is concern that Congress ceded too much authority to the
executive branch by allowing CMMI to override statute, especially in
Medicare, in the name of a payment change ``test.''
What are your views on the appropriate use of CMMI authority?
If confirmed, will you commit to ensuring that CMS would not use
CMMI to avoid working with Congress?
Considering that many CMMI tests have run for an extended period of
time without meeting the criteria for expansion, is there a length of
time sufficient to determine if a model works?
With CMMI having a large budget of $10 billion for each decade and
little accountability to Congress, what metrics would you use to
determine whether CMMI is successful?
Answer. Innovation is critically important to advancing goals in
health care. The CMS Innovation Center is integral to the
administration's efforts to promote high-value care and encourage
health care provider innovation. If confirmed as Secretary, I can
commit to you that we will be wise stewards of CMMI funds and follow
the evidence generated by Innovation Center models.
Question. HHS finalized a number of rules toward the end of the
President Trump's term that the Biden administration is reviewing.
While this is a routine practice for incoming administrations, have you
identified which rules you would continue, modify, orwithdraw? Please
respond specifically on:
Most Favored Nation (MFN) Model (Interim Final Rule with Comment
Period); and
Fraud and Abuse: Removal of Safe Harbor Protection for Rebates
Involving Prescription Pharmaceuticals and Creation of New Safe Harbor
Protection for Certain Point-of-Sale Reductions in Price on
Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager
Service Fees.
Answer. If I am fortunate to be confirmed, we will conduct a
thorough review to identify and analyze the tools at our disposal to
reduce the price of drugs and make treatments more affordable and
accessible for the American people. President Biden has been clear that
reducing costs is a top priority for this administration, and I hope we
are able to work together on these issues.
Question. If confirmed, you would be integral to determining what
goes into President Biden's budget submissions to Congress. Prior
administrations of both parties have proposed specific policy changes
that aim to improve Medicare, with many of those policies reducing
baseline Medicare spending. Democrats characterized Trump
administration budget policies that would make payment system changes
that bring efficiencies and reduce Medicare spending as ``cuts'' (even
when the identical policy had been proposed by the Obama
administration). Do you view any budget policy proposal that reduces
Medicare spending as a Medicare ``cut''?
Answer. I believe that we must protect Medicare beneficiaries,
being careful stewards of taxpayer dollars and the Medicare Trust
Funds. I look forward to working with Congress to consider policies
that would lower costs for seniors, and also enhance our ability to
reduce waste, fraud, and abuse in these vital programs.
Question. There are concerns that the inclusion of calcimimetic
medications in the Medicare End Stage Renal Disease (ESRD) bundled
payment rate may harm beneficiaries' access to these treatments. There
are anecdotal reports that some patients have had to change or
otherwise stop using a medicine that has worked for them in response to
this payment policy change. How would you ensure that ESRD patients
have access to calcimimetic treatments and monitor patient outcomes in
this area?
Answer. I agree that is it important for Medicare beneficiaries,
particularly vulnerable groups such as those beneficiaries with ESRD,
to have access to medically necessary treatments such as calcimimetics.
If confirmed, I will work to ensure that Medicare beneficiaries
continue to have access to these treatments and that patient outcomes
are not compromised.
Question. Numerous press reports indicate that the Department of
Justice and the Federal Bureau of Investigation, in conjunction with
the U.S. Attorney's Office, have opened an investigation into the
allegations that New York Governor Andrew Cuomo and his administration
took actions that exacerbated the COVID-19 crisis in nursing home
facilities, allegedly leading to increased fatalities. Will you commit
to, if confirmed, fully cooperate with any investigation that examines
whether the State of New York, Governor Cuomo himself, Governor Cuomo's
staff, or the Cuomo Coronavirus Task Force obstructed justice or
violated Federal guidance by pressuring nursing home facilities to
accept patients who tested positive for COVID-19?
Answer. I am deeply committed to protecting our most vulnerable
Americans by addressing the disproportionate impact of COVID-19 on our
seniors and nursing home residents, but if I am fortunate enough to be
confirmed, I will not have any role in the Department of Justice or
Federal Bureau of Investigation decision making with respect to this
matter. At HHS, we will follow the law and carry out our mission to
protect people's health care.
private insurance
Question. How would President Biden's proposal to lower the
Medicare eligibility age affect Medicare's already precarious financial
situation and would such a plan require raising taxes?
Answer. President Biden has proposed to allow Americans to enroll
in Medicare at an earlier age using general revenue, not the Medicare
trust funds. At the same time, this administration knows the importance
of lengthening the solvency of the HI trust fund because Medicare's
current beneficiaries depend on it. I am committed to working with you
and your colleagues on solutions both to extend the life of the
Medicare HI trust fund and to expand health-care coverage.
Question. Idaho has proposed or implemented several reforms in an
attempt to diversify private insurance options so that consumers can
choose a plan that best fits their needs and their budget. Several
years ago, Idaho sought to combine Medicaid and private market
innovation waivers to better coordinate insurance options and lower
patient costs. Unfortunately, this approach was rejected because of
overly stringent statutory and regulatory requirements. Meanwhile,
Idaho insurers have started offering renewable short-term, limited
duration plans, which are less expensive than those offered on the
exchange.
I strongly support the right of States, as the primary regulators
of the individual market, to adopt innovative solutions that benefit
consumers. How do you view HHS's role in the individual market, and
what reforms would you propose that could impact the types of plans
offered to consumers?
Answer. Making sure that all Americans have access to quality,
affordable health care is one of the Biden administration's top
priorities. If confirmed as Secretary of HHS, I will work to identify
opportunities that ensure all Americans can access the care that they
need and look forward to working with States to help improve health
care for their residents.
Question. As States invest in their health systems and public heath
infrastructure, many could choose to address coverage gaps or
alternative coverage options through Affordable Care Act section 1332
waivers. Would you support States using these waivers to increase
coverage in innovative ways of their own choosing? Are there policies
that you consider inappropriate for a waiver?
Answer. I support innovative approaches to make sure that all
Americans have access to quality, affordable health care, and I believe
section 1332 waivers can be one tool States can use to achieve such
results. If confirmed as Secretary, I look forward to working with
States to help improve health care for their residents.
Question. Do you support the use of existing enforcement mechanisms
for Affordable Care Act subsidies? Should the Federal Government claw
back funds if audits of an individual's income show that the individual
is not eligible for the subsidy?
Answer. The Affordable Care Act gives millions of Americans access
to quality, affordable health coverage. If confirmed, it will be my job
to ensure that we are following and enforcing applicable laws and
regulations.
waste, fraud, and abuse
Question. Careful stewardship of public resources is essential,
both to maintaining our citizens' trust in their government, and to
ensuring that government programs are effective. HHS is an enormous
entity and prudent management of its agencies will require close
scrutiny from its leadership. However, the loss of California's Federal
pandemic funding to fraudsters over the past year suggests that this
careful scrutiny has not been a priority to you as Attorney General.
What initiatives would you undertake to ensure careful stewardship
of the
trillion-plus dollars in annual spending that HHS oversees, ensuring
that each dollar is spent consistently with the law and the intent of
Congress?
Answer. At the California Department of Justice, our team has
cracked down on Medicare and Medicaid fraud to protect these lifelines,
recovering almost $1 billion in just the last 3 years from defendants
that defrauded California's State's Medicaid program with false claims
for payment, and in 2020, we expanded the Bureau of Medi-Cal Fraud and
Elder Abuse to its own division so we could better investigate and
prosecute fraud. This has been a priority for me as Attorney General
because it is critical we are being good stewards of taxpayer dollars
and making sure our health programs are efficient. If I am confirmed as
HHS Secretary, I would continue this focus and would like to work with
you and the Congress to ensure strong oversight of Federal programs and
continue a bipartisan focus on reducing waste, fraud, and abuse.
Question. On November 30, 2020, then chairman of the Finance
Committee Chuck Grassley sent a letter to the Office of the Inspector
General of the Department of Labor seeking an investigation into
California's Employment Development Department (EDD), with particular
attention to fraud and the EDD's practice of mailing documents that
contain individuals' social security numbers.
A November 23, 2020 letter to California Governor Gavin Newsom,
with you as a carbon-copied recipient, from District Attorneys from
various areas of the State who were on the California District
Attorney's Statewide EDD Fraud Task Force requested a personal meeting
and request for State officials to become involved in ``halting what
appears to be the most significant fraud on taxpayer funds in
California history.''
A December 3, 2020 Los Angeles Times article on the ``tsunami'' of
prison unemployment fraud in California, which the article identified
was fueling street crime, reported that ``multiple District Attorneys
interviewed by the Times said they are frustrated that State officials,
including State Attorney General Xavier Becerra, have not taken
leadership in what some have described as the biggest taxpayer fraud in
California history.''
A January 28, 2021 Los Angeles Times article identified that State
officials in California have ``confirmed more than $11 billion in
fraud, and are investigating $19 billion in other, suspicious claims
for potential fraud.'' The magnitude of fraud in largely federally
financed unemployment programs in California--upward of $30 billiona of
fraudulent or suspicious payments and claims--is staggering, the
largest fraud in California history, and widely reported for quite some
time.
Despite all of this, since warning signals were sounded in at least
late November of last year, a scan of the California Attorney General's
press releases does not appear to identify any response to multiple
calls for State officials to get involved in battling fraud. Instead,
during the period November 23, 2020 through February 25, 2021, there
were at least 25 press releases directed at political activities by
your office against the Trump administration.
Oversight and protection of Federal taxpayer resources is a
responsibility of Federal Government officials, including the
Department of Health and Human Services (HHS). Any Secretary of HHS,
which is responsible for an enormous amount of payments of Federal
taxpayer resources, must take fraud seriously and devote requisite
resources to battle fraudsters. Money intended for unemployment
insurance payments, or payments from HHS, that ends up in pockets of
fraudsters is money that does not go to those truly in need.
Given that you were warned about unemployment insurance fraud, and
asked to respond, at least by the end of November last year, please
explain:
When were you first asked to respond to California's massive
unemployment fraud?
Why multiple District Attorneys interviewed by The Los Angeles
Times in late November or early December of last year reportedly
identified their frustration over lack of action by State officials
regarding unemployment compensation fraud and their assessment that you
had ``not taken leadership'' in the face of the biggest taxpayer fraud
in California's history?
What actions did you take, and when, to combat unemployment
compensation fraud in California (and please provide supporting
documentation)?
How many full-time equivalent hours of work in the California
Attorney General's office were devoted to battling unemployment fraud
relative to hours devoted to activities to battle the Trump
administration during the period between November 23, 2020 and February
25, 2021?
Answer. At the California Department of Justice, we have made
combating fraud a serious priority. When the Department has been given
primary authority combating fraud such as in the Medicare and Medicaid
program, we have cracked down on this fraud to protect these lifelines,
recovering almost $1 billion in just the last 3 years from defendants
that defrauded California's State's Medicaid program with false claims
for payment, and in 2020, we expanded the Bureau of Medi-Cal Fraud and
Elder Abuse to its own division so we could better investigate and
prosecute fraud. In regard to other programs, the California Department
of Justice provides support to investigators in departments like the
California Employment Development Department investigators when
requested. In investigations where the California Department of Justice
has found fraud in any public benefits program, we primarily refer
those cases to District Attorneys who carry out the vast majority of
criminal prosecutions in California. If I am confirmed as HHS
Secretary, I would continue this focus and would like to work with you
and the Congress to ensure strong oversight of Federal programs and
continue a bipartisan focus on reducing waste, fraud, and abuse.
medicaid
Question. What would be your top Medicaid priorities?
Answer. The President has made clear his commitment to protecting
and strengthening Medicaid so that this critical program can continue
to provide life-saving access to care for millions of Americans.
Medicaid will also continue to play an essential role in the Biden
administration's response to the COVID-19 pandemic. If confirmed, I
will work to ensure that people have access to quality and affordable
care, and to ensure that Medicaid makes progress on addressing the
major health-care challenges facing our country, including maternal
health.
Question. Data infrastructure in State Medicaid programs is
extremely outdated. Historically, State Medicaid programs have
attributed this to a lack of focus on improving data infrastructure
among competing priorities. If confirmed, would you prioritize improved
data systems at the State level to promote the sharing of data--such as
claims, laboratory results, and eligibility information--between State
systems and data sharing with the Federal Government?
Answer. Medicaid data is an important tool for improving health
equity and access to health care. I believe we need better data because
good data leads to good policy. If confirmed, I look forward to
partnering with States to improve Medicaid data.
Question. You have highlighted the need to stop consolidation in
California that gives hospitals unfair market power. I am interested in
how this view may influence your position on the use of restrictive
networks by insurance companies to drive down cost. For example, if a
major hospital system chooses not to enter into a contract with any
Medicaid managed care companies in a State, would you have HHS
intervene at the Federal level or leave that to the companies and State
to resolve?
Answer. As Attorney General in California, I worked to tackle the
issue of hospital consolidation. If confirmed, I will enforce the laws
and regulations on the books and work to ensure that individuals have
adequate access to affordable, quality health care.
Question. If confirmed, would you rescind Medicaid section 1115
waivers that were approved in the prior administration? If so, could
this create considerable disruption and prevent the adoption of
waivers, given State Medicaid operations could be changed with each new
administration?
Answer. Medicaid is an important lifeline for many American
families. Section 1115 demonstrations can be invaluable in allowing
States to pursue innovative ideas through Medicaid. If confirmed, I
will work to ensure that States' Medicaid section 1115 demonstrations
promote the objectives of the Medicaid program and that these
demonstrations are approved in accordance and compliance with the
Medicaid statute.
Question. The pipeline for new drugs and therapeutics is changing
rapidly and dramatically. Medicaid remains the primary payer for rare
disease treatments, yet the Medicaid Drug Rebate Program (MDRP) has not
evolved to keep up with new technologies, like cell and gene therapies.
Should the MDRP be updated to ensure patients with rare diseases,
including cancers and sickle-cell disease, can receive the treatments
they need? How would you address affordability without causing
innovators to reduce or eliminate investments in cell and gene
therapies out of fear of government involvement?
Answer. Medicaid is a crucial lifeline for ensuring that Americans
with low incomes, especially those with complex health care needs, have
adequate access to quality health care, including lifesaving therapies.
We need to foster innovation in medical technology to encourage the
development of new therapies. If confirmed, I look forward to working
with you to ensure that Medicaid beneficiaries have access to those
therapies.
Question. If confirmed, will you commit to allowing prescription
drug value-based arrangements in Medicaid to expand flexibility and
coverage of lifesaving treatments, especially for cell and gene
therapies?
Answer. I believe that people should have timely access to
lifesaving innovative therapies, including prescription drugs,
biologics, devices, and other medical products such as cell and gene
therapies. We need to foster innovation in medical technology to
develop new lifesaving therapies. If confirmed, I look forward to
working with you and other members to find solutions to address the
high cost of new therapies.
Question. In your role as Attorney General, how have you worked to
ensure Federal Medicaid funding does not go to non-citizens (a
requirement under Medicaid) even as California allows non-citizens
under 26 years old to be covered by its Medicaid program? How do you
ensure accountability related to the bifurcated Federal and State
funding streams?
Answer. The law does not allow people with undocumented status in
this country to receive Federal Medicaid benefits except in very rare
circumstances. If confirmed, it will be my job to make sure that the
Department follows the law.
miscellaneous
Question. The Secretary of Health and Human Services serves as a
trustee on the Board of Trustees of the Federal Old-Age and Survivors
trust fund and the Federal Disability Insurance trust fund. As a
trustee, you would, if confirmed, have a role in helping to develop
annual ``trustee reports'' on the financial condition of the trust
funds. In 2017, allegations were made that a single public trustee for
Social Security somehow forced insertion of assumptions into models
used to project the future finances of Social Security that led to the
``playing up the potential future insolvency of the program.'' One
piece of evidence to support the allegations was that the Chief Actuary
for Social Security wrote a public statement of actuarial opinion
containing some sort of public rebuke of questionable elements of the
2015 Social Security trustee report. The Chief Actuary's Statement of
Actuarial Opinion from the 2015 report is available on the Social
Security Chief Actuary's website (on pp. 256-257 of https://
www.ssa.gov/oact/TR/2015/tr2015.pdf). Given that you will assist in
developing trustee reports if confirmed, it is important to know that
you have knowledge of and sound judgement regarding Social Security
trust funds. Do you agree that the Statement of Actuarial Opinion of
the 2015 trustee report represents a public rebuke of questionable
elements of the trustee report--elements that represent assumptions
used to project the future finances of Social Security to play up the
potential future insolvency of the program?
Answer. If confirmed as Secretary, I can commit to you that we will
work with you to give you and this committee the information you need
to make the right decisions with respect to Medicare.
Question. In response to a questionnaire sent to you by the Senate
Committee on Finance, you included the following: ``I served on the
Ways and Means Committee for 2 decades, where I focused on protecting
and strengthening Medicare, Medicaid, and health-care payments and
program financing, and where, in 2015, I led efforts to successfully
stave off roughly 20-percent cuts in Social Security Disability
Insurance.'' Republicans on the Finance Committee, led at the time by
then-Chairman Hatch, worked with Republicans and Democrats in the
House, and Obama administration officials, to put in place reforms to
the Disability Insurance program at Social Security to make it better
for beneficiaries and taxpayers. Unfortunately, Senate Democrats at the
time took the position that nothing should be changed, aside from
taking resources from the Old-Age and Survivors (``retirement'') trust
fund and giving those resources to the Disability Trust Fund--something
they referred to as a ``clean reallocation.'' The reforms that then-
Chairman Hatch led from the Senate, and a reallocation of resources
between trust funds, ultimately became law. None of those reforms
privatized anything or cut benefits for anyone, aside from one change
that was inserted by the Obama administration to cut benefits for
certain upper-earners, and the reallocation ensured that Disability
Insurance benefits did not have to be cut, which otherwise would have
occurred. However, it is not clear the sense in which you ``led''
efforts in the House Ways and Means Committee to arrive at what became
the reforms. Can you provide evidence of how you led the House efforts,
such as legislation that you had sponsored that ultimately ended up in
the Disability Insurance reform package?
Answer. As chairman of the House Democratic Caucus and ranking
member of the House Ways and Means Subcommittee on Social Security, I
was deeply committed in this effort to preventing cuts to Social
Security, including introducing legislation, as part of this debate.
Question. During your tenure at the House Ways and Means Social
Security Subcommittee, you said numerous times that ``Social Security
has not added 1 penny to our deficit and our debt.'' I don't believe
that Social Security has contributed a great deal to deficits and debt,
but to be honest with respect to government accounts of taxpayer
resources, there have been contributions.
In his book titled ``Stress Test: Reflections on Financial Crises''
(Crown Publishers, New York, 2014), former Treasury Secretary Timothy
Geithner wrote the following: ``. . . I objected when Dan Pfeiffer
wanted me to say Social Security didn't contribute to the deficit, but
it did contribute. Pfeiffer said the line was a `dog whistle' to the
left, a phrase I had never heard before. He had to explain that the
phrase was code to the Democratic base, signaling that we intended to
protect Social Security.''
Do you agree with Secretary Geithner that Social Security has
contributed to the deficit?
When you repeatedly made public statements that ``Social Security
has not added 1 penny to our deficit and our debt,'' were you being
truthful, or sounding a ``dog whistle'' to the left as, according to
Geithner, former Obama administration official Dan Pfeiffer
characterizes such statements?
Answer. I am committed to protecting benefits for American seniors,
and if I am confirmed as HHS Secretary, my commitment will extend to
efforts to protect Medicare and seniors' benefits, and I hope we can
find common ground to work together on solutions to strengthen these
lifelines.
Question. As Attorney General, you filed 122 lawsuits against the
Trump administration, with some of these lawsuits related to HHS
programs. The sheer volume is indicative of how active States can be
when they are philosophically opposed to the administration in power.
What impact would the threat of lawsuits or actual lawsuits filed by
States against HHS have on how you would run the Department?
Answer. If I am confirmed as HHS Secretary, I will follow the law,
and we will comply with the law when implementing the President's
agenda and the laws passed by Congress.
Question. President Biden announced your nomination for HHS
Secretary simultaneously with his nomination of Dr. Vivek Murthy as
Surgeon General. Dr. Murthy has in the past identified gun violence as
a public health issue. Do you agree with Dr. Murthy's opinion that gun
violence is a health-care issue, and if so, how would you use your
position as HHS Secretary to address it?
Answer. The American Public Health Association lists gun violence
as a public health issue. If I am confirmed as HHS Secretary, I will
support ongoing peer-
reviewed research efforts at CDC and NIH, and implement the President's
agenda.
Question. The U.S. Supreme Court recently enjoined enforcement of
California's restrictive rules on gatherings for religious ceremonies.
Indeed, some in the public health community have said that California's
extreme restrictions, including on gatherings, may have been
counterproductive. How, as HHS Secretary, would you balance advocacy
for public health with respect for constitutionally guaranteed
liberties, including religious freedom?
Answer. As a person of faith myself, I believe deeply in religious
freedom. It is a protection in our Constitution that makes the United
States so unique and special. This pandemic continues to disrupt our
daily lives and routines, and we need to be vigilant in mitigating the
spread and protecting our fellow citizens. If confirmed as HHS
Secretary, I will follow the law and Constitution in all our efforts to
implement the President's agenda.
______
Follow-up Questions Submitted by Hon. Mike Crapo
Question. The response Mr. Becerra provided on the questions of
unemployment fraud in California did not address the specific questions
asked in the original question for the record. Please respond directly
and substantively to the questions that were asked.
Answer. I have long been concerned about fraud across our State and
take allegations of fraud seriously. Typically, District Attorneys
(DAs) prosecute any fraudulent action in their counties, and while we
can join investigations, DAs are routinely the arbiters. At the
California Department of Justice (DOJ), it's our policy not to comment
on any potential or pending investigation--even confirmation or
denial--to protect the integrity of our work.
The question concerning the number of hours spent on unemployment
fraud in relation to our Federal lawsuits seems to presume that we have
spent substantial time on our Federal lawsuits, perhaps compared to
other work at DOJ. Yet over the first 3 fiscal years during my tenure
as Attorney General, our Federal lawsuits amounted to roughly 1 percent
of our DOJ budget.
Question. The response Mr. Becerra provided did not address the
question of whether the nominee agrees that the Statement of Actuarial
Opinion of the 2015 trustee report represents a public rebuke of
questionable elements of the trustee report. Given the importance of
Social Security programs, it is important to know whether the nominee
agrees or not. Please be directly responsive to the question.
Answer. The role of the Secretary of Health and Human Services as a
trustee on the Board of Trustees for the Federal Old-Age and Survivors
trust fund and the Federal Disability Insurance trust fund is vital.
While I can't speak to the intentions of the Chief Actuary for Social
Security in the 2015 Annual Report of the Trustees of the Federal Old-
age and Survivors Insurance and Federal Disability Insurance trust
funds, I believe that the future of Social Security is of the utmost
importance. If confirmed as Secretary, I will approach this duty with
the care and attention it deserves.
Question. The response Mr. Becerra provided did not answer whether
he can provide evidence of how he led the House efforts, such as
sponsored legislation that ended up in the ultimate package. The
nominee identifies that he had introduced legislation, as part of a
debate. Please identify the specific legislation, and whether it ended
up in the Bipartisan Budget Act of 2015.
Answer. I introduced H.R. 3150, the One Social Security Act, on
July 22, 2015, which proposed merging two trust funds--the Social
Security Disability Insurance (SSDI) fund and the Old-Age and
Survivors' Insurance fund--to cover possible shortfalls. While it did
not become law, it led to conversations about how to prevent Social
Security's disability trust fund from running out of money.
As for preventing the nearly 20-percent cuts to SSDI, I alerted
House Democratic colleagues to the possible SSDI shortfall and made
clear that the budget deal of October 2015 must not decrease SSDI
benefits. Ultimately, I wrangled fellow House Democrats to put their
feet down and insist on staving off cuts. The deal later passed without
the cuts.
Question. The response Mr. Becerra provided regarding deficits,
debt, and Social Security did not answer the specific questions asked.
Please answer whether you do or do not agree with Secretary Geithner
that Social Security has contributed to the deficit; and please answer
whether your numerously iterated statement that ``Social Security has
not added 1 penny to our deficit and our debt'' is truthful or, as a
former Obama administration official reportedly has identified the
statement, a ``dog whistle'' to the left.
Answer. I stand by my statement that Social Security has not added
1 penny to the deficit. As a member of Congress, I have been a champion
for benefits for seniors including Social Security and Medicare. As HHS
Secretary, if confirmed, I will continue to work with Congress to
ensure that seniors have access to critical lifeline programs like
Medicare.
______
Questions Submitted by Hon. Chuck Grassley
Question. During the last 2 years as chairman of this committee,
I've focused some of my oversight on what steps the Department of
Health and Human Services has taken to detect and deter foreign threats
to taxpayer-funded research. As part of my oversight, I've also worked
to ensure that the Department's Office of National Security is given
full, complete, and consistent access to all Intelligence Community
information involving threats to the Nation's health care, such as
COVID-19. That office has gained access to some Intelligence Community
elements but more must be done.
Do you agree that China is a significant and consistent bad actor
when it comes to stealing U.S. taxpayer-funded intellectual property
and academic research? If so, what will you do to protect American work
product from the communist Chinese government's theft and espionage
activities? If not, why not?
If confirmed, do you intend to work with the Intelligence Community
to better understand the origins of COVID-19 and China's involvement?
If not, why not?
If confirmed, will you commit to briefing this committee on those
efforts?
If confirmed, will you commit to updating me on the functions of
the Office of National Security and how it's interacting within the
Intelligence Community?
Answer. If confirmed, I look forward to working with the committee
to protect research from undue foreign influences. As the president has
said, China is a serious competitor, and I am deeply concerned about
China's record of stealing intellectual property and engaging in
coercive and malign economic practices. If confirmed, I will work with
my colleagues to protect American work products from these activities.
and I also am committed to working with the intelligence community and
other partners to understand the origins of COVID-19, and I will keep
the committee apprised.
I recognize the critical role of scientific collaborations based on
principles of scientific excellence, integrity, responsibility to the
public, and fair competition in advancing its mission. The National
Institutes of Health (NIH) has taken a number of steps to address these
risks, including clarifying expectations around foreign affiliation
disclosures, financial conflicts of interest, and research support from
foreign governments. Protecting the integrity of science is a priority
for me to ensure that U.S. institutions and the American public benefit
from their investment in biomedical research. If confirmed, I will work
closely with NIH in their efforts to protect research integrity.
Question. Congress's ability to acquire information from Federal
agencies is critical to its constitutional responsibility of conducting
oversight of the executive branch. If you are confirmed, will you
commit to providing thorough, complete, and timely responses to
requests for information from members of this committee, including
requests from members of the minority?
Answer. As I committed during Thursday's hearing, I will provide
prompt responses in writing to requests from any members of this
committee.
Question. Science tells us that an unborn child has many of the
neural connections needed to feel pain, perhaps as early as eight weeks
and most certainly by 20 weeks fetal age. Providing health care to
unborn children and their mothers can help reduce infant mortality
rates in low-income communities, research also suggests. Some States
already offer prenatal care and other health services to unborn
children through the Medicaid program. What is your view on whether
unborn children should be entitled to Medicaid coverage, and do you
believe that the Federal Government has a role to play in encouraging
such coverage?
Answer. Medicaid is an important source of pre- and post-natal
care, and if I am confirmed, I will work to ensure that pregnant people
have access to quality health care that improves their own health and
the health of their babies. I look forward to working with members of
this committee and Congress to expand access to affordable quality care
including through the Medicaid program.
Question. Last year, Senator Wyden and I released a report to
colleagues exposing the extensive financial ties between manufacturers
of opioids and opioid-related products and tax-exempt organizations.
This investigation found that manufacturers made more than $65 million
in payments to a handful of tax-exempt organizations since 1997 to
amplify their business interests. Would you agree that the Physician
Payments Sunshine Act should be expanded to include these types of
transactions so that the public is aware them?
Answer. As Attorney General, I have acted to combat the opioid
crisis, including holding drug makers accountable. As California
Attorney General, I worked to shine a light on the relationships
between opioid companies and their consultants. The Open Payments
Program established by your Physician Payments Sunshine Act promotes
transparency and accountability by making information about certain
financial relationships available to the public. If confirmed, I look
forward to working with you on ways to promote transparency of the
financial ties of opioid manufacturers.
Question. In 2020, I cosponsored the Temporary Reauthorization and
Study of the Emergency Scheduling of Fentanyl Analogues Act and it was
signed into law. The law extended the Drug Enforcement Administration's
temporary scheduling order to proactively control deadly fentanyl
analogues. Fentanyl-related overdose deaths continue to rise and
sophisticated drug trafficking organizations manipulate dangerous
substances to skirt the law, so this critical law placed fentanyl
substances in Schedule I so that they can be better detected and
criminals can be held accountable for their actions. The law sunsets in
May of 2021. You as Attorney General of California signed a letter in
December 2019 joining all 55 other State and territory Attorneys
General asking Congress to permanently codify a temporary emergency
scheduling order keeping fentanyl-related substances classified as
Schedule I drugs. If confirmed, do you support permanently codifying a
temporary emergency scheduling order keeping fentanyl-related
substances classified as Schedule I drugs?
Answer. I recognize that fentanyl and fentanyl analogues pose a
significant danger, and are responsible for far too many deaths every
year. I continue to believe that we should place sensible restrictions
on these substances that pose harm. I am also cognizant of the vital
role HHS plays in the scheduling process and the need to ensure that
our actions are not inadvertently stifling the type of research that is
needed to develop new drugs that can help address the opioid crisis in
America. I commit that, if confirmed, I will work with you on
legislation to ensure the appropriate scheduling of the fentanyl and
fentanyl analogues that pose a danger.
Question. In 2003, Congress added an outpatient prescription drug
benefit to the Medicare program called Part D. We did it the right way
for seniors and taxpayers by allowing the forces of free enterprise and
competition to drive costs down and drive value up. Key to designing
this program was ensuring there was competition, not government
mandates--to drive innovation, curb costs, expand coverage, and improve
outcomes. This is why we wrote the non-interference clause into the
law. The non-interference provision expressly prohibits Medicare from:
negotiating drug prices, setting drug prices, and establishing a one-
size-fits-all list of covered drugs. That language doesn't prohibit
Medicare from negotiating with drug makers. It prohibits the government
from interfering in the negotiations that are actually happening. The
Congressional Budget Office has repeatedly stated that repealing non-
interference wouldn't save money unless there was a restrictive
formulary, therefore restricting patient access to critical drugs.
President Biden, then as a candidate for president, said he wanted to
``allow Medicare to negotiate lower drug prices'' and last Congress the
U.S. House of Representatives passed legislation that sought to give
the Department of Health and Human Services (HHS) Secretary ``broad
power to negotiate lower drug costs now.'' As a member of Congress, you
cosponsored legislation that would have enabled the Secretary of HHS
the ability to negotiate with pharmaceutical manufacturers. Does the
Secretary of HHS have the authority to circumvent the 2003 law to
negotiate prescription drug prices in Medicare? If confirmed, does the
Biden administration support changes to Medicare's non-interference
clause to stifle the free market that includes amending or rescinding
the non-interference clause provision?
Answer. Like President Biden, I believe we must do all we can to
lower the costs of prescription drugs and make them more accessible for
Americans. If confirmed, I look forward to working with Congress to
build upon the good work you did in the Finance Committee on this
important issue and finding ways to achieve these important goals.
Question. I recently requested the CDC to publicly release its
weekly formula--including the State-by-State pro-rata share for
allocating vaccines to States, territories, and tribes. No matter where
you live, Iowans and all Americans should have fair access to a
vaccine. Iowans must have confidence we are receiving our fair share of
vaccines. I appreciate the CDC routinely releasing State-by-State
vaccine data for allocation, doses delivered, and administration.
However, it is difficult to determine based on this data whether Iowa
is receiving its fair share. This publicly reported data can also lag.
Will the Biden administration commit to the CDC publicly releasing its
State-by-State weekly pro-rata share of vaccine allocations?
Answer. If confirmed, I look forward to working with the Department
to ensure there is transparent and equitable distribution of vaccine
allocations.
Question. In Iowa, grandmothered health plans have enabled many
middle-class Iowans to keep the health plans and doctors they like at a
reasonable price since the Affordable Care Act was implemented. For
example, over 56,000 Iowans are covered by grandmothered health plans.
To put this in context, about 59,000 Iowans signed up for the Federal
health insurance exchange in 2021. Iowans have chosen health plans that
meet their individual needs. Currently, grandmothered health plans'
existence is determined by the Department of Health and Human Services
(HHS) through the Centers for Medicare and Medicaid Services (CMS)
annually through non-enforcement extensions. If confirmed, are you
committed to maintaining these affordable, consumer-chosen health plan
options for Iowans by extending the non-enforcement authority for
grandmothered health plans annually? Or do you support actions to
remove choice for Iowans requiring them to select a one-size-fits-all
Obamacare plan?
Answer. Making sure that all Americans have access to quality,
affordable health care is one of the Biden administration's top
priorities. If confirmed, I will examine rules and other policies to
ensure all Americans can access the care that they need.
Question. I support transparency in the 340B Drug Pricing Program.
The previous administration finalized a 340B Drug Pricing Program
Administrative Dispute Resolution regulation that went into effect in
January 2021. This final rule sets forth the requirements and
procedures for the 340B Program's administrative dispute resolution
(ADR) process. The rule establishes a 340B Administrative Dispute
Resolution Board to review claims. In addition, on December 30, 2020,
the Department of Health and Human Services' Office of the General
Counsel released an advisory opinion. If confirmed, are you committed
to the continued implementation of the 340B Drug Pricing Program
Administrative Dispute Resolution final rule and Office of General
Counsel's advisory opinion? If confirmed, what other detailed steps
will the Biden administration take to ensure transparency in the 340B
Drug Pricing Program?
Answer. The 340B Drug Pricing Program is an indispensable program
for our safety-net providers serving some of our neediest populations.
If confirmed, I look forward to working with you and other members of
Congress to uphold the law and ensure this vital program is able to
support vulnerable communities.
Question. In 2017, I sponsored the Over the Counter Hearing Aid Act
with Senator Warren, which was included in the FDA Reauthorization Act
of 2017. It required the FDA to issue a regulation by August 2020
establishing the requirements for products in this category. This
legislation was based on recommendations put forth by the Presidential
Council of Advisors on Science and Technology and the National
Academies of Science Engineering and Medicine to increase consumer
access to hearing aid technology and decrease costs associated with
hearing aids. The Food and Drug Administration has not completed
rulemaking on this. If confirmed, will you work to prioritize
rulemaking so consumers can access affordable help for hearing loss
that Congress intended?
Answer. Thank you for your leadership on this issue. I commit that,
if confirmed, I will support FDA in their work to ensure availability
of over-the-counter hearing aids. I recognize this as a public health
priority as hearing loss can have a negative effect on communication,
relationships, and other important aspects of life.
Question. A Centers for Disease Control and Prevention (CDC)
Morbidity and Mortality Weekly Report found the use of telehealth
increased 154 percent during the last week of March 2020 during the
emergency of COVID-19 compared to the same period in 2019. We know the
use of telehealth has continued throughout the COVID-19 pandemic. The
Centers for Medicare and Medicaid Services (CMS) throughout the public
health emergency authority has allowed more than 80 services to be
furnished via telehealth. The data and response from patients and
providers prove permitting telehealth services is a positive action to
improve access and care. This last Congress, we provided permanent
coverage for mental health telehealth visits under Medicare, which is
helpful during the pandemic and will remain critical for many Americans
afterwards. If confirmed, are you committed to working with Congress
and in the executive branch to extend telehealth flexibilities in
Medicare beyond the pandemic? Additionally, some providers, including
community health centers, face regulatory barriers based on provider
type or site of service. If confirmed, do you support removing
telehealth barriers for certain providers?
Answer. Telehealth is an important tool to improve health equity
and improve access to health care. Health care should be accessible, no
matter where you live. If confirmed, I will look at the telehealth
flexibilities developed for the current public health emergency and
determine how we can build on this work to improve health equity and
improve access to health care, including at community health centers.
Question. If confirmed, does the Biden administration plan to
change the State-Federal partnership in response to the COVID-19
pandemic by placing conditions of participation, including specific
public health mitigation efforts, on States in order to receive vaccine
doses?
Answer. If confirmed, I would work within HHS to determine the best
way to ensure transparent and equitable distribution of vaccine
allocations.
Question. If confirmed, does the Biden administration plan to
change the State-Federal partnership in response to the COVID-19
pandemic by placing conditions of participation, including specific
public health mitigation efforts, on States in order to receive Federal
funding to respond to COVID-19?
Answer. If confirmed, I would work within HHS to determine the best
way to ensure transparent and equitable distribution of COVID-19 relief
funding.
Question. I am a proud champion for greater transparency in
government. This extends to the need for greater transparency in health
care. I am the author of the Physician Payments Sunshine Act, which
requires public disclosure of payments between drug companies and
doctors and have introduced legislation to apply the same disclosure
rules to nurse practitioners and physician assistants. In 2019, the
Trump administration issued two major rules requiring price
transparency for hospitals and health insurance companies. The rules
took effect in January 2021. This effort shines a light on the health-
care industry that is all too often shrouded in secrecy. While Congress
can build upon the rules, consumers can finally see sunshine in health-
care pricing. I have cosponsored legislation to codify the two health-
care price transparency rules. This transparency will bring more
accountability and competition to the health-care industry. If
confirmed, do you plan to maintain, modify, or rescind these health-
care transparency rules that give consumers the ability to compare
prices online so they can make an informed choice about what's best for
them and their families?
Answer. If I am fortunate enough to be confirmed, I will ensure
that the Department continues to take steps to improve price
transparency, so consumers can look behind the curtain to understand
how providers and insurers are operating.
Question. As a direct result of the Affordable Care Act's one-size-
fits-all approach, many Iowans have been priced out of health
insurance. To rectify this, the Trump administration and Iowa Insurance
Division enabled Iowans more choice and competition in the health-care
marketplace by enabling and expanding short-term
limited-duration insurance (STLDI). This gives Iowans access to health
insurance with consumer protections. If confirmed as Secretary of
Health and Human Services, will you stifle competition and limit the
health plan choices for Iowans? Specifically, will you modify or
rescind the current regulations enabling Americans to purchase STLDIs?
Answer. Making sure that all Americans have access to quality,
affordable health care is one of the Biden administration's top
priorities. If confirmed, I will examine rules and other policies to
ensure that plans provide Americans access to the care that they need.
Question. It is important to give people affordable options for
health insurance. Small business owners, like Iowa farmers, want to be
able to provide insurance for their employees. Association Health Plans
are a way for these small businesses to band together to expand access
to health insurance and drive down costs. I have introduced legislation
and support efforts to expand the pathway to affordable and accessible
health care remaining open to employees across America. Association
Health Plans allow small businesses to join together to obtain
affordable health insurance as though they were a single large
employer. The coverage offered to association members is subject to the
consumer protection requirements that apply to the nearly 160 million
Americans who receive coverage from large employers. If confirmed, will
you as Secretary of Health and Human Services modify or rescind current
regulations enabling employers and employees access to Association
Health Plans removing the ability to access affordable health
insurance?
Answer. Making sure that all Americans have access to quality,
affordable health care is one of the Biden administration's top
priorities. If confirmed as Secretary of HHS, I will examine all rules
and policies to ensure all Americans can access the care that they
need.
Question. I support access to affordable health-care coverage for
all Iowans, regardless of their health status or pre-existing
conditions. Americans want to be in control of their own health care.
National, single-payer health systems do not allow that. The Affordable
Care Act took options away from people and adopting a single-payer
system will make that worse. A national, single-payer health system
would eliminate private health insurance for nearly 200 million
Americans and require middle-class Americans to pay much more in taxes.
Single-payer health care would also dramatically increase government
spending substantially, fail to meet patient needs quickly, reduce
provider payments rates and reduce quality of care, and the government
would have more control over health care. It also threatens the
benefits that current seniors on Medicare have paid into the system
their entire working lives. If confirmed, do you intend to take
administrative actions to implement the vision of a one-size-fits-all
government-run health care scheme like single-payer? If so, please
describe what authority you believe you have to take such actions?
Answer. President Biden has made it very clear that his goals for
improving the American health-care system begin with building on the
successes of the Affordable Care Act, and I am committed to working
toward that goal.
Question. If confirmed, will you take actions as Secretary of
Health and Human Services that stifle innovation and competition in
health care?
Answer. Thank you for this question. I believe it is important to
foster innovation and competition in our health-care system. Americans
should have access to health-care services and products at an
affordable price.
Question. Throughout the pandemic, the Trump administration gave
States through the Medicaid program more flexibility to continue to
care for and protect individual Americans and communities at most risk.
If confirmed, will you work throughout the public health emergency to
maintain these flexibilities for States?
Answer. I agree that these emergency flexibilities have played an
important role in enabling State Medicaid programs to respond
effectively to the COVID-19 pandemic. If confirmed, I am prepared to
work closely with State Medicaid programs to ensure that they have the
flexibility they need to care for Medicaid beneficiaries throughout the
public health emergency.
______
Questions Submitted by Hon. John Cornyn
vaccine allocation
Question. In order to streamline the distribution of COVID-19
vaccine from manufacturers to the States, the Trump administration
created a pro rata formula that the Biden administration has left in
place. The formula requires Federal administrators to run an automated
algorithm in a program called Tiberius,\3\ which then calculates the
division of vaccine doses nationwide based on the size of each State's
adult population. While Texas has received the second-most vaccine
doses in the country, an analysis of Centers for Disease Control and
Prevention data has shown the State ranks near the bottom, 49 out of
50, when it comes to doses per 100,000.
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\3\ https://www.defense.gov/Explore/News/Article/Article/2441698/
pro-rata-vaccine-distribution-is-fair-equitable/.
The State population numbers used in the algorithm are derived from
the U.S. Census Bureau's 2018 data. Texas is one of the youngest States
in the Nation, with 25.5 percent \4\ of the State population under 18
years old. With that said, Texas media \5\ has noted ``[s]till, even
when adjusted for adults only, Texas ranks 48th.''
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\4\ https://www.census.gov/quickfacts/TX.
\5\ https://www.houstonchronicle.com/news/investigations/article/
Nobody-is-getting-enough-Texas-near-the-15906851.php.
What steps would you take as Secretary to ensure Texans receive an
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equitable share in future distributions?
Answer. If confirmed, I commit to working with the Department to
ensure equitable distribution of vaccinations for States and local
jurisdictions, including the State of Texas.
1115 waivers
Question. In January, CMS granted Texas a 10-year extension of its
Medicaid 1115 waiver, providing critical funding and stability for the
program and Medicaid providers. The extension carries forward many
policies and programs approved across two different administrations
that ensure quality outcomes, transparency, and greater access to care.
A one size fits all approach cannot meet the needs of a State as large
and diverse as Texas, and the flexibility inherent in the 1115 waiver
gives the State the authority to employ innovative solutions.
There are concerns that the Biden administration will seek to
withdraw approval of waivers that were granted at the end of the Trump
administration. It is a dangerous precedent for the first action of a
new administration to undo the final actions of the previous
administration as States will no longer be able to trust in their
negotiations with CMS.
Will you commit to maintaining Texas' waiver extension as approved?
Will you pledge to work with Texas to ensure the stability of the
health-care safety net, which is heavily dependent on funding provided
through the 1115 waiver?
Answer. Medicaid is an important lifeline for many Texans. Section
1115 demonstrations can be invaluable in allowing States to pursue
innovative ideas through Medicaid. If confirmed as HHS Secretary, I
would work to ensure that States' Medicaid section 1115 demonstrations
promote the objectives of the Medicaid program and that these
demonstrations are approved in accordance with and comply with the
Medicaid statute.
foreign threats to research
Question. In 2019, this committee held a hearing on foreign threats
to taxpayer-funded research after multiple reports of espionage by the
People's Republic of China. We have seen attempts by foreign entities
like North Korea to steal intellectual property related to COVID
vaccine development and I continue to hear concerns from research
institutions in Texas.
Do you believe that NIH and other funders of public research should
consider cybersecurity protocols that institutions have in place when
evaluating applications for research grant funds?
What additional initiatives are you considering to ensure taxpayer
funded research is protected from foreign threats?
Answer. If confirmed, I look forward to working with the committee
to protect research from undue foreign influences. As the president has
said, China is a serious competitor, and I am deeply concerned about
China's record of stealing intellectual property and engaging in
coercive and malign economic practices. If confirmed, I will work with
my colleagues to protect American work products from these activities.
I also am committed to working with the intelligence community and
other partners to understand the origins of COVID-19, and I will keep
the committee apprised.
I recognize the critical role of scientific collaborations based on
principles of scientific excellence, integrity, responsibility to the
public, and fair competition in advancing its mission. The National
Institutes of Health (NIH) has taken a number of steps to address these
risks, including clarifying expectations around foreign affiliation
disclosures, financial conflicts of interest, and research support from
foreign governments. Protecting the integrity of science is a priority
for me to ensure that U.S. institutions and the American public benefit
from their investment in biomedical research. If confirmed, I will work
closely with NIH in their efforts to protect research integrity.
esrd
Question. I have heard that some Medicare beneficiaries with End-
Stage Renal Disease (ESRD) are being denied access to certain therapies
following the inclusion of calcimimetic medicines in the ESRD bundled
rate. For example, I've heard that some dialysis centers are requiring
patients to change or stop using a medicine now that it is part of the
bundled rate. It is extremely disturbing that dialysis patients, a
group that is already impacted by significant disparities, would be
taken off a treatment for economic reasons by the dialysis center.
What will you do to ensure that ESRD patients will continue to have
access their calcimimetic treatment and what will you do to monitor
patient outcomes in this area?
Answer. I agree that is it important for Medicare beneficiaries,
particularly vulnerable groups such as those beneficiaries with ESRD,
to have access to medically necessary treatments such as calcimimetics.
If confirmed, I will work to ensure that Medicare beneficiaries
continue to have access to these treatments and that patient outcomes
are not compromised.
Question. Four hundred thousand Medicare beneficiaries are on
dialysis, and those patients have not benefited from any meaningful
innovation in their standard of care in decades. Over the last several
years, I have joined colleagues on both sides of the aisle and worked
with CMS, the patient community, and innovators to encourage adoption
of a new policy to spur innovation in medical technology for Medicare
patients under the ESRD bundled payment system. CMS has made
significant progress, having created the TPNIES add on payment for
innovation in medical technology used in the provision of dialysis
services. However, our work is not done. CMS should better align its
metrics for innovation and clinical improvements over existing
technologies with the lens FDA uses to evaluate such improvements and
innovations. And CMS should also extend by another year the period of
time during which the add-on payment can be made, having established an
application and qualification process via rulemaking that essentially
negates the first year of the add on payment window. I will again work
with my colleagues on legislation to make these additional improvements
to the work CMS has already done, and hope that you will commit to
working with me to achieve full success on this policy for Medicare
patients in whatever is the most expeditious and achievable path.
Will you commit to working with Congress to implement these
policies and bring long overdue innovation to this vulnerable group of
patients?
Answer. I agree that it is important to foster innovation in
medical technology that improves health-care outcomes. If confirmed, I
look forward to working with Congress to improve access to innovative
technologies to Medicare ESRD beneficiaries.
drug pricing--rebate wall
Question. We continue to see participants in the pharmaceutical
supply chain, including some manufacturers and PBMs, engage in
behaviors designed to foreclose competition. One form of potentially
anticompetitive behavior is known as a ``rebate wall'' or ``rebate
trap''--a practice that, while serving as Attorney General for
California,\6\ you acknowledged can foreclose competition and raise
prices for consumers. Rebate walls occur when a firm with dominant
market share requires a payer to prevent patients from accessing new
innovation by coupling volume-based discounts with retaliatory measures
such as the clawback of rebates. Rebate walls are especially
problematic in therapeutic areas such as the autoimmune market where
established medicines control considerable market share (i.e., patient
volume) and have FDA-approval for multiple indications.
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\6\ file://cornyn-fs01/jeffreyl/Finance%20Committee/Hearings/117th/
Becerra%20Nomination/
State_of_California,_Office_of_the_Attorney_General.pdf.
A recent report \7\ found that removing rebate walls could save
patients more than $6,000 for high-cost ($70,000 list price) infused
biologics. Do you agree that a rebate wall can be problematic for
patients, especially when it forecloses patient access to new,
innovative, and often times lower cost brand and biosimilar options?
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\7\ https://www.pacificresearch.org/wp-content/uploads/2020/12/
RebateWall_F_web.pdf.
As Secretary of HHS, how would you engage with FTC, FDA, and other
agencies to address anticompetitive rebate wall practices? For example,
how would you build upon the FTC and FDA's ongoing work to address
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competition issues in the biosimilars market, including rebate walls?
Answer. Like President Biden, I believe we must do all we can to
lower the costs of prescription drugs and make them more accessible for
Americans who depend on these medications. Competition in the market
has helped control the growth in spending on prescription drugs and as
California Attorney General I made it my mission to ensure that the
marketplace worked better. I believe that biosimilars have a role to
play in containing the cost of expensive therapies by creating
competition. I am committed to reducing drug prices and ensuring
Americans have access to the drugs that they need. If confirmed as
Secretary of HHS, I look forward to working with you to find ways to
achieve these important goals. I will also work across the government
to address barriers to reducing drug prices.
biosimilars
Question. Biologic medicines treat some of the most serious
conditions such as cancer, diabetes, and inflammatory diseases.
Treating these conditions also represents a significant cost burden to
the Medicare Part B program and the patients its serves. Biosimilar
medicines are approved by FDA to be as safe and effective to previously
approved reference biologic products that have gone off patent. This
represents the opportunity for high-value competition with savings
estimates up to $100B over the next 5 years.
What role do you see high-value, off-patent products like
biosimilars playing in the Medicare program in helping to ease Medicare
spending and reduce patient cost?
Will you commit to explore demonstration programs through CMMI or
other authorities that allow savings from biosimilar adoption to be
reinvested in patients and the health-care system?
Seniors are paying the high cost of prescription drugs. I
introduced the Increasing Access to Biosimilars Act (S. 4134 in the
116th Congress) to encourage competition through the use of lower-cost
biosimilars. The Increasing Access to Biosimilars Act would establish a
5-year, voluntary demonstration program to allow providers to share in
the savings created by the use of biosimilars. Medicare savings would
be guaranteed as the shared savings payments are only available when
the biosimilar ASP is less than the reference biologic ASP.
Would you work with my colleagues and me to advance a biosimilars
shared savings demonstration and test ways to encourage more biosimilar
adoption?
Answer. We can all agree that the cost of prescription drugs are
too high. Seniors should never have to choose between a meal and their
medications. Biosimilars have a role to play in containing the cost of
innovative yet expensive biologic treatments by creating competition.
As Attorney General, I helped to promote competition by taking on a
number of pharmaceutical companies who restricted competition through
``pay-for-delay'' schemes, which delayed putting a generic product on
the market to compete with the brand-name product, therefore keeping
the price of that brand name product high. If confirmed, I will
continue to work on finding ways to lower drug costs and ensuring
Americans have access to prescription drugs. As Secretary, I look
forward to hearing your ideas for innovative models to do just that,
and I look forward to working with you on this important issue.
340b--contract pharmacies
Question. Do you agree that the 340B statute does not mention
contract pharmacies or define any role for them in the 340B program,
and--notwithstanding that--contract pharmacies have pursued ways to
generate revenue from their 340B patients, ultimately at cost to the
Federal Government?
As HHS Secretary, how do you plan to address recent increases in
diversion and duplicate discounting in the 340B program?
In your December 2020 letter to Secretary Azar, you noted that
``some manufacturers are illegally conditioning 340B pricing on the
provision of claims data to an agent of the manufacturer with
insufficient compliance under HIPAA.'' Assuming HIPAA were satisfied,
would you still consider a manufacturer conditioning 340B pricing on
the provision of claims data to a third party to be illegal?
Answer. The 340B Drug Pricing Program is an indispensable program
for our safety-net providers serving some of our neediest populations.
If confirmed, I look forward to working with you and other members of
Congress to uphold the law and ensure this vital program is able to
support vulnerable communities.
unaccompanied alien children program
Question. If confirmed as Secretary of Health and Human Services,
you would be responsible for supervising the Office of Refugee
Resettlement (ORR) and its Unaccompanied Alien Children program. We are
currently seeing a huge increase in apprehensions of unaccompanied
migrant children (or UACs) along the border, particularly in the Big
Bend and Del Rio Border Patrol sectors, where encounters have increased
by 141 and 122 percent, respectively.
Many, if not most of these children will ultimately be referred to
the ORR UAC Program. Under the Flores settlement agreement, these
children must be placed in non-secure, State-licensed facilities or
placed with a family member or other sponsor.
What is your plan with respect to HHS's contracts with State-
licensed facilities? Would you ensure that HHS has sufficient capacity
to house children until they can receive at least preliminary merits
hearings in their cases?
I am concerned about releasing children to sponsors while they are
in removal proceedings. To the extent that we're releasing to family
members, we need to be sure that they are here legally and that they
will be responsible for ensuring that the child shows up to the court
proceedings. And we need to be very conscious of the costs that such
placements impose on State and local governments--which are already
shouldering significant costs related to the COVID pandemic.
Answer. I appreciate your attention to this issue and the
opportunity to answer this question. A guiding child welfare principle
driving ORR's mission, along with legal requirements, is that
children's best interests are served when he or she can safely be
released to their family. HHS will release children without unnecessary
delay to the care of appropriate sponsors, who are responsible for
ensuring that children appear for any proceeding for which the children
are a party. When a child is scheduled for a hearing before an
immigration court while the child is in ORR care and custody, ORR
arranges to transport the child to their hearings. ORR funds a national
network of legal service providers who may represent children or appear
as friends of the court at any immigration hearing the child is
scheduled to appear.
ORR consistently seeks to balance permanent licensed bed capacity
needs with being a good steward of taxpayer funds by closely monitoring
migration patterns and reviewing historical trends in order to project
program needs expediently and as accurately as possible. If confirmed,
I will do everything in my power to ensure the safety and well-being of
these vulnerable children.
center for innovation in advanced development and manufacturing
Question. During the Obama administration, HHS created the Center
for Innovation in Advanced Development and Manufacturing (CIADM)
program. This was a public-private partnership model that was created
back in 2012 specifically to help protect Americans from the impacts of
bioterrorism, of pandemic influenza and of other epidemics.
In response to the COVID-19 pandemic, HHS activated two CIADMs, one
in Maryland and one at Texas A&M, as part of its COVID-19 response to
domestically produce COVID-19 vaccine candidates and therapeutics.
These CIADMs are serving as domestic manufacturers for the next tranche
of vaccine candidates expected to be reviewed by the FDA--J&J,
AstraZeneca, and Novavax, and working around the clock to manufacture
these promising vaccine candidates. The program has not been without
challenges, but the foresight of the Obama administration to create the
program and the quick action by the Trump administration to activate
these CIADMs show that the CIADM program could be a model to strengthen
our domestic manufacturing capacity, strengthening our vaccine and
therapeutics supply chain and helping ensure we can end this pandemic
and respond to future public health emergencies quickly.
Are you familiar with the CIADM program?
Answer. I am familiar with the CIADM program, which helps to ensure
a sustainable domestic medical countermeasure infrastructure.
Question. Will you commit to building on the successes of the CIADM
program? No program is perfect of course--but this program clearly is
playing a vital role in ending the pandemic domestically and likely
globally.
Answer. If confirmed, I look forward to working with the Biomedical
Advanced Research and Development Authority (BARDA) to expand
innovative solutions and strengthen our domestic manufacturing
capacity.
medicare program integrity
Question. I'm very concerned about the amount of Medicare funds
lost to errors, waste, fraud, and abuse. Previously, CMS expressed the
need to ``elevate program integrity, unleash the power of modern
private-sector innovation, prevent rather than chase fraud waste and
abuse through smart, proactive measures, and unburden our provider
partners so they can do what they do best--put patients first.'' Also,
Congress included language in the Fiscal Year 2021 appropriations
encouraging CMS ``to consider pilot programs using AI-enabled
documentation and coding technology to address CMS's top program
integrity priorities and reduce administrative burden.'' I think we can
do more to harness the expertise used in the private sector to benefit
our Medicare beneficiaries and safeguard the Medicare trust fund. I
hope this is an area of policy that we can work on together.
Will you commit to working with this committee to prioritize the
use of artificial intelligence and other emerging technologies to
bolster Medicare program integrity and protect the Medicare Trust Fund?
Answer. As California Attorney General, I cracked down on health-
care fraud. Fighting fraud and abuse is important for maintaining a
strong Medicare program. It is my understanding that CMS has taken
steps to explore the possibilities of artificial intelligence for
program integrity purposes. If confirmed, I will work with the
committee to make sure that we are good stewards of the Medicare
program and taxpayer dollars.
children's health
Question. As HHS Secretary, you will oversee a number of programs
and agencies important to children from health coverage programs vital
to children's health such as Medicaid and the Children's Health
Insurance Program (CHIP) to programs responsible for training the
pediatric health-care workforce like the Children's Hospital Graduate
Medical Education Program (CHGME) to pediatric research initiatives at
the National Institutes of Health.
What are your priorities for child health if confirmed?
Answer. Programs such as Medicaid and the Children's Health
Insurance Program (CHIP) are crucial lifelines for ensuring that
children have adequate access to quality health care. I had the great
honor to help expand CHIP as a member of the House of Representatives,
and have voted in support of reauthorizing the Children's Hospital
Graduate Medical Education Program (CHGME). If confirmed, I would work
to ensure children are receiving necessary health care so they can grow
and thrive. I would also look to better ensure access to oral health
and vision care for children, both necessary for children to thrive in
school. And let us not forget that improving child health begins with
ensuring maternal health. I will work tirelessly to reduce maternal and
infant mortality and morbidity, using the expertise and resources
across the many HHS agencies whose missions include ensuring child
health. I look forward to working with Congress, and with State and
local partners to make sure that we are improving child health.
Medicaid and CHIP are critical programs for children, providing
coverage for over 40 million children. Medicaid is also the backbone of
the pediatric health-care system providing care across the continuum
from screenings and preventive to highly specialized diagnoses and
treatments.
Question. What are your plans to strengthen this safety net for
children and the providers who care for them?
Answer. If confirmed, I would work to support and strengthen
crucial programs such as Medicaid and CHIP to ensure that children have
adequate access to quality health care. In particular, I would look to
better ensure access to oral health and vision care for children, while
working to reduce maternal and infant mortality and morbidity. In
addition, I would work to ensure that the providers who care for our
children receive the support and resources they need to deal with the
COVID-19 crisis and to make sure our children have access to quality
care from the get-go.
The pandemic is having a profound impact on children's health and
the providers who care for them.
Question. What are your immediate plans to address the current
crisis in the increasing number of children facing severe mental,
emotional and behavioral health challenges due to social isolation and
the serious impact of the pandemic on the health of their families and
caregivers?
Answer. I am deeply concerned about the impact of the COVID-19
pandemic on the mental, emotional, and other behavioral health outcomes
of our children and their families and caregivers. I agree this must be
an urgent national priority. If confirmed, I commit to working on this
issue. In particular, we must ensure that we are fully leveraging the
Medicaid and CHIP programs to connect children to the behavioral health
care they need to navigate this unprecedented time and available SAMHSA
funding to support behavioral health.
Question. The pediatric health-care safety net has been affected by
the pandemic in different ways then the adult health care system, with
less direct Federal financial support because they are not eligible for
Medicare funding streams. What are your plans to sustain a stable
pediatric health care system now and beyond the pandemic?
Answer. Medicaid and CHIP are lifelines to children and help form
the fabric of the pediatric health-care safety net. Over 77 million
individuals are enrolled in those programs, and about half are
children. It is critical that we work to support our pediatric health-
care safety net and pediatric health-care providers during the COVID-19
pandemic and beyond. If confirmed, I would make it a priority to
provide necessary support to pediatric providers.
The Children's Hospital Graduate Medical Education Program (CHGME)
provides significant support for the training of pediatricians and
pediatric specialists. But unfortunately, the funding for this program
still lags far behind the Medicare GME program--funding only half of
what Medicare GME provides per resident.
Question. What are your plans to address this gap in training
support for our Nation's pediatric workforce?
Answer. If confirmed, I will work to focus attention and resources
to bolster our Nation's health-care workforce, including those who work
with pediatric populations. HRSA's Children's Hospital Graduate Medical
Education (CHGME) and
Developmental-Behavioral Pediatrics programs are key pieces in the
overall workforce landscape. If confirmed, I look forward to working
with Congress to continue training a high-quality, skilled pediatric
workforceto help increase access to these services.
During the pandemic, telehealth has played a major role in
providing access to care for Medicaid beneficiaries, including
children.
Question. How will HHS support the continued use and enhancements
needed under Medicaid to ensure telehealth continues to enable access
to care for children?
Answer. Telehealth is an important tool to improve health equity
and improve access to health care. Health care should be accessible, no
matter where you live. Medicaid has made great strides in expanding
services available through telehealth, including pediatric services,
during the public health emergency. If confirmed, I will look at the
telehealth flexibilities developed for the current public health
emergency and determine how we can build on this work to improve health
equity and improve access to health care.
As you know, pediatric health care is organized differently than
adult health care. Pediatric care is more regionalized and often
results in children, especially those with complex health needs, having
to travel across State lines for care. Under Medicaid, this can be
challenging for them and their providers with different policies State
to State. The Advancing Care for Exceptional Kids (ACE Kids) Act passed
in 2019 and effective next year, is one step in addressing these
inconsistencies and getting much needed national data to inform care
improvements.
Question. If confirmed, how would you approach these cross-State
challenges that children with complex needs face when traveling for
needed care?
Answer. Programs such as Medicaid and CHIP are crucial lifelines
for ensuring that children have adequate access to quality health care,
especially those with complex needs. I had the great honor to help
expand CHIP as a member of the House of Representatives. If confirmed,
I will work to ensure children are receiving necessary health care so
they can grow. I look forward to working with other departments across
the administration, Congress, and with State and local partners to make
informed decisions that address the specific needs of children with
complex medical conditions.
A major focus in health care among policy makers has been on
pursuing delivery system reforms that improve quality and reduce costs.
The Federal Government has traditionally focused more on adult
populations rather than the needs of children in these reforms. As a
result, Medicaid for children still lags behind Medicare in supporting
improvements in care and innovative payment models.
Question. What steps will you take to promote increased emphasis on
these types of innovations in Medicaid targeting the unique needs of
children?
Answer. If confirmed, I will work with Congress and State and local
partners to spur and encourage innovation in these important programs.
Innovative delivery system and payment models are vital to ensuring
that Medicaid and CHIP are equipped to address emerging pediatric
health issues and can continue to provide children with access to
quality health care.
supply chain
Question. Regarding further distribution of personal protective
equipment (PPE) and COVID-19 vaccines and ancillary products, how will
government coordination with the private sector be managed? How will
updates and information be communicated to the health-care supply chain
in a timely manner?
Answer. The global pandemic has highlighted the vulnerabilities of
the health-care supply chain for many products. In order to continue
responding to the COVID-19 pandemic and better prepare the Federal
Government to respond to any future public health emergencies, it is
critical that HHS work to improve and expand health-care supply chain
capabilities. If confirmed, I'm committed to working in coordination
with the private sector on this urgent matter.
Question. How does the new administration plan to coordinate with
and leverage the expertise of the commercial health-care supply chain
to get product the last mile and get supplies into providers' hands
across the care continuum?
Answer. Coordination across departments, agencies, and industries
is key to ensure the adequacy of the health care supply chain. If
confirmed, I'm committed to working on this urgent matter.
Question. Once the COVID-19 pandemic is under control, how do you
anticipate partnering with the commercial supply chain to ensure that
the country is ready for the next public health emergency? Have you
considered solutions such as a ``vendor managed inventory'' solution to
help guarantee that non-expired product could be available on demand?
Answer. As the Nation begins to turn the corner on the COVID-19
pandemic, it will continue to be important to think ahead to the next
public health emergency. If confirmed, I will work with Assistant
Secretary of Preparedness and Response (ASPR) to ensure these efforts
can increase the Nation's ability to meet demand in future crises.
Question. How does the Biden administration intend to use the DPA
authority and will the administration do so with thoughtful
consideration of those with expertise in the medical supply chain so
the existing infrastructure and supply are augmented rather than
duplicated?
Answer. If confirmed, I commit to working closely with members of
this committee on efforts related to the COVID-19 response, including
the use of DPA and its potential impacts.
bundled payments
Question. The health-care system needs to continue to innovate
while maintaining high quality and improving patient outcomes. The CMS
Innovation Center, or CMMI, has several innovative models underway,
including the Bundled Payment for Care Improvement Advanced (BPCI-A),
that uses bundled payments to improve care, foster provider
collaboration and lower health-care costs. We have hospitals and
physician groups participating in bundled payments, and many see them
as a way to drive the health-care system towards better value and
better patient outcomes. When utilized with patient outcomes (and
protections) and measurable value in mind, CMMI can be used to test new
models without disrupting the rest of the program while a model is
being tested.
What is your vision for CMMI, and how can leverage what we have
learned to expand advanced payment models to meet Medicare
transformation goals?
Answer. Innovation is critically important to advancing goals in
health care. The CMS Innovation Center is integral to the
administration's efforts to accelerate promote value-based care and
encourage health care provider innovation. If confirmed as Secretary, I
can commit to you that we will follow the evidence generated by
Innovation Center model tests when considering whether to expand a
model.
The Medicare Advantage program is currently covering about 24
million seniors, including almost 2 million in Texas. A recent report
shows that MA has a higher percentage of racial minorities than fee-
for-service (32 percent in MA compared to 21 percent in FFS) and MA
beneficiaries tend to be older (almost 52 percent are between 70-84
years of age). We also know that seniors would prefer to remain in
their home and their community, and that some seniors have trouble
accessing care.
Question. How can we leverage existing tools in the Medicare
Advantage program, particularly in home-based care, to ensure that
seniors get the care they need?
Answer. Medicare Advantage plays an important role in giving people
access to care. I believe we have to take every approach we can in
order to get people the health care they need at an affordable price.
If confirmed as Secretary of HHS, I look forward to working with you
and other members of Congress to achieve this important goal.
______
Questions Submitted by Hon. Richard Burr
covid-19
Question. In order to mitigate the financial challenges hospitals
faces as a result of the COVID-19 pandemic, certain third-party
companies are able to offer hospitals cash advances for the Medicare
segment of their business as is currently offered by these third-party
companies for the hospital's commercial segment. These cash advances on
Medicare claims may be utilized by hospitals accepting Medicare
patients to offset their loss of revenue from elective procedures that
are not being performed as a result of the COVID-19 pandemic. However,
many hospitals believe that accepting a cash advance from a third-party
to cover such losses is non-allowable under Medicare regulations.
Will you work with hospitals and third-party companies to provide
clarity on all options available and allowed under the Medicare program
for hospitals suffering from cash flow issues due to the COVID-19
pandemic?
Answer. During the pandemic, while some providers have experienced
challenges with overcapacity, many other providers have faced financial
setbacks related to billing disruption, the suspension of non-essential
surgeries and procedures, and health care staff unable to work. As you
know, Congress has provided financial relief to providers and suppliers
through the Provider Relief Fund, Paycheck Protection Program, and the
CMS Accelerated and Advance Payments Program, among other relief
efforts. If confirmed, I will review Federal requirements to determine
if there are barriers to providers obtaining financial assistance.
Question. Operation Warp Speed was created in March 2020 to
accelerate the development of countermeasures for COVID. This public-
private partnership with HHS and the Department of Defense is a
historic example of American innovation. As of the end of January, five
of the six Operation Warp Speed vaccine candidates have entered phase 3
clinical trials--two of which, Moderna and Pfizer, have received
emergency use authorization (EUA) from the FDA as of February 25, 2021.
Should you be confirmed, what will your role be in this extremely
successful public-private partnership?
What do you plan to change about the program?
Answer. I agree with the success of the operation in its ability to
accelerate the development and manufacturing of COVID-19 vaccine
candidates. If confirmed, I would work with all key partners to
understand how to best support the ongoing development and distribution
of medical countermeasures for COVID-19.
fda-cms coordination
Question. We are in an exciting era of biomedical research and
development, from which all generations of Americans stand to benefit.
The development of new medical products is only half of the story,
innovators must meet the FDA's gold standard of approval, then jump the
hurdles of CMS's coverage and pricing decisions. This process can add
time between when a medical product is approved by FDA and when a
patient can use it. What opportunities do you see for FDA and CMS to
work in parallel in order to be prepared for the next decade of novel
medical products and reduce the time patients wait for CMS to make a
decision on an FDA approved product?
Answer. I agree with the goal of expediting patient access to new
medical products. I understand FDA and CMS have taken certain steps
towards parallel review, and I will support appropriate measures to
enable payors to make informed decisions earlier in the process.
clinical trials
Question. Last year, I worked with Senator Cardin on legislation to
improve access to clinical trials for Medicaid beneficiaries. This
bill, the Clinical Treatment Act, was signed in to law late last year.
Medicaid beneficiaries have historically been less likely to
participate in clinical trials because they had to pay for the
associated medical care as a part of the trial. When this law is
implemented, routine care costs for individuals participating in
clinical trials will be covered, providing them access to treatments
that can save and improve their lives. Additionally, by having more
Medicaid beneficiaries participate in clinical trials, we will broaden
the base of clinical trial participants so we can bring cutting-edge
treatments to more Americans.
If confirmed, it will be your responsibility to implement this new
law. What steps will you take to ensure that Medicaid patients can
quickly benefit from this new policy?
Answer. If confirmed, I will work to implement your newly enacted
legislation to broaden access to potentially lifesaving clinical trials
for Medicaid beneficiaries. I look forward to working with you and
States to implement the law and to ensuring that Medicaid beneficiaries
who wish to participate in clinical trials have adequate access to the
health care they need.
medicaid
Question. You may be aware that Georgia recently gained approval of
a unique Medicaid waiver that establishes a pathway for currently
ineligible individuals to gain coverage by meeting Qualifying Hours and
Activities. No currently enrolled Medicaid beneficiaries would be
impacted by the program. Do you believe the State's ``Georgia
Pathways'' waiver fulfills the purpose of Medicaid by providing
coverage to currently uninsured individuals, and will you commit to
keep an open mind about this waiver and other State-led initiatives to
innovate within their Medicaid programs that fits their individual
State needs?
Question. Section 1115 demonstrations can be invaluable in allowing
States to pursue innovative ideas through Medicaid. If confirmed, I
will work to ensure that States' Medicaid section 1115 demonstrations
promote the objectives of the Medicaid program and that these
demonstrations are approved in accordance with and comply with the
Medicaid statute.
transparency
Question. Empowering consumers with health-care price information
so they can make informed health-care decisions has long been a
bipartisan priority. If confirmed as Secretary, are you committed to
ensuring full implementation of the Department's Transparency in
Coverage final rule?
Answer. If I am fortunate enough to be confirmed, I will ensure
that the Department continues to take steps to improve price
transparency, so consumers can look behind the curtain to understand
how providers and insurers are operating.
foster care
Question. The Family First Prevention Services Act created a new
Federal category for settings that deliver trauma-informed treatment
for foster children with serious emotional or behavioral issues in a
residential setting, known as Qualified Residential Treatment Programs
(QRTPs). QRTPs are one of the few residential settings that are
eligible for title IV-E reimbursement. Recently, however, the Centers
for Medicare and Medicaid Services (CMS) indicated QRTPs with more than
16 beds may meet the definition of an Institutions for Mental Diseases
(IMDs), preventing Medicaid reimbursement for care in these
circumstances. This interpretation is not consistent with congressional
intent.
Do you believe that QRTPs should be exempted from the IMD payment
exclusion, allowing children in foster care to have Medicaid coverage
in these placements?
Answer. This is an important and complex question that I am
committed to addressing quickly if I am confirmed by the U.S. Senate. I
am similarly concerned that children in foster care receive necessary
medical care without disruption. As such, I will work closely with the
Centers for Medicare and Medicaid Services to resolve this issue, and
will consider all available administrative and legislative vehicles to
ensure that children in foster care receive the medical care that they
need and to which they are entitled.
Questions Submitted by Hon. Patrick J. Toomey
Question. I find it deeply concerning that you supported the
government's use of march-in rights in the case of remdesivir. Dr.
Francis Collins has publicly testified that the National Institutes of
Health (NIH) does not have the authority to use march-in rights to
lower the cost of a drug. Further, I have strong concerns with the
disincentives created for innovators once government has set the
precedent that it will ``march in'' and steal their intellectual
property on a whim. As follow up to my questions during the hearing:
Can you assure me that you will not use your authority as Secretary
of HHS to abuse the Bayh-Dole statute by invoking this march-in
authority--that has never been used by NIH--to punish companies when
you don't like their prices?
Do you acknowledge that the administration does not have the legal
authority to use march-in rights to lower drug prices?
Your letter to the Trump administration seems to conflict with the
original intent of Bayh-Dole. Do you acknowledge that the intent of the
Bayh-Dole Act is to incentivize public-private partnership and
investment in innovative products?
Answer. Like President Biden, I believe we must do all we can to
lower the costs of prescription drugs and make them more accessible for
Americans. If confirmed, I look forward to working with Congress to
build upon the good work you did in the Finance Committee on this
important issue. If confirmed, I look forward to working with Congress
to find ways to achieve these important goals.
Question. Separately, I have concerns regarding the legality and
appropriateness of tying Medicare reimbursement for certain drugs to
the prices foreign countries pay. The most obvious issue is the
downstream effect it will have on patient access to lifesaving
medicines.
If confirmed, will you advocate for reviving the interim final rule
establishing the Most Favored Nation Model or promulgate similar
rulemaking that ties the price Medicare pays for certain drugs to
prices paid in other countries?
Answer. President Biden is committed to lowering the price of
prescription drugs. Like President Biden, I believe prescription drugs
must be affordable and accessible for all Americans. If confirmed, I
will work to strengthen Medicare and Medicaid, reduce the cost of
health care and prescription drugs, and ensure we are accountable in
spending resources wisely and effectively. You have my commitment to
work with you and other members of Congress on this issue.
Question. The Biden administration is requesting $20 billion for
vaccinations. Just 59 days ago, Congress provided $8.75 billion for
vaccine-related expenses. $3 billion has been made available to States,
but it has become incredibly difficult to know exactly how much money
remains available and how much has been spent or obligated in granular
detail.
My staff has requested certain documents from the Department of
Health and Human Services commonly referred to by the previous
administration as ``weekly draw down reports.'' These reports provide
some insight into the allocation of Federal funding and subsequent
spending by the States. It is my understanding that these reports have
been shared with other members of this chamber and are generally used
for press inquiries.
Prior to any vote on COVID-19 relief, it is important all members
are given an opportunity to view these weekly draw-down reports. If
confirmed, will you commit to providing this information to Congress on
a weekly basis?
Answer. If confirmed, I commit to providing transparent and timely
review of information.
______
Questions Submitted by Hon. Tim Scott
leveraging virtual health technology and
telehealth to expand access to care
Enhancing Telehealth Access
Question. Earlier this week, joined by Senator Schatz and a
bipartisan group of my Senate colleagues, I introduced the Telehealth
Modernization Act, legislation aimed at increasing access to high-
quality health-care services, particularly for our Nation's seniors, by
codifying crucial flexibilities for telehealth coverage.
Long before the pandemic began, South Carolina had emerged as a
leader in telehealth innovation, hosting one of just two federally
recognized Telehealth Centers of Excellence in the Nation. High-quality
telehealth services and networks spearheaded by cutting-edge providers
like the Medical University of South Carolina have transformed the
Palmetto State's health-care landscape. Unfortunately, however, for the
majority of the State's roughly 1 million Medicare beneficiaries,
outdated coverage restrictions have long inhibited access to telehealth
services.
For years, rigid rules around patient location (geographic and site
of service), eligible services and provider sites, and other components
of care have created substantial barriers to telehealth utilization. In
February 2020, for instance, just prior to the COVID-19 public health
emergency (PHE), only 0.1 percent of Medicare fee-for-service (FFS)
primary care visits were delivered via telehealth. In any given week
before the PHE, an average of just 14,000 Medicare beneficiaries
received a telehealth service.
Congress took decisive steps towards expanding telehealth access
through the CHRONIC CARE Act, particularly for the roughly 36 percent
of Medicare beneficiaries nationwide who have chosen to enroll in
Medicare Advantage (MA) plans, more than three-quarters of which
provided extra telehealth benefits, even before the pandemic struck.
For South Carolina, however, MA penetration remained below 30 percent
last year. For the 72 percent of SC's Medicare beneficiaries enrolled
in FFS coverage, substantial restrictions have remained.
While these Medicare access gaps predated the pandemic, the spread
of COVID-19 highlighted the urgency of updating telehealth coverage
rules, prompting Congress to provide authority for pivotal emergency
waivers designed to ensure safe access to care for seniors and other
vulnerable populations. As the pandemic raged, Medicare beneficiaries
turned to telehealth services to minimize viral exposure risk and
receive medically necessary care in safe and accessible settings. In
April 2020, more than two-fifths (43.5 percent) of Medicare FFS primary
care visits were provided through telehealth, and from mid-March
through early July of that year, more than 10.1 million beneficiaries
accessed telehealth services.
Without congressional action, however, these emergency
flexibilities will expire at the end of the PHE, creating an access
cliff for tens of millions of Medicare beneficiaries, including many
who have come to rely on telehealth for critically needed care.
If confirmed, can you commit to making the expansion of telehealth
access, particularly for seniors and vulnerable populations, a priority
for the Department of Health and Human Services?
The Telehealth Modernization Act would eliminate a number of
outdated restrictions on Medicare coverage for telehealth services,
including by removing geographic and originating site restrictions and
ensuring that federally qualified health centers and rural health
clinics can continue to serve as distant sites, even after the pandemic
subsides. Would you support these types of policy proposals as a means
of expanding access to care?
Can you commit, if confirmed, to working with my office, Senator
Schatz's office, and the offices of other telehealth champions to
ensure that the tens of millions of Medicare beneficiaries enrolled in
FFS do not face a telehealth service coverage cliff when the public
health emergency expires?
In the absence of the emergency waivers, what would you cite as
some of the most significant barriers to telehealth access,
particularly for seniors and those with serious health conditions, and
what steps would you take as HHS Secretary, if confirmed, to address
some of these barriers?
What role or roles do you see telehealth and other virtual health
technologies in playing within the administration's broader goal of
combating health disparities?
I see our digital infrastructure as a powerful tool in addressing
health disparities. If confirmed, how would you work with other Federal
agencies and officials to bolster broadband access and bridge the
digital divide?
Answer. Telehealth is incredibly important tool to improve health
equity and improve access to health care. Health care should be
accessible, no matter where you live. If confirmed, I will look at the
telehealth flexibilities developed for the current public health
emergency and determine how we can build on this work to improve health
equity and improve access to health care. As you mentioned, access to
broadband is critical to the expansion of access to telehealth
services, and I look forward to working with you and other departments
across the administration, if confirmed, on this important issue.
Improving the Medicare Diabetes Prevention Program (MDPP) Expanded
Model
Question. The Medicare Diabetes Prevention Program (MDPP) Expanded
Model (EM) leverages proven interventions to prevent the onset of type
2 diabetes in Medicare beneficiaries with prediabetes. In 2016, the
Chief Actuary of CMS certified that ``beneficiaries participating in
diabetes prevention programs have achieved success with losing weight
and reducing the incidence of diabetes'' and that the expansion was
``expected to reduce Medicare expenditures.'' According to CMS, the
program at the core of the expanded model ``has been shown to reduce
the incidence of diabetes by 71 percent in persons age 60 years or
older.''
Unfortunately, the exclusion of innovative virtual suppliers from
the MDPP EM has impeded the program's reach and created substantial
access gaps, particularly for older Americans living in rural and
underserved urban communities. Politico reported that only 202
beneficiaries had used the program in 2018, and an American Journal of
Managed Care study published in June 2020 concluded that ``inadequate
MDPP access'' stemmed in part from ``severe shortages'' of suppliers,
particularly in States with large populations of Medicare beneficiaries
of color. The COVID-19 pandemic has highlighted and exacerbated these
access barriers, but regulatory flexibilities remain limited.
In order to address these access gaps, last Congress, I partnered
with Senator Warner in leading a number of letters to HHS and CMS
leaders, urging them to take administrative action to enable the
participation of CDC-recognized virtual suppliers in the MDPP EM. We
also introduced the bipartisan, bicameral PREVENT DIABETES Act, which
would accomplish the same goal legislatively. Unfortunately, virtual
suppliers remain excluded from the program, and even the flexibilities
provided for the pandemic emergency period have proven unable to
improve access for beneficiaries in need.
The Biden administration has cited combating health disparities as
a key policy priority. According to the CDC, 13 percent of American
adults have diabetes, including 26.8 percent of those aged 65 or older.
Diabetes prevalence varies substantially by race/ethnicity, affecting
16.4 percent of Black adults, 14.9 percent of Asian adults, and 14.7
percent of Hispanic adults, versus 11.9 percent of White adults.
Inclusion of virtual suppliers in MDPP could help to address these
disparities and improve outcomes for older Americans across the board.
In your testimony, you also pointed to reducing health-care costs
as one of your primary aims in taking on this role, should you be
confirmed. A 2018 study that focused specifically on the provision of
DPP services through virtual providers found statistically significant
evidence of reduced costs and utilization pattern changes for a
Medicare population.
If confirmed, can you commit to working, in consultation with my
office, Senator Warner's office, and other relevant Federal officials,
to enhance access to the Medicare Diabetes Prevention Program?
Can you commit to reviewing the robust evidence base and giving due
consideration to the bipartisan and bicameral requests that I have led,
in partnership with Senator Warner and others, to secure the inclusion
of CDC-recognized virtual suppliers in the MDPP EM?
Beyond the MDPP EM, what do you see CMMI's role to be in terms of
facilitating the demonstration and evaluation of virtual care solutions
and digital health tools?
More broadly, can you speak to the administration's efforts to
enable Medicare beneficiaries to leverage digital health tools for the
prevention and treatment of disease? Are their limitations in your
ability to expand access to these valuable resources for those that
want to use them within Medicare?
Answer. Innovation is important to advancing goals in health care,
and the CMS Innovation Center is integral to the administration's
efforts to promote high-value care and encourage health-care provider
innovation, including virtual and digital health innovation. With
respect to the Medicare Diabetes Prevention Program (MDPP) expanded
model, I understand that CMS issued regulatory flexibilities in
response to the COVID-19 pandemic, including waiving the limit on
virtual sessions that can be provided by MDPP suppliers. If confirmed
as Secretary, I commit to working with you on this and other models to
reduce health disparities and prevent chronic diseases such as
diabetes.
enhancing access to innovation
Question. As co-chair of the bipartisan, bicameral Personalized
Medicine Caucus, I have long championed the potential for cutting-edge
innovations like gene and cell therapies to transform the treatment
landscape. In recent years, the pace of development on these fronts has
accelerated, with a report from last Spring suggesting that more than
360 gene and cell therapies were in the United States' clinical
pipeline, versus fewer than 300 just 2 years earlier. More than one-
third of these therapies aim to treat rare diseases, providing cause
for optimism to patients across the country, as 95 percent of the 7,000
known rare diseases currently lack an FDA-
approved treatment option. Individuals with sickle cell disease, for
instance, which affects an estimated 100,000 Americans, could feasibly
see a cure on the horizon.
According to a 2019 statement by key FDA leaders, the agency
anticipated, at that point, approving 10 to 20 new gene and cell
therapies every year by 2025, in addition to receiving a projected 200
investigational new drug applications for gene and cell therapy
candidates annually, beginning in 2020.
That said, even in the face of these potentially lifesaving
developments, hurdles remain, even for gene and cell therapies that
successfully gain FDA approval. A number of laws and regulations around
Medicaid ``best price,'' the Anti-Kickback Statute (AKS), and the Stark
Law, among other relevant statutes, understandably failed to
contemplate this new generation of gene and cell therapies, which have
only recently begun to come to market.
A disproportionate share of the patients affected by the diseases
most likely to be treated by the early waves of gene and cell therapies
receive health care coverage through Medicare or Medicaid. With that in
mind, would you agree that HHS should do all that it can to ensure
access to FDA-approved cell and gene therapies when a doctor and a
patient agree that it is the most appropriate treatment option?
The current Medicaid reimbursement structure was not designed with
curative therapy payments in mind. For the roughly 100,000 Americans
affected by SCD and other painful and debilitating conditions, these
outdated rules risk delaying patient access and hinder Medicaid's
ability to pay for innovative therapies based on their value. How will
HHS overcome barriers in the current Medicaid reimbursement structure
for cell and gene therapies, giving patients access to cures and not
just treatments?
In December, HHS finalized the ``Establishing Minimum Standards in
Medicaid State Drug Utilization Review (DUR) and Supporting Value-Based
Purchasing (VBP) for Drugs Covered in Medicaid, Revising Medicaid Drug
Rebate and Third Party Liability (TPL) Requirements (CMS 2482-F)''
rule, which took important steps towards ensuring that State Medicaid
programs have the flexibility they need to hold manufacturers
accountable for the performance of their therapies. Will HHS commit to
implementing this rule and ensuring that patients have timely access to
lifesaving cell and gene therapies?
If and when HHS implements this rule, barriers to value-based
arrangements will remain, both within the Federal health-care programs
and in the private sector. Can you commit, if confirmed, to work with
my office to develop the additional legislative and regulatory
solutions needed to facilitate meaningful value-based arrangements for
drugs, biologics, devices, and other innovative medical products?
Answer. I believe that people should have timely access to
lifesaving innovative therapies, including prescription drugs,
biologics, devices, and other medical products. We need to foster
innovation in medical technology to develop new lifesaving therapies.
If confirmed, I look forward to working with you and other members to
find solutions to address the high cost of new therapies.
Question. The prior administration issued new AKS safe harbors to
protect value-based arrangements among health-care providers and other
industry stakeholders, but value-based arrangements for drugs and
biologics received no such protections, inhibiting the development of
these types of agreements and jeopardizing patient access to
innovation. Will you commit to developing a safe harbor that would help
promote greater innovation in the pricing of drugs and biologics?
Answer. I look forward to working with the Office of Inspector
General and the Department of Justice to explore whether a safe harbor
would help promote access to beneficial innovation while also
protecting against fraud and abuse.
Question. Over the past decade, Congress and the FDA have worked
together to develop a useful set of tools to ``fast track'' new drug
and biologic discoveries through the FDA review process. These tools,
known as ``fast track,'' ``breakthrough,'' and ``regenerative medical
advanced therapy designation,'' have the potential to bring new
treatments to patients faster, helping to confront some of the most
serious medical challenges. For example, one rapidly emerging area of
innovative discovery known as allogeneic ``T-cell immunotherapy'' for
the treatment of cancerous tumors, blood cancers and autoimmune
diseases, has benefited from these avenues through the FDA review
process.
However, even after the FDA uses these tools to find said
treatments clinically safe and effective, applicants must navigate a
second component of the FDA review process, known as the ``Chemistry,
Manufacturing and Controls'' or ``CMC'' process. This part of the
process includes an on-site FDA inspection of manufacturing facilities,
which must be completed before a new treatment can come to market.
Unfortunately, even before the pandemic, this stage in the review
process had become considerably delayed, with immunotherapy products
that have shown strong safety and efficacy in clinical studies being
held up because of a lack of clarity and consistency from the agency on
CMC requirements. I appreciate the challenges created by the pandemic,
but these CMC delays existed before the pandemic, and without action,
they will persist even after the pandemic subsides, imperiling patient
access to lifesaving innovations.
Can you commit to resolving this issue when you arrive at the
Department and to expediting the FDA's CMC review process, as well as
the requisite inspections, for these urgently needed fast-tracked
therapies?
Answer. I commit to do everything I can to ensure that safe and
effective therapies get to market as efficiently as possible. While FDA
paused all on-site surveillance domestic inspections in March 2020 due
to the COVID-19 pandemic, FDA investigators continued mission critical
inspections and other activities to ensure FDA-regulated industries are
meeting applicable FDA requirements. FDA also later began resuming
surveillance inspections in July 2020. To date, FDA has not experienced
a significant impact on its ability to take actions on drug and
biologic applications.
FDA has also been employing other tools to evaluate facilities, as
appropriate, such as requesting records and other information or
reviewing trusted foreign regulator inspection records under existing
Mutual Recognition Agreements. These tools have been, in many cases,
successful to allow the agency to take actions on applications in lieu
of an inspection.
I will work with FDA to ensure the agency uses every appropriate
tool to get critical safe and effective therapies to market as
efficiently as possible.
vaccines
Seniors' Access to Preventive Care
Question. While Medicare Part B covers a number of vaccines,
including for influenza, pneumococcal, and hepatitis B, with no
beneficiary cost-sharing, the majority of vaccines recommended for
adults, including for older adults, are covered under Part D, where
seniors can face substantial copays. While cost-sharing can serve as a
useful and appropriate tool in other contexts, those rationales do not
apply in the case of ACIP-recommended vaccinations, and studies have
shown a direct correlation between cost-sharing and increased
abandonment rates for vaccines.
As a number of my colleagues and I noted in a letter we sent to CMS
on this subject last summer, ``A 2017 report by Avalere Health found
between 47 and 72 percent of the 24 million Medicare beneficiaries with
Part D coverage had some level of cost sharing for vaccines, ranging
from $35 to $70 in 2015. Another study found that only 4 percent or
less of Medicare Part D enrollees had access to vaccines with no cost
sharing.''
How can the Biden administration address the issue of ensuring
medically necessary preventive care for all populations?
Answer. Ensuring access to health care, including preventive care,
for all populations is a top priority of the Biden administration. If
confirmed, I look forward to working with Congress to find ways to
ensure preventive care, including recommended vaccination, is
accessible for all populations, including Medicare beneficiaries.
health-care coverage
Question. Many of my constituents have expressed concerns about
your longstanding support for a single-payer health-care system, which
many of them see as an existential threat. In addition to eliminating
employer-sponsored health plans and replacing them with one-size-fits-
all public coverage, legislation that you supported while in Congress
would exact unprecedented payment cuts on health care providers, likely
triggering hospital and practice closures, early physician retirements,
and a decline in care quality and innovation.
Even before the pandemic began, Medicare paid just half of what
private insurance reimbursed for the same hospital care. If SC's
providers were to lose all commercially insured patients, confronted
with a Medicare-only payer mix, many would be forced to close,
particularly in rural areas, where close to one-third of the State's
residents live.
These concerns are not merely hypothetical, as a survey of
countries with single-payer systems shows. During the 2018-2019 flu
season, for instance, one in every four patients in Britain had to wait
more than four hours in the ER to get the care they needed. Even left-
leaning sources in Britain acknowledge that rationing care had risen
dramatically in the years leading up to the pandemic. This meant
massive delays for cataract surgery, hip and knee replacements,
arthritis treatments, and other high-demand procedures. Furthermore, in
terms of medications, of the new cancer drugs launched between 2011 and
2018, 95 percent were available in the U.S., versus fewer than three-
quarters in the U.K.
If confirmed, this role will provide you with a powerful podium to
advocate for your policy preferences, and many of my constituents are
worried that your support for government-run health care will inform
the decisions you make, whether in terms of provider cuts, efforts to
downsize Medicare Advantage, or any number of other proposals that
could jeopardize access to care. What would you say to address these
concerns, given your 3 decades of public support for government-run
health care?
If confirmed, can you commit to working to bolster and enhance the
employer-sponsored health care system that provides coverage to roughly
50 percent of all Americans?
Answer. President Biden has made it very clear that his goals for
improving the American health-care system begin with building on the
successes of the Affordable Care Act. If I am confirmed, I will work to
implement his agenda, build on the Affordable Care Act, and expand
coverage and reduce costs for all Americans.
Question. Looking at the current coverage landscape, what are some
of the innovations in commercial health-care coverage and benefit
design that you see as most compelling, promising, or worthy of
replication? If confirmed, what would you do to promote, further
publicize, or otherwise advance these innovative models?
Do you believe that employer wellness plans can or should play a
role in driving positive health outcomes for Americans and lowering
long-term health-care costs?
Answer. I believe that there can be many innovative strategies
which can help improve health outcomes for Americans and lower long-
term health-care costs. If confirmed as Secretary of HHS, I look
forward to reviewing the information we have available to determine
what approaches are working well and where there might be opportunity
for further innovation.
Medicare Advantage
Question. A growing share of Medicare beneficiaries, rising from
just one-quarter in 2010 to 36 percent in 2020, have chosen to enroll
in Medicare Advantage (MA), which is managed by private insurers and
has a 94 percent satisfaction rate. MA has enjoyed increasingly strong
bipartisan backing, with 64 Senators and 339 members of the House
signing on to a letter of support for the program last year.
MA plans cover an increasingly broad array of extra benefits,
relative to the fee-for-service model. Of all MA plans, 88 percent
cover hearing aids and 91 percent cover glasses and eye exams, while 92
percent include dental benefits and 96 percent have a fitness benefit.
Given the overwhelming bipartisan support and the additional
benefits, as well as the growing competition in the MA market, what
steps would you look to take, if confirmed, to continue increasing
access to and education on MA options for seniors?
Answer. Medicare Advantage serves millions of Americans and is one
important option for seniors. I believe that we have to take every
approach we can in order to provide people access to quality health
care. If confirmed as HHS Secretary, I look forward to working with
Congress on this important issue.
religious liberty and conscience protections
Question. Since long before I came to Congress, I have prioritized
protections for religious liberty and freedom of conscience, one of our
core constitutional rights. I have also been a committed defender of
all human life, including the lives of the unborn. Your stated
positions on a number of issues, included late-term abortion, life,
conscience protections, and overreaching government policies that
infringe on religious freedoms have raised significant concerns among
many South Carolinians.
Prior to taking any actions with implications for people of faith,
can you commit to consulting and engaging with religious liberty
advocates, including those who disagree with your previously stated
positions on the issues above?
Answer. As a person of faith, I certainly understand the importance
of people's faith in their own lives, and I would always seek a range
of views when making any decisions, if I am fortunate to be confirmed.
Question. If confirmed, can you commit, through all of your actions
as HHS Secretary, to uphold religious liberty and freedom of conscience
for all Americans, including those with deeply held religious
convictions and beliefs?
Answer. As a person of faith, I believe deeply in religious
freedom. I was raised in a Catholic home, and we would get up early on
Sunday mornings to go to mass. My faith is a big part of who I am
today, and I'm grateful that we live in a country that recognized the
right of all Americans to exercise their religion. It's part of what
makes the United States so special. I am also proud that, in this
nomination, I have the support of the Catholic Health Association and
other faith-based groups. If confirmed as HHS Secretary, in executing
the President's agenda, I would certainly follow the law and
Constitution in our efforts to protect people's health.
access to home infusion therapy
Question. As the CDC and researchers across the world have noted,
COVID-19 presents the most severe health risks to older individuals, as
well as to those with underlying conditions, making the Medicare-
covered population especially vulnerable to this disease.
Unfortunately, Medicare beneficiaries in need of medical care or
treatment for issues unrelated to the pandemic too often face a
grueling decision, whereby they must choose between forgoing the
services and medications they need by staying at home or,
alternatively, seeking care in a hospital setting or physician's
office.
However, many of these patients could viably receive their infused
or injectable medications at home, relieving them of the risks
associated with traveling to an institutional setting to receive their
treatments.
Considering these ongoing challenges, can you commit to
prioritizing policies that increase access to home infusion therapy for
patients who want to receive their treatments at home?
Answer. I agree that we must ensure Medicare beneficiaries have
access to quality health-care services, including access to these
services in the home. During the public health emergency, CMS has taken
actions to expand flexibilities under Medicare so that health-care
services can be furnished to Medicare beneficiaries in the safety of
their homes. If confirmed, I commit to working with you on making sure
Medicare beneficiaries have access to the services and medications they
need.
______
Questions Submitted by Hon. Bill Cassidy
Question. The CARES Act provides FDA with authority to expedite the
facility inspections. Do you think that FDA should exercise this
authority to address or prevent drug shortages, particularly as ramping
up vaccine manufacturing capacity may mean redirecting activities and
resources from manufacture of other drug products?
Answer. While the COVID-19 pandemic strained FDA's ability to
perform traditional foreign inspections, as I understand it, the agency
has worked to improve inspection capabilities within the current public
health environment. I agree that we must apply the lessons learned
during this public health emergency to our work going forward.
Question. How do you think that FDA can best regulate tobacco
products?
Answer. Tobacco use is the single largest preventable cause of
disease and death in the United States. Each year, more than 480,000
people in the United States die prematurely from diseases caused by
cigarette smoking and exposure to secondhand tobacco smoke. As you
know, FDA has comprehensive tools to protect the public from the
harmful effects of tobacco use through science-based tobacco product
regulation. If confirmed, I will ensure FDA effectively uses this
authority in the interest of the public's health.
Question. Do you support a product standard that would limit the
level of nicotine in cigarettes or other tobacco products?
Answer. If confirmed, I will engage in this conversation with FDA
and other experts across the Department and will examine potential
actions in this area.
Question. Based on your reading of the statute and applicable
regulations, what is the scope of FDA's regulatory authority over
tobacco products and do you believe it extends to synthetic nicotine
products?
Answer. This is a legal question that I have not personally
examined but, if confirmed, this is a question that I intend to resolve
through consultation with the attorneys and experts at HHS.
Question. How do you think that implementation of the
interoperability regulations fits into data exchange efforts
surrounding COVID-19?
Answer. Interoperability has proven to be an important innovation
in health care that has gained bipartisan support. I believe we need
increased access to data because good data leads to good policy. If
confirmed, I look forward to partnering with States.
Question. Medicare is often slow to cover new technologies, even
when they represent significant clinical improvements over the existing
standard of care. This is even when we have committed significant
Federal resources to supporting a product through the research and
development process as well as FDA review, like we did with the
artificial pancreas. What do you think CMS can do to make sure that
Medicare can cover these new technologies?
Do you support the Trump administration's final rule creating a
new, accelerated Medicare coverage pathway to ensure national coverage
for breakthrough products?
Answer. I agree that it is important to foster innovation in
medical technology, which has the potential to improve health-care
outcomes. If confirmed, I will work to ensure Medicare beneficiaries
have access to medically necessary innovative technologies.
Question. How do you think that HHS could discourage rebate traps
or rebate walls?
Answer. Like President Biden, I believe we must do all we can to
lower the costs of prescription drugs and make them more accessible for
Americans who depend on these medications. I am committed to reducing
drug prices and ensuring Americans have access to the drugs that they
need. If confirmed as Secretary of HHS, I look forward to working with
you to find ways to achieve these important goals. I will also work
across the government to address barriers to reducing drug prices.
Question. Given current events and the importance of animal
research to address medical emergencies such as COVID-19, as well as
research for practically every other area of disease, can you tell us
what steps HHS and NIH plan to take to ensure that air transport of and
access to animal models in the U.S. is assured?
Answer. Research conducted in and supported by the NIH is
invaluable to advancing the biomedical sciences and human health. If
confirmed, I look forward to working with NIH and others at HHS to
further the essential work of the NIH.
______
Questions Submitted by Hon. James Lankford
Question. The HHS contraceptive mandate, promulgated under the
Obama administration, purported to offer cost-free birth control to all
women. However, because of massive exemptions given to grandfathered
corporate entities and even to the government's own plans for Medicare
and the U.S. military, one-third of all Americans were not even covered
by the original mandate. Yet the Federal Government insisted that it
could not find an alternate solution for the relatively small number of
religious organizations with conscientious objections to paying for
contraceptive coverage. One of these groups was the Little Sisters of
the Poor, an order of Catholic nuns who care for the elderly poor who
have nowhere else to go.
The losing attempt to force nuns to pay for birth control has now
been to the Supreme Court three times and has lost a resoundingly three
times. At oral argument in April of 2016, the Obama administration
admitted that it can find ways to accomplish a policy goal of fully
covered contraception without conscripting nuns into the process.
Continuing this unnecessary fight is not only an affront to the
First Amendment, but also a waste of valuable government resources and
time. But you are leading one of the ongoing lawsuits to continue
forcing the Little Sisters of the Poor to choose between shutting down
their ministry to the elderly poor or violating their religious
beliefs.
Will you commit that if confirmed, you will not re-impose the
contraceptive mandate on religious ministries like the Little Sisters
of the Poor?
Answer. President Biden has committed to building on the Affordable
Care Act to ensure that men and women have expanded access to health
care. I strongly believe women should not be put through unnecessary
hurdles to access to health care.
Question. I am concerned about the increasing trend to medically
transition children who have self-diagnosed gender dysphoria. This has
led to children as young as nine being prescribed puberty blockers that
have irreversible consequences such as permanent infertility. The vast
majority of Americans do not believe that a 9-year-old child can
consent to puberty blockers or that a 13-year-old girl can consent to a
double mastectomy.
If confirmed, under your leadership, what steps will the Department
take to ensure that children are not subjected to experimental hormone
therapy with life-
altering effects?
Do you believe insurance must be required to pay for and doctors
must be required to administer puberty-blocking drugs and sex-
reassignment surgeries to children as young as 13?
Do you agree that doctors and hospitals should have the right to
refuse to participate in gender transition therapies and treatments due
to medical, religious or moral convictions?
Answer. If I am fortunate to be confirmed, I will rely on doctors
and scientists to offer clear, scientific, fact-based information on
issues like this because I believe medical decisions should be left to
individuals and their health providers. As HHS Secretary, I will follow
the law when it comes to regulating insurance and respecting
constitutional freedoms.
Question. As you may know, an Obama administration regulation
change that took effect on January 11, 2017 expanded the non-
discrimination clause of title IV-E of the Social Security Act in a way
that resulted in faith-based child placing agencies being faced with
the dilemma of abandoning their religious beliefs and convictions or
losing funding and possibly their licenses to operate.
HHS issued a notice of non-enforcement for the Obama-era rule. It
subsequently announced and published its final rule (86 FR 2257) on
nondiscrimination requirements in grants to allow faith-based child
welfare organizations to operate in accordance with their faith.
If confirmed, will you commit to allowing faith-based
organizations, specifically child welfare providers, to serve and
partner with the Federal Government in accordance with their sincerely
held religious beliefs?
Answer. I believe deeply in religious freedom. I am a person of
deep faith myself. And faith-based organizations certainly have a role
to play in our health-care and human services mission. If I am
fortunate enough to be confirmed, I will work with our faith-based
partners to deliver health care to Americans who need it and respect
our Constitution.
Question. You have been asked a number of times over the past few
days about the impact that Pharmacy Benefit Managers (PBMs) have on the
pharmaceutical industry and drug prices. As you may be aware, the Trump
administration released a number of executive orders over the past few
years intended to decrease drug prices. While many of those proposals
have since been temporarily frozen, one proposal that we hoped would be
seriously looked at was not able to cross the finish line. That is
PBMs' use of Direct and Indirect Remunerated Fees, or DIR Fees.
Many Oklahoma pharmacists have talked to my office to share their
frustration with the current DIR fees, specifically under Medicare Part
D. Under the current policy these fees may not be charged at the time a
claim is processed. When the PBMs and plan sponsors collect these fees,
pharmacists are given almost no insight about why they were imposed.
Also, it is virtually impossible for the pharmacy owner to assess his
or her actual reimbursement rate at the outset of the plan year, the
time of dispensing medication, or at the end of the contractual term.
This leaves pharmacies, particularly small and rural pharmacies,
with little to no financial security based on the unknown level of fees
they may be charged for simply doing their job and providing
prescriptions to their customers, and has many times caused local
pharmacies' doors to close. If we do not take a closer look at this, we
may be nearing the end of many small, local pharmacies and the
necessary services they provide their communities.
Will you commit to documenting the impact of DIR fees on pharmacies
and to working with Congress toward viable solutions?'
Answer. Small and rural pharmacies are critical to our Nation's
health-care system. We must do all we can to ensure that Americans can
access important health-care services, including from local pharmacies
in their communities. If confirmed, I look forward to working with
Congress to ensure that community pharmacists have predictability.
Question. A little over a week ago, I sent a letter to the CDC
asking that additional guidance be released for senior individuals who
are isolated in long-term care facilities, but have received both doses
of the COVID-19 vaccine. Many people who are elderly or may be more
vulnerable to COVID have seen the vaccine as the light at the end of
the tunnel. With little clarity on what can change after their full
vaccine dosage, many seniors are more confused and hopeless than ever.
Will you commit, if confirmed, to work with the CDC to ensure that
such guidance is quickly released and that continued guidance be
released as new updates occur?
Answer. HHS and CDC stand committed to providing the best, most
current data and scientific understanding available to protect the
health, safety, and well-being of our communities. And, if confirmed, I
will work to continue that effort and provide updated guidance as
appropriate.
Question. You have discussed transparency and accountability at
great length when it comes to all areas of the current health-care
system. What specific solutions are you looking at to provide
transparency when it comes to health-care costs and prescription drug
costs?
Answer. The American people are entitled to know what they're
buying. And, like President Biden, I believe prescription drugs must be
affordable and accessible for all Americans. I am committed to reducing
drug prices and ensuring Americans have access to the drugs that they
need.
Question. If confirmed, you will have authority over the largest
Federal department by budget and some of our largest Federal
expenditures like Medicare and Medicaid. As I am sure you are aware, in
September 2020, CBO predicted that if no changes were made, the
Medicare Hospital Insurance Trust Fund would be insolvent in 2024.
How will you work to ensure the solvency of the Medicare trust
funds without implementing additional financial stress on taxpayers?
Answer. If confirmed, my team and I will be ready to sit down with
you and other members of Congress to discuss both short- and long-term
solutions to guarantee Medicare's future.
Question. In 2019, the Senate Finance Committee considered a
bipartisan amendment, of which I was a part, to reduce cost-sharing for
seniors in Medicare Part D. Generic and biosimilar medicines can only
provide significant savings for patients if they are covered on the
appropriate Medicare Part D formulary tier.
Will you work with us to ensure Part D covers newly available
generic and biosimilar medicines and ensure proper formulary tier
coverage?
How will you work to encourage more use of generics and biosimilars
in Part D?
Answer. Competition in the market has helped control the growth in
spending on prescription drugs. I believe that generic drugs and
biosimilars have a role to play in containing the cost of innovative
yet expensive therapies by creating competition. Like President Biden,
I believe we must do all we can to lower the costs of prescription
drugs and make them more accessible for Americans who depend on these
medications for their health. If confirmed as Secretary of HHS, I look
forward to working with Congress on these important issues.
Question. During the pandemic telehealth has played a major role in
providing access to care for both Medicaid beneficiaries, including
children, and Medicare beneficiaries, including our Nation's most
vulnerable elderly individuals. How will HHS support the continued use
and enhancements needed under Medicaid and Medicare to ensure
telehealth continues to enable access to care for people of all ages?
Answer. Telehealth is an important tool to improve health equity
and improve access to health care. Health care should be accessible, no
matter where you live. If confirmed, I will look at the telehealth
flexibilities developed for the current public health emergency and
determine how we can build on this work to improve health equity and
improve access to health care.
Question. Diabetes is the seventh leading cause of death in
America. More than 34.2 million Americans, equivalent to 10.5 percent
of the population, have diabetes. Minorities are up to three times more
likely to be diagnosed with the disease. About 1.25 million Americans
suffer from type 1 diabetes alone. Insulin is the most common treatment
option for those with type 1 diabetes. Over the past 10 years, the
price of insulin has nearly quadrupled, even though the product has
been on the market for almost 100 years, with no significant changes to
warrant such a dramatic price increase. The skyrocketing price of
insulin has put the lives and livelihoods of millions of Americans at
risk due to many families having to make the tough choice of affording
life-sparing medication or other necessities such as food or rent.
Though insulin has largely remained the same, innovation in America
is at work to create insulin products through many different means--
hoping to bring more competition to the insulin market, thus driving
down prices.
As of March 23, 2020, insulin is now considered a biologic product
and is regulated under the Public Health Services Act. The Biologics
Price Competition and Innovation Act (BPCIA) passed as part of the ACA,
created an abbreviated Biologic License Application process for
biosimilars. The biosimilar definition to receive access to this
abbreviated pathway requires a product to (1) be highly similar, and
(2) have no chemically important differences to the originator product.
In the months and years to come, many are hopeful to see this
transition bring about more treatment options for Diabetes patients.
In the fiscal year 2021 appropriations bill, my office worked for
report language that would require the FDA to prioritize the approval
of biosimilar insulin applications, including chemically synthesized
insulins, should such a product request approval and provide examples
of how FDA has given express attention to biosimilar insulin
applications and FDA's plans in place to ease the application process
for such products.
Will you ensure that all new insulin products have the ability to
approach the FDA for an approval application in order to ensure robust
competition for insulin products so the millions of Americans living
with diabetes may have access to new and affordable insulin?
Answer. As you note, millions of Americans are impacted by
diabetes. If confirmed, I look forward to working with you and other
congressional leaders to expanding access to and lowering the costs of
insulin.
Question. Given the severe dependence on foreign active
pharmaceutical ingredients (API) production, what do you believe the
Federal Government's role should be to support domestic API
manufacturing and related pharmaceutical supply chains?
Answer. The global pandemic has highlighted the vulnerabilities of
the global supply chain for many products. In order to continue
responding to the COVID-19 pandemic and better preparing the Federal
Government to respond to any future public health emergencies, it is
critical that HHS work to improve and expand domestic supply chain
capabilities. If confirmed, I'm committed to working on this urgent
matter.
______
Questions Submitted by Hon. Todd Young
united network for organ sharing
Question. I have been championing oversight and reform of Organ
Procurement Organizations (OPOs) for a few years now, including via an
active, bipartisan investigation in this committee into OPOs and their
oversight body, the United Network for Organ Sharing (UNOS), led by
Chairman Wyden and former Chairman Grassley. Because UNOS has not been
compliant with the investigation, however, the Senate Finance Committee
was forced to issue UNOS a subpoena for the documents necessary for
Congress to assess important issues related to system failures, patient
safety lapses, and potential Medicare fraud. By virtue of the OPTN
Final Rule, however, the HHS Secretary has broad authority to request
any documents he or she deems necessary from OPOs or UNOS.
As HHS Secretary, will you commit to using this authority in all
ways appropriate to support the ongoing bipartisan Senate Finance
Committee investigation?
Answer. I am committed to making sure that patients who need organs
receive the help they need with organ transplantation. To that end, we
will work with the committee to support their oversight efforts related
to organ procurement, where appropriate.
office of organ policy
Question. On January 15, 2021, HHS notified Congress that the
Division of Transplantation was moving from HRSA to the Office of the
Assistant Secretary for Health, in line with calls from patient
advocates to create a dedicated Office of Organ Policy.
Can you commit to ensuring that oversight will be a key function of
that new office?
Would you be willing to work with us on oversight of OPOs and UNOS
so we can hold these organizations accountable?
Answer. I am committed to making sure that patients who need organs
receive the help they need with organ transplantation. To that end, I
will look into all options that move us closer to this goal.
center for medicare and medicaid innovation (cmmi)
Question. The Center for Medicare and Medicaid Innovation (CMMI) is
charged with testing and evaluating voluntary health-care payment and
service delivery models with the intent of increasing quality and
efficiency while reducing program expenditures under Medicare,
Medicaid, and the Children's Health Insurance Program. There is
absolute value in innovating and experimenting with health care payment
and service delivery systems. We won't know if we're truly making a
difference unless we experiment and evaluate.
What are your plans for CMMI?
What issues and models do you hope to test in the innovation
center?
Do you plan on canceling any existing or announced models?
Answer. Innovation is critically important to advancing the
administration's goals in health care. The CMS Innovation Center is
integral to the administration's efforts to accelerate the move from a
health-care system that pays for volume to one that pays for value and
encourages health-care provider innovation.
drug pricing
Question. President Biden's health-care plan he campaigned on
highlighted several policies to address drug pricing including allowing
Medicare to negotiate drug prices, limiting launch prices for drugs,
and limiting drug price increases beyond inflation.
Which Biden policy for controlling drug pricing will be the top
priority for implementing quickly if you become HHS Secretary?
Do you plan on implementing all of these policies? When?
We've heard a lot about the Most Favored Nation model--do you plan
on going forward with this model? Or do you plan on rescinding it?
We've also heard a lot about the Rebate Rule which has recently
been delayed for a year--do you plan on going forward with this model?
Or do you plan on rescinding it?
Answer. Like President Biden, I believe we must do all we can to
lower the costs of prescription drugs and make them more accessible for
Americans. If confirmed, I look forward to working with Congress to
build upon the good work you did in the Finance Committee on this
important issue.
Question. There have been proposals in Congress to repeal or
significantly modify the Average Manufacturer Price (AMP) cap in the
Medicaid Program, including a provision in the House Democrats' COVID
relief package to repeal the AMP cap.
What do you think the impact will be on the commercial market and
patients if the cap is removed?
Answer. I believe that people should have timely access to
prescription drugs, biologics, devices, and other medical products. If
confirmed, I look forward to working with you and other members in a
bipartisan fashion.
social determinants of health
Question. Social determinants of health (SDOH) are the economic and
social conditions that affect an individual's health and well-being,
such as access to reliable transportation and stable housing.
Addressing these factors can have a meaningful impact on the prevention
and management of chronic diseases in our communities.
Do you have plans to address social determinants of health?
Are you considering establishing some sort of commission or
interagency council to address potential SDOH barriers?
Answer. The COVID-19 pandemic has laid bare inequities within our
society and how social and economic conditions impact an individual's
health and well-being. If confirmed, I intend to take a department-wide
approach to the advancement of equity, consistent with President
Biden's charge to Federal departments and agencies, and this would
include examination of ways to address the social determinants of
health.
future of telehealth
Question. According to the Centers for Medicare and Medicaid,
weekly telehealth visits increased from 12,000 a week before the
coronavirus spread in March to more than 1 million a week across the
country. Currently, authorizations included in the CARES Act create
additional flexibilities which allow the use of telehealth services,
including remote patient monitoring (RPM) technologies; however, these
flexibilities are only extended until the end of the public health
emergency.
Does this administration have any plans to advance policies
specifically related to the permanency of telehealth waivers that were
implemented during the pandemic?
Will HHS continue to support telehealth applications like RPM
beyond the public health emergency?
Answer. Telehealth is an important tool to improve health equity
and improve access to health care. Health care should be accessible, no
matter where you live. If confirmed, I will look at the telehealth
flexibilities developed for the current public health emergency and
determine how we can build on this work to improve health equity and
improve access to health care.
medicaid integrity
Question. Medicaid is a very significant portion of the portfolio
at HHS as more than 77 million people are currently enrolled in
Medicaid and CHIP. In December 2018, the Office of Inspector General
released a report showing that California ``made Medicaid payments of
$959.3 million on behalf of 802,742 ineligible beneficiaries and $4.5
billion on behalf of 3.1 million potentially ineligible
beneficiaries.''
As Attorney General of California at the time, were you aware of
these major program integrity issues?
Did your office take action to recoup any of these funds for
taxpayers?
How would you fix this systemic issue as head of HHS?
Answer. The Medicaid program is a lifeline for American families
all around the country. With this in mind, it is vitally important that
the Department works together with States to protect the integrity of
the Medicaid program. If confirmed, I look forward to working within
the Department and with Congress and States to make sure we are doing
all we can to protect the Medicaid program and the millions of people
it serves.
welfare reform
Question. A half-century ago, President John Kennedy memorably
declared, ``A rising tide lifts all boats.'' Generations of public
leaders have since invoked Kennedy's metaphor as shorthand for the
notion that if enough economic growth can be achieved, every American
will benefit. Even in the best of times, not all boats are rising--
because some boats inevitably need holes patched. Our system only works
when everyone is able to seize the economic opportunities that are
available. However, our complex and uncoordinated Federal welfare
system, with its various benefit cliffs and phase-outs, discourage
millions of low-income adults from seizing those economic opportunities
to work and provide for their families. For some, our safety net has
effectively become a poverty trap, keeping low-income individuals and
families stuck in poverty for generations instead of acting as a
springboard to prosperity.
With so many of our health and human services programs housed at
HHS, what are some ideas you have for welfare reform?
Are you planning on making this issue a priority?
Answer. HHS's Administration for Children and Families (ACF)
administers the Temporary Assistance for Needy Families (TANF) block
grant which, through States, provides cash assistance to low-income
families as well as other services and supports. I welcome the
opportunity to work with Congress to address improvements in the TANF
program and the Federal welfare system.
mental health
Question. Our Nation is facing an unprecedented mental health
challenge in response to the coronavirus outbreak. For many people who
live with mental illness and substance use disorders, the fear of the
virus and increased economic hardship have created new mental health
and addiction challenges for people across the country. A Kaiser Family
Foundation poll found that 45 percent of adults say the outbreak has
affected their mental health, while a separate study estimated that the
pandemic could cause as many as 150,000 additional ``deaths of
despair'' from suicide and overdose.
If confirmed, how would you try to address this growing crisis?
Answer. Unfortunately, the COVID-19 pandemic has dramatically
impacted mental health and well-being for too many Americans. If
confirmed, I am committed to working on this issue, including
supporting programs and initiatives across the continuum of prevention,
intervention, treatment, and recovery support services as well as
strengthening enforcement of this country's mental health parity laws.
Question. What kinds of resources and flexibilities would you
consider providing to States in order to address this issue head-on?
Answer. The COVID-19 pandemic has brought with it additional
resources and flexibilities for telehealth services. Telehealth
services are a key piece of the puzzle for increasing access to
behavioral health services. If confirmed, I look forward to working to
build on the lessons learned during the COVID-19 pandemic to support
health-care access for more Americans.
Question. What additional tools might you need from Congress in
order to accomplish these goals?
Answer. HHS has many tools to expand access to health-care
services. If confirmed, I commit to thinking critically about this
issue and supporting robust investments that will sustain and expand
access to behavioral health services.
abortion/conscience protections
Question. As a member of Congress, you voted against a ban on
partial-birth abortions; penalties for sex-selective abortions;
protecting minors from being driven across State lines to procure an
abortion without parental consent; and making it a Federal offense of
harming or killing a child in utero during a violent crime.
Can you explain why you voted these ways?
Will you use HHS's trillion-dollar budget to advocate for policies
that promote abortion and attack conscience protections for health
workers?
Answer. Throughout my career, I have always sought to protect and
expand men and women's access to health care. I believe in making sure
that women have access to the health care they need under the law. If I
am confirmed as HHS Secretary, I will follow the law.
coverage of innovative technologies
Question. The COVID-19 pandemic has furthered the necessity for
access to medical technology including medical devices and diagnostic
testing. CMS recently has made great strides to ensure coverage and
improved payment for new and innovative technologies, including
``breakthrough'' technologies, which will help to make it easier for
clinicians and patients to access life-saving or life-altering devices
and diagnostic tests.
How will you work to continue these efforts as HHS Secretary?
Answer. I agree that it is important to foster innovation in
medical technology that improves health-care outcomes. If confirmed, I
look forward to working with you to increase Americans' access to
lifesaving technologies.
private practice
Question. Prior to the pandemic, we saw private practices start to
disappear because of hospital mergers and acquisitions, bankruptcies,
or physician retirements. I am concerned this trend will only continue.
If confirmed, what steps would you take to address this issue?
Answer. As Attorney General, I took on hospital consolidation that
raised prices on patients and created noncompetitive markets that left
consumers with little choice. This has been a major focus of mine on
the health-care front, and if confirmed as HHS Secretary, I will
continue to examine ways that we, at the Federal level, can confront
this issue, and I hope to work with you on this front, Senator.
supply chains
Question. Given the number of supply chains critical to the U.S.
economy, what level of insight do you have into their vulnerabilities?
Do we have the necessary levels of insight into medical supply
chains, including pharmaceuticals and PPE, to securely source these
critical supplies?
What industrial supply chains were prepared or unprepared to handle
the stresses caused by the pandemic?
Answer. The COVID-19 pandemic has highlighted the vulnerabilities
of the global supply chain for many products. I am aware that HHS's
Biomedical Advanced Research and Development Authority (BARDA) has
invested in and is working to expand pharmaceutical manufacturing in
the United States for use in producing medicines needed during the
COVID-19 response and future public health emergencies. This work will
expand domestic manufacturing of raw materials and active
pharmaceutical ingredients for drugs. If confirmed, I will continue to
support ongoing efforts in this area, as well as support the work HHS
is doing with the FDA and DOD to expand domestic capacity for supplies
needed in the ongoing COVID-19 response.
biden's health-care promises
Question. Last year, then-candidate Biden proposed increasing
Federal health-care spending by more than $2 trillion--and proposed to
offset some of that cost with direct and indirect offsets, and cost
reductions.
What are those offsets and cost reductions?
Answer. President Biden has an ambitious plan to get the COVID-19
pandemic under control and improve access to affordable quality health
care for American families. If confirmed, I look forward to working
with Congress to further those efforts.
state licensure/geographic restrictions
Question. State licensing barriers and geographical restrictions
have made access to care difficult for some patients, especially those
in rural and/or underserved areas.
Do you have plans to address these barriers to access?
Answer. As you know, provider licensing is generally under the
purview of State governments. To date, HHS has taken steps under Public
Readiness and Emergency Preparedness (PREP) Act authorities to expand
the vaccination workforce and enable States to utilize qualified health
care professionals (e.g., pharmacists) to respond to the pandemic. If
confirmed, I look forward to working with you to explore other avenues
to expand access to health care, especially for those in rural and
other underserved areas.
______
Questions Submitted by Hon. Ben Sasse
Question. The previous administration was criticized frequently for
denying science in their handling of the pandemic, and yet this
administration has done the same with regards to school re-opening.
Study after study has shown that schools can reopen safely and that
transmission in schools is dramatically lower than community
transmission. We also know that there is a huge public health risk to
keeping schools closed, with low-income children, minority children,
and children with disabilities suffering the most. You spoke in your
committee questionnaire about launching a Disability Rights Unit to
``ensure that students with disabilities have received their legally
entitled quality education,'' so I would hope that you share these
views.
Do you agree that schools remaining closed creates its own public
health risk that disproportionately impacts these high-need groups?
Answer. Schools play a critical role in promoting equity in
education and health for groups disproportionately affected by COVID-
19. If confirmed, I commit to working with the CDC and State and local
leaders to ensure everyone has the resources and support necessary to
ensure children nationwide are able to attend school safely.
Question. Do you agree with the view that access to vaccinations
for teachers should not be a prerequisite for reopening?
Answer. The CDC's school reopening guidance noted that vaccinations
were a key tool for reopening, and I agree with President Biden who has
said teachers should be a priority in any vaccination effort. At HHS,
we will follow the science and commit to helping States and localities
have the information they need to reopen schools safely, if they choose
to reopen.
Question. Setting back school reopenings even further, the CDC
guidance released earlier this month recommends virtual-only learning
in middle and high school and hybrid learning in elementary school for
schools in ``red zones,'' and then defines red zones in such a way that
it's estimated that 76 percent of students would fall into a school in
a so-called ``red zone.'' The administration also claimed its goal was
for most students to have the option of in-person instruction one day a
week, even though roughly two-thirds of students already have the
option of in-person learning.
If confirmed, will you work with the Centers for Disease Control to
make sure that their guidance does not directly contradict the stated
goal of increasing in-
person learning?
Answer. I understand the importance of providing robust resources
and support to schools in order for them to open as safely and as soon
as possible. If confirmed, I look forward to working with the experts
at CDC on the issue of safely reopening schools nationwide.
Question. Will you consider encouraging the CDC to amend or rescind
their guidance?
Answer. I understand the importance of providing robust resources
and support to schools in order for them to open as safely and as soon
as possible. If confirmed, I look forward to working with the experts
at CDC on the issue of safely reopening schools nationwide.
Question. Can you explain how billions of dollars provided to
schools years from now (as seen in the American Rescue Plan Act) could
possibly aid in a quick reopening for kids that are suffering now, many
of whom have been out of school for nearly a year?
Answer. I understand the importance of providing robust resources
and support to schools in order for them to open as safely and as soon
as possible. If confirmed, I look forward to working with the experts
at CDC on the issue of safely reopening schools nationwide.
Question. As California Attorney General you sued the Federal
Government to ensure that California could force churches to pay for
abortions in their health-care plans and sued the Federal Government to
ensure that the Little Sisters of the Poor would not be provided an
exemption from paying for contraception. In NIFLA v. Becerra you
argued, incorrectly according to the justices of the Supreme Court,
that pro-life pregnancy centers should be forced to tell women how to
obtain State-funded abortions.
Given your track record, how can we trust you to successfully run
the Department of Health and Human Services and carry out the law?
Will you commit to protecting the Hyde amendment, and if not, what
is your justification for failing to protect the amendment, which has
been the law of the land since 1976 and is supported by a majority of
Americans who do not believe that taxpayer dollars should fund
abortions?
As a member of Congress, you also voted against the Born-Alive
Abortion Survivors Protection Act, a bill that I first introduced in
2015. Can you explain your opposition to babies being provided medical
care in the rare cases where they survive abortion attempts?
Will you commit to not re-impose the contraception mandate on
religious ministries like Little Sisters of the Poor?
Will you commit to ensuring that medical professionals are not
forced to perform procedures, like abortion, that go against their
religious convictions?
Answer. If I am fortunate enough to be confirmed as HHS Secretary,
I will follow the law.
Question. Medicaid Improper Payments rates have hit an all-time
high, and during your time as Attorney General of California we saw
California pay out an estimated $30 billion in fraudulent unemployment
claims.
Can Americans feel safe putting over a trillion dollars in the
taxpayer-funded Medicare and Medicaid programs in your hands given the
mismanagement of your State?
If confirmed, what are your plans to fix improper payment rates
across all HHS programs and ensure that dollars are going to those
individuals who need them most?
Answer. Fighting fraud and abuse, while ensuring payments are made
properly, are important for maintaining the strength of HHS's programs,
including the Medicare and Medicaid programs. As California Attorney
General, I made it a priority to crack down on health-care fraud. If
confirmed, I will work with you to strengthen HHS programs and make
sure resources are spent wisely and effectively.
Question. Enrollment in the Medicaid program has exploded during
the pandemic, partially due to problematic language in last year's
relief bills where States have no choice but to provide services even
to people who are not actually eligible for the program.
Do you commit to working with States and Congress to actually
identify which enrollees are eligible and which are not?
Do you commit to making sure that the Medicaid program is able to
serve those individuals who are truly in need?
Do you believe States should have the right to remove ineligible
enrollees, which is currently restricted by FFCRA?
Wouldn't Medicare-for-All threaten not only the care for the people
in the Medicare program but also those on Medicaid given the already
weak financial status of the trust fund, which is currently projected
to run out of funds in 2026?
Answer. Medicaid is a lifeline for millions of Americans around the
country. As California Attorney General, I made it a priority to crack
down on health-care fraud, waste, and abuse. If confirmed, I will work
with you and your colleagues to strengthen Medicaid and ensure
resources are spent wisely and effectively.
Question. We have too often ignored the fact that States like
Nebraska actually lost health-care options as a result of the ACA. My
State benefited tremendously from Trump administration rules expanding
Associations Health Plans and Short-Term Limited Duration Plans, and
I'm concerned about the rules establishing these plans potentially
being rescinded due to politics rather than actual data. These plans
are very popular in my State and often cost half as much as ACA plans
while providing more personalized coverage.
Can you point to any actual evidence that these plans destabilized
the market, as you warned they would in a 2018 letter to CMS?
Will you commit to working with Congress and other agencies to
preserve these plan options for the millions of Americans who have
enrolled?
Answer. Making sure that all Americans have access to quality,
affordable health care is one of the Biden administration's top
priorities. If confirmed, I will examine rules and other policies to
ensure all Americans can access the care that they need.
Question. In Congress you voted against allowing Americans to save
more of their money tax-free in Health Savings Accounts. Can you
explain your opposition?
Answer. Making sure that all Americans have access to quality,
affordable health care is one of the Biden administration's top
priorities. As health-care costs have continued to rise, more burden
has been shifted to consumers in the form greater cost-sharing. We must
work to reduce barriers to access, including excessive cost-sharing.
______
Questions Submitted by Hon. John Barrasso
Question. As a doctor, I have grave concerns about the impact a one
size fits all system would have on access to care, especially in rural
communities.
Previously, Obamacare took a step in this direction with the
Independent Payment Advisory Board (IPAB). This 15-person unaccountable
board was supposed to make decisions regarding Medicare reimbursements.
I was disturbed about giving so much power over Medicare to an
unelected and unaccountable group of bureaucrats. Congress thankfully
repealed the IPAB after you left Congress in 2018.
Do you support the recreation of the IPAB or any new government
board that has the power to reduce access to care for patients?
Answer. Ensuring that Americans have access to high quality health
care, including in rural areas, is a priority of mine. I believe that
beneficiaries should come first, and if I am confirmed, I will work you
and other members on solutions to reduce the cost of care and lengthen
the trust fund's solvency.
Question. Currently, illegal immigrants are not allowed to receive
most Federal health-care benefits. In particular, they are not eligible
to receive insurance through the ACA exchange.
Do you support maintaining the ban on illegal immigrants receiving
health insurance through the exchange?
Answer. If I am confirmed as HHS Secretary, I will follow the law.
Question. Do you support expanding Medicaid to require the use of
Federal taxpayer dollars to pay for illegal immigrants to receive full
Medicaid benefits?
Answer. If I am confirmed as HHS Secretary, I will follow the law.
Question. As a doctor, I want to ensure the United States continues
to lead the world in medical and scientific innovation. This has never
been more important than during the COVID-19 pandemic. We have seen
firsthand the importance of generating new vaccines and therapeutics to
combat COVID-19. Looking forward, we must do more to address drug
pricing. We must do it of course without harming innovation.
The White House Counsel of Economic Advisers found H.R. 3, the
House Democrats drug pricing proposal, would reduce the number of new
drugs by up to 100 over a decade.
Are you concerned about legislative proposals that will decrease
the number of new and innovative treatments for American patients?
Answer. The United States is a leader in medical and scientific
innovation. The COVID-19 vaccines were developed faster than any
vaccine in history. Innovation can only help patients if it's
affordable. That's why I, like President Biden, believe we must do all
we can to lower the costs of prescription drugs. If confirmed as
Secretary of HHS, I look forward to working with you to find ways to
reduce drug prices and ensure Medicare beneficiaries have access to the
drugs that they need.
Question. It is vital for the United States to learn from the
COVID-19 pandemic and ensure we are better prepared for future public
health emergencies. In particular, I am interested in addressing the
supply chain for personal protective equipment (PPE).
How do you anticipate partnering with the private-sector supply
chain to ensure that the country is ready for the next public health
emergency?
Do you believe HHS has a role in creating greater supply chain
resiliency, in particular ensuring more PPE is made in the United
States?
Answer. The global pandemic has highlighted the vulnerabilities of
the global supply chain for many products. In order to continue
responding to the COVID-19 pandemic and better preparing the Federal
Government to respond to any future public health emergencies, it is
critical that HHS work to improve and expand domestic supply chain
capabilities. If confirmed, I'm committed to working on this urgent
matter.
Question. Telehealth utilization has increased significantly as a
result of the COVID-19 pandemic.
What steps or policies is the administration considering to ensure
the American health care system continues to move forward with more
telehealth innovation?
Answer. Telehealth is an important tool to improve health equity
and improve access to health care. Health care should be accessible, no
matter where you live. If confirmed, I will look at the telehealth
flexibilities developed for the current public health emergency and
determine how we can build on this work to improve health equity and
improve access to health care.
______
Prepared Statement of Hon. Mike Crapo,
a U.S. Senator From Idaho
WASHINGTON--U.S. Senator Mike Crapo (R-ID), ranking member of the
U.S. Senate Finance Committee, delivered the following remarks at a
hearing to consider the nomination of Xavier Becerra to be Secretary of
Health and Human Services.
The Department of Human Health and Services (HHS) is a sprawling
department, with over 80,000 employees and responsibility for over $1
trillion in annual spending. HHS and its agencies directly affect
everyday life, including running programs that provide health-care
coverage to nearly 150 million people. The HHS Secretary will shape
Medicare, Medicaid, Obamacare, and many other important programs in the
Finance Committee's jurisdiction. These responsibilities are formidable
in normal times, but the COVID-19 pandemic has made the HHS mission
even more critical, as these programs will play a key role in the
pandemic response.
This hearing is important for us to understand how Attorney General
Becerra would carry out these monumental responsibilities. A few weeks
ago, I outlined several issues in the health-care space where I intend
to focus my efforts as ranking member, including fostering innovation
to improve patient care and making our health-care system more
efficient. The COVID-19 pandemic has threatened Americans' physical and
economic health, but it has also reinforced the value of innovation and
provided an opportunity to test changes that foster it.
HHS has used its authority under the Public Health Emergency to
waive numerous requirements to ensure Medicare beneficiaries and other
patients receive care during the pandemic. Patients have benefited from
expanded access to telehealth and expedited approval of COVID-19
vaccines, diagnostics, and treatments.
Going forward, Medicare and Medicaid patients should have the same
access to innovative items and services as those with commercial
insurance. We must carefully evaluate our response to the pandemic and
implement appropriate reforms based on the lessons we have learned. HHS
should partner with this committee in that effort.
Another long-term priority for many on this committee is to finally
address Medicare's looming financial problems. Medicare's financial
stability was a key issue discussed by the bipartisan Bowles-Simpson
Commission on which I served with Attorney General Becerra a decade
ago.
Although the Commission's proposal did not reach the required
super-majority of 14 of 18 votes for adoption, it did produce a
constructive, bipartisan blueprint to reform and secure our entitlement
programs. Medicare's finances remain unsettled, with the Medicare
trustees currently projecting that the Hospital Insurance (HI) trust
fund will go broke in 2026, and unforeseen circumstances could move the
insolvency date even closer. The new administration should work with
Congress in a bipartisan way to ensure that Medicare is able to serve
current and future beneficiaries.
In yesterday's hearing before the HELP Committee, many of my
colleagues raised concerns about the enforcement of California's
restrictive actions related to COVID-19, including the ban on indoor
religious services that was rejected by the Supreme Court. They also
raised questions about challenges to HHS's authority to provide a
conscience exemption from the Obamacare contraception coverage mandate.
A coalition of pro-life Americans sent a letter to all Senators in
opposition to the nomination of Xavier Becerra to be Secretary of
Health and Human Services. I ask that the letter be included as part of
the record.
Nearly a year ago, this committee worked together to expand
unemployment compensation programs in response to the economic
devastation caused to workers by shutdowns. As time has passed, there
has been substantial reporting of fraud perpetrated against
California's unemployment insurance program. Fraudsters, including
international criminal organizations, have siphoned off perhaps more
than $11 billion. That raises questions regarding what specific steps
were taken to combat unemployment fraud, and when those steps were
taken.
Finally, you have long been an advocate for moving all Americans to
a government-run ``Medicare for All'' plan, raising concerns that your
policy preferences could undermine the Medicare programs that rely on
private insurance. You and I have talked about this privately, and I
will discuss it further with you in the question period. I strongly
support private insurance so patients can choose the coverage option
that best meets their needs.
The popular Medicare Advantage program that covers 24 million
beneficiaries must be allowed to continue to thrive. And the successful
Medicare Part D program must continue to serve its 47 million enrollees
without government interference.
The number of issues I have raised indicate the scope and
importance of this position. I look forward to hearing your testimony
and your responses to questions.
______
Submitted by Hon. Mike Crapo, a U.S. Senator From Idaho,
and Hon. James Lankford, a U.S. Senator From Oklahoma
February 18, 2021
The Honorable Patty Murray The Honorable Ron Wyden
Chairwoman Chairman
Committee on Health, Education,
Labor, and Pensions Committee on Finance
U.S. Senate U.S. Senate
Washington, DC 20510 Washington, DC 20510
The Honorable Richard Burr The Honorable Mike Crapo
Ranking Member Ranking Member
Committee on Health, Education,
Labor, and Pensions Committee on Finance
U.S. Senate U.S. Senate
Washington, DC 20510 Washington, DC 20510
Dear Senators,
As organizations committed to the protection of unborn children and
their mothers from abortion and representing millions of pro-life
Americans, we write to you in opposition to the nomination of Xavier
Becerra to be Secretary of Health and Human Services. Mr. Becerra is an
enemy to every pro-life policy and law and has demonstrated complete
disregard for the religious and moral convictions of those opposed to
the brutal act of abortion. His radical record in public office as
California's Attorney General and member of Congress leads our
organizations to ask you to reject Mr. Becerra's nomination.
As Attorney General, Mr. Becerra went out of his way to attack pro-life
policies and conscience protections. He led the charge against the
Title X Protect Life Rule which, under the prior administration,
successfully defunded Planned Parenthood of $60 million.\1\ Despite the
Supreme Court already siding with the Little Sisters of the Poor in an
earlier case, Mr. Becerra took the nuns and similar groups to court to
force them to violate their consciences.\2\ However, perhaps most
ironically, Mr. Becerra has argued in opposition to following an
existing Federal law against forcing healthcare entities to provide,
pay for, provide coverage of, or refer for abortion (the longstanding
Weldon Amendment) calling the enforcement of such provisions
``illegal.''\3\ Notably, if confirmed Mr. Becerra would be responsible
for overseeing the title X program, establishing the federal preventive
service mandates that infringed on the conscience rights of the Little
Sisters of the Poor, and enforcing the Weldon Amendment.\4\
---------------------------------------------------------------------------
\1\ Mr. Becerra lost in the 9th Circuit in February 2020. A request
to review this decision was denied in May 2020. The Title X policy was
allowed to resume March 4, 2020. See California v. Azar.
\2\ The Little Sisters of the Poor won at the Supreme Court on July
8, 2020 in a similar case. Mr. Becerra's case against the Little
Sisters has been sent back to the 9th Circuit to be decided in light of
this decision. See Little Sisters of the Poor v. Commonwealth of
Pennsylvania.
\3\ https://khn.org/morning-breakout/california-defends-authority-
to-require-insurers-to-cover-abortion-as-protecting-womens-rights/.
\4\ Mr. Becerra's refusal to enforce the Weldon Amendment led to a
loss of $200 million in Medicaid funding for California, HHS OCR Press
Release 12/16/20.
We are also concerned about Mr. Becerra's abuse of his statewide office
to target pro-life health centers and journalists. Taking pregnancy
centers to court to enforce California's so-called Reproductive FACT
Act, Mr. Becerra futilely sought to force government-compelled speech
on pro-life individuals who refused to direct women to abortion
centers.\5\ Furthermore, he sought to intimidate and prosecute
investigative journalists David Daleiden and Sandra Merritt after their
reporting uncovered the unethical and likely illegal sale of aborted
baby body parts by Planned Parenthood. Mr. Becerra sought 15 felony
charges for recording 14 videos against these journalists, a move that
the Los Angeles Times Editorial Board called ``a disturbing
overreach.''\6\
---------------------------------------------------------------------------
\5\ Mr. Becerra lost at the Supreme Court, which found the law to
be likely unconstitutional. See NIFLA v. Becerra.
\6\ https://www.latimes.com/opinion/editorials/la-ed-planned-
parenthood-charges-20170330-story.html.
More recently, Mr. Becerra's actions to exploit the COVID-19 pandemic
to expand abortion demonstrate that he will not let a crisis go to
waste. As most Americans sought to direct resources to essential health
services, Mr. Becerra led a letter of pro-abortion state Attorneys
General who sought to use the public health emergency to lift federal
restrictions on chemical abortion under the FDA Risk Evaluation and
Mitigation Strategy (REMS) protocol. Such a change to the REMS would
lead to mail order abortion without physician oversight, a situation
which could have dire consequences for women and girls. Additionally,
Mr. Becerra led another letter of pro-abortion Attorneys General
calling for the administration to fund research involving fetal tissue
claiming that ``no alternatives to human fetal tissue . . . have been
shown to be as powerful conducting these important studies''.\7\
Neither of the leading COVID-19 vaccines, developed by Pfizer and
Moderna, used human fetal tissue in their production, demonstrating
that this view is out of step with current science.
---------------------------------------------------------------------------
\7\ https://www.oag.ca.gov/system/files/attachments/press-docs/
Multi-State%20Letter%20re%
20Fetal%20Tissue%20Ban.pdf.
These radical views are not new for Mr. Becerra, whose pro-abortion
track record extends back to his earliest years in public office. While
a member of Congress, he voted against pro-life priorities such as the
Pain-Capable Unborn Child Protection Act, the Born-Alive Abortion
Survivors Protection Act, and the No Taxpayer Funding for Abortion Act.
Becerra even voted against commonsense legislation to prohibit partial
birth abortion \8\ and the Unborn Victims of Violence Act which made it
a crime to harm or kill an unborn child during the commission of a
violent crime--38 states including California currently have similar
protections.\9\
---------------------------------------------------------------------------
\8\ https://clerk.house.gov/Votes/2003530.
\9\ https://www.ncsl.org/research/health/fetal-homicide-state-
laws.aspx.
Mr. Becerra's confirmation would be divisive and a step in the wrong
direction. We understand that the president needs to assemble a
cabinet; however, Mr. Becerra has proven himself to be an enemy of the
health of women and the unborn. He cannot be entrusted with our
national health programs and policies and is not qualified to serve as
---------------------------------------------------------------------------
Secretary of Health and Human Services.
For these reasons, we ask you to reject his nomination.
For Life,
Marjorie Dannenfelser Thomas Glessner, J.D.
President President
Susan B. Anthony List National Institute of Family and
Life Advocates (NIFLA)
Tom McClusky Carol Tobias
President President
March for Life Action National Right to Life Committee
Kristan Hawkins Lila Rose
President Founder and President
Students for Life Action Live Action
Catherine Glenn Foster Abby Johnson
President and CEO Founder and CEO
Americans United for Life And Then There Were None
Penny Young Nance Ryan T. Anderson, Ph.D.
President and CEO President
Concerned Women for America LAC Ethics and Public Policy Center
Donna J. Harrison M.D. Russell Moore
Executive Director President
American Association of Pro-Life
Obstetricians and Gynecologists Southern Baptist Ethics and
Religious Liberty Commission
Fr. Frank Pavone Craig DeRoche
National Director President and CEO
Priests for Life Family Policy Alliance
Jor-El Godsey Roland C. Warren
President President and CEO
Heartbeat International Care Net
Andrew M. Bath Anne O'Connor
Executive Vice President and
General Counsel Vice President of Legal Affairs
Thomas More Society National Institute of Family and
Life Advocates (NIFLA)
Garrett Bess Travis Weber
Vice President of Government
Relations and Communications Vice President for Policy and
Government Affairs
Heritage Action for America Family Research Council
David Daleiden Michelle Cretella, M.D.
Project Lead Executive Director
The Center for Medical Progress American College of Pediatricians
Jordan Sekulow Brian Burch
Executive Director President
American Center for Law and Justice Catholic Vote
Terry Schilling Colleen Holcomb
Executive Director President
American Principles Project Eagle Forum
Bradley Mattes Jonathan Keller
President President and CEO
Life Issues Institute California Family Council
Steven Ertelt Alexandra Snyder, Esq.
Editor CEO
LifeNews.com Life Legal Defense Foundation
Michael Gonidakis Lois Anderson
President Executive Director
Ohio Right to Life Oregon Right to Life
Samuel H. Lee John Stemberger
Director President and General Counsel
Campaign Life Missouri Florida Family Policy Council
Gene Mills John Helmberger
President Chief Executive Officer
Louisiana Family Forum Minnesota Family Council
Janet Morana Bob Vander Plaats
Co-Founder President
Silent No More The FAMiLY Leader
Eric J. Scheidler Tami Fitzgerald
Executive Director Executive Director
Pro-Life Action League NC Values Coalition
Cathie Humbarger Joshua Edmonds
CEO Executive Director
Reprotection, Inc. Georgia Life Alliance Committee
Zach Rodgers Monica Migliorino Miller, Ph.D.
Executive Director Director
Right to Life of Northeast Indiana Citizens for a Pro-Life Society
Joe Langfield Dale A. Bartscher
Executive Director Executive Director
Human Life Alliance South Dakota Right to Life
Esther Ripplinger Larry Cirignano
Executive Director DC Representative
Human Life of Washington Children First Foundation
Deborah Tilden Eva Andrade
Co-Founder President
S.M.A.R.T. Women's Healthcare Hawaii Family Forum
Peggy Nienaber Mike Fichter
Vice President President and CEO
Faith and Liberty Indiana Right to Life
Gregory Cox Julaine K. Appling
Lead Missionary President
National Pro-Life Center on Capitol
Hill Wisconsin Family Action
Andrew Shirvell, J.D. Shawn Hyland
Founder and Executive Director Executive Director
Florida Voice for the Unborn Family Policy Alliance of New
Jersey
Amber Haskew Cheryl Sullenger
Director of Public Policy Senior Vice President
Liberty Counsel Action Operation Rescue
Rabbi Yaakov Menken Honorable Joel Grewe
Managing Director Executive Director
Coalition for Jewish Values Generation Joshua
Bryan Kemper Mike Rouse
President President
Stand True--Youth Pro-life Outreach
of Priests for Life The American Association of
Christian Schools
Marc Tuttle
President
Right to Life of Indianapolis
______
Submitted by Hon. James Lankford,
a U.S. Senator From Oklahoma
CATHOLIC MEDICAL ASSOCIATION
_______________________________________________________________________
Upholding the Principles of the Catholic Faith in the Science and
Practice of Medicine
550 Pinetown Rd., Suite 205
Ft. Washington, PA 19034-2607
Ph 484-270-8002
Fax 866-714-0242
www.cathmed.org
[email protected]
February 22, 2021
The Honorable Ron Wyden
Chair, Senate Committee on Finance
United States Senate
221 Dirksen Senate Office Building
Washington, DC 20510
Dear Mr. Wyden, Ranking Member Mr. Crapo, and committee members,
The Catholic Medical Association is the largest organization of
Catholic health-care professionals in the United States. We represent
over 2,500 faithful Catholics in the medical community across the
country who provide high quality, ethical medical care in accordance
with their Catholic faith.
As president of this organization, I write on behalf of our members to
strongly oppose the nomination of Mr. Xavier Becerra to be Secretary of
Health and Human Services Department. Mr. Becerra's partisan,
ideological record of opposing individual and institutional conscience
rights protections, religious freedom and the sanctity of life will
significantly impact the ability of our memberships to practice ethical
medicine guided by their faith.
Mr. Becerra's lack of experience in health care makes him inherently
unqualified to lead a department responsible for the health and well-
being of our citizens at this critical time of pandemic.
If appointed, Mr. Becerra would lead an agency responsible for creating
policies that could significantly affect not only our members, but all
Catholic and Christian health-care workers, their patients and faith
based organizations. He has voiced support to rolling back conscience
rights protection, instituting contraceptive and abortion mandates in
health-care coverage, and advancing gender ideology. It would be our
expectation that all actions taken by the Health and Human Services
comply with the Hyde, Church and Welden Amendments. Given the
President's expressed religious views, we ask that no actions be taken
in opposition to the conscience rights and religious liberties of our
members. Our organization remains willing to work with the
administration and the Health and Human Services Department to
accomplish these goals.
In Congress, Mr. Becerra voted against a ban on partial birth
abortions, against making it a crime to hurt an unborn child during
another crime, and voted in favor of taxpayer-funded abortions. As
Attorney General for the State of California, Mr. Becerra showed he is
willing to use the power of the state against religious organizations
and pro-life causes. His actions have been shown to be on the wrong
side of the constitution in cases involving the Little Sisters of the
Poor and NIFLA v. Becerra.
With the overwhelming regulatory and financial power of the HHS, Mr.
Bacerra will advance policies with harmful and detrimental impact on
pro-life, religious organizations and individuals.
Catholic health care is a direct outreach of our mission as Catholics
to love our neighbors, feed the poor and heal the sick. Catholic
hospitals currently provide 1 out of every 6 hospital beds in the
United States. Catholics provide adoption and foster care services;
help resettle immigrant families and are leading the fight against
human trafficking. We fear many of these services will be eliminated if
Mr. Becerra is confirmed. We have reasonable concern that Mr. Becerra
will use coercive powers to advance ideological policies of Planned
Parenthood and special interests to force Catholic institutions to
violate deeply held beliefs in the provision of care. Our members would
be forced to make a decision between practicing ethical medicine or
violating deeply held religious beliefs. Forcing out faith-based
health-care providers risks undermining the health-care workforce and
significantly harming the health-care capacity needed to fight current
and future public health crises in our nation. At this critical time in
our nation's history, we need to be supporting these individuals and
institutions, not trying to shut them down.
Mr. Becerra is the wrong choice to be Secretary of the Department of
Health and Human Services. His past record shows he is hostile to faith
based organizations and individuals. Appointing Mr. Becerra will
directly affect the ability of thousands of Catholic individuals and
institutions to provide ethical, high quality, and compassionate care.
His confirmation will divide this country even further at a time when
unity is most needed.
Sincerely yours,
Michael S. Parker, M.D.
President, Catholic Medical Association
______
Heartbeat International
5000 Arlington Centre Boulevard, Suite 2277
Columbus, Ohio 43220-2913
614-885-7577
https://www.heartbeatinternational.org/
https://www.heartbeatservices.org/services-home/
February 18, 2021
The Honorable Charles E. Schumer The Honorable Mitch McConnell
Majority Leader Minority Leader
U.S. Senate U.S. Senate
322 Hart Senate Office Building 317 Russell Senate Office Building
Washington DC 20510 Washington, DC 20510
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
221 Dirksen Senate Office Building 239 Dirksen Senate Office Building
Washington, DC 20510 Washington, DC 20510
Dear Majority Leader Schumer, Minority Leader McConnell, Chairman
Wyden, and Ranking Member Crapo:
As the world's largest network of pregnancy help centers serving
pregnant women, Heartbeat International strongly opposes the nomination
of Xavier Becerra for Secretary of Health and Human Services.
Every woman deserves love and support during an unexpected pregnancy.
Heartbeat and its network of nearly 3,000 pregnancy help organizations
worldwide work tirelessly to provide hope and help to women and
families experiencing unexpected pregnancies.
Our network of pregnancy help provides compassionate care because no
woman should feel alone, coerced, or so hopeless that she ends her
child's life through abortion.
In 2019 alone, pregnancy centers nationwide served nearly 2 Million
people with free services.\1\
---------------------------------------------------------------------------
\1\ ``Pregnancy Centers Stand the Test of Time,'' Charlotte Lozier
Institute's Pregnancy Center Report, published 2020.
- 94% of these organizations provide material aide such as diapers
and formula at no cost to families in need.
- 86% offered parenting classes to mothers and fathers.
- 486,213 women received free ultrasounds.
- 21,698 women and men received abortion recovery help at a center.
- 98% of pregnancy help organization clients report a positive
experience.\2\
---------------------------------------------------------------------------
\2\ Data from Next Level, Heartbeat International's Client
Management System.
Each day, Option Line (our 24/7 pregnancy helpline) receives more than
1,000 calls from people seeking pregnancy help. Last year alone, Option
Line connected more than 350,000 people to their local pregnancy help
---------------------------------------------------------------------------
organization for care.
From a free pregnancy test to a temporary home, pregnancy help
organizations exist to meet the needs of the women they serve.
Heartbeat's network of care does all of this in an effort to realize
its vision to make abortion unwanted today and unthinkable for future
generations.
The approval of Mr. Becerra for Secretary of Health and Human Services
would be devastating to the thousands of grassroots volunteers and
staff who daily champion life-affirming choices that he sought to
muzzle.
As Attorney General of California, Mr. Becerra sought to force pro-life
pregnancy help organizations to intentionally direct pregnant women
toward abortion providers, undermining their conscience and diluting
their very purpose.
Under the so-called Reproductive FACT Act, Becerra wanted to force
these same organizations that exist to provide alternatives to abortion
to tell women where to get an abortion.
Despite such a mandate being a clear violation of the centers' free
speech rights and religious conscience, Mr. Becerra was so beholden to
the pro-abortion lobby that he took the case all the way to the Supreme
Court in an effort to silence these centers. Thankfully, in the case of
NIFLA v. Becerra, the Supreme Court ruled in favor \3\ of the centers'
free speech, holding that it was unconstitutional for the State of
California to force private organizations to speak a message that was
antithetical to their very reason for existence.
---------------------------------------------------------------------------
\3\ National Institute of Family and Life Advocates v. Becerra, 585
U.S. ------ (2018), accessed 02/17/2021, https://supreme.justia.com/
cases/federal/us/585/16-1140/.
He did all this while receiving donations from abortion proponents.
According to Open Secrets,\4\ Planned Parenthood gave Becerra thousands
of dollars in donations over his long political career. All the while,
Mr. Becerra received perfect scores from Planned Parenthood and NARAL
Pro-Choice America on his abortion record.
---------------------------------------------------------------------------
\4\ https://www.opensecrets.org/members-of-congress/
summary?cid=N00009774&cycle=
CAREER.
As Attorney General, Mr. Becerra sought to use the power of government
to force pregnancy help organizations to support abortion, and our
grave concern is that this same Mr. Becerra would leverage the newfound
position and the power of the Department of Health and Human Services
to work against the good work of grassroots pregnancy help
---------------------------------------------------------------------------
organizations.
While opinions regarding the legality of abortion may differ, everyone
should agree that it is a good thing to empower women so that they
never feel that their only choice is to end the life of their unborn
child. It is indicative of Mr. Becerra's extreme position on abortion
that he would attempt to shut down those who are merely providing help
and hope to women and families.
For these reasons, we implore you to reject the nomination of Xavier
Becerra. Surely there is someone less beholden to the lobbyists of the
abortion industry and more qualified to truly lead the Health and Human
Services department.
Regards,
Jor-El Godsey
President
CC: All U.S. Senators
______
National Institute of Family and Life Advocates
10333 Southpoint Landing Blvd., Suite 107
Fredericksburg, VA 22407
Phone: 540-372-3930
Fax: 540-372-3929
www.NIFLA.org
[email protected]
February 19, 2021
To Whom It May Concern:
The National Institute of Family and Life Advocates (NIFLA) opposes the
nomination of Xavier Becerra to be Secretary of Health and Human
Services (HHS). Because of our experience with Becerra and his
radicalized agenda, we believe that he is not qualified for this
appointment. We respectfully ask that you reject his nomination.
NIFLA is a non-profit legal and medical organization that exists to
train, equip and represent more than 1,600 life-affirming pregnancy
center members across the nation. Pregnancy centers provide hope,
counsel, medical services, material resources, housing referrals, and
much more to mothers considering abortion, all for free. Primary among
these is the procedure of ultrasound, which is medically necessary to
confirm a viable intrauterine pregnancy. Statistics show more than 80%
of mothers considering abortion decide to choose life after seeing an
ultrasound image of their unborn child.
In 2016, NIFLA brought a lawsuit against Becerra because, as California
Attorney General, he abused his statewide office to target our
pregnancy centers. In his attempt to enforce California's so-called
Reproductive ``FACT'' Act, Becerra futilely sought to force government-
compelled speech on religiously motivated pro-life centers by requiring
them to place notices on their walls advising clients how they could
procure a state-funded abortion. Becerra vowed to aggressively enforce
the law and make sure that pro-life centers use the walls of their
waiting areas as billboards to advertise for and promote abortion.
This mandated compelled speech violated the pregnancy centers' First
Amendment rights and undermined their mission to offer life-affirming
care to women and children. It forced such centers to speak a message
with which they fundamentally disagreed.
May the government force Alcoholics Anonymous to post signs promoting
the sale of liquor to its clients? Could the government force the
American Cancer Society to promote the sale of tobacco and cigarettes?
If Becerra had his way with pro-life pregnancy centers then such
scenarios (which are absurd) could very well happen, depending upon who
has the political clout to promote their agenda.
While California's so-called Reproductive ``FACT'' Act was
unconstitutional, Becerra insisted that it be enforced. The law was
struck down by the United States Supreme Court in the landmark case of
NIFLA v. Becerra 138 S. Ct. 2361 (2018). The Supreme Court ruled 5-4 to
block California's blatant discrimination against non-
profits that give life-affirming options to women facing unplanned
pregnancies. Justice Clarence Thomas wrote the majority opinion of the
Court which held that the free speech guarantees of the First Amendment
to the U.S. Constitution prohibits government compelled speech when
such speech mandates and compels people to speak a message with which
they fundamentally disagree and which violates their consciences.\1\ In
concurrence, Justice Kennedy stated that ``viewpoint discrimination is
inherent in the design and structure of [the] Act'' and that California
required ``primarily pro-life pregnancy centers to promote the State's
own preferred message advertising abortions.''
---------------------------------------------------------------------------
\1\ That free speech standard was distinguished by Justice Thomas
from situations where the State is regulating the conduct of the
physician in which that physician's speech is merely incidental to
conduct, such as speech related to the performance of an abortion.
The Supreme Court handed Becerra a humiliating defeat in NIFLA v.
Becerra, which ended up costing the taxpayers of California millions of
dollars. They were ordered to pay attorneys' fees to his successful
opponents. Immediately after this decision was handed down, Becerra
referred to it as ``unfortunate'' and stated he would seek other ways
---------------------------------------------------------------------------
to promote abortion services in California.
Becerra absolutely should not be in charge of such a powerful
department as HHS. In such a position of authority and power, he will
easily continue his attacks against pregnancy centers through
bureaucratic rules and regulations. Such actions will guarantee further
litigation against HHS and the government. Ultimately, under NIFLA v.
Becerra, the government will lose, costing the taxpayers millions more
in litigation costs.
Becerra's actions to enforce the ``FACT'' Act also caused the State of
California to be cited by HHS, the very organization he now is
nominated to lead, for violating federal conscience protections. The
Office of Civil Rights Conscience and Religious Freedom Division
conducted an independent investigation and determined that the ``FACT''
Act violated the Weldon and Coats-Snowe Amendments by requiring
``licensed covered facilities'' to refer for abortion. It further
violated the Weldon amendment by subjecting ``unlicensed covered
facilities'' to discrimination by targeting them for burdensome and
unnecessary notice requirements because they do not refer for or make
arrangements for abortion.
More recently, Becerra's actions to exploit the COVID-19 pandemic to
expand abortion demonstrate that his radical abortion agenda knows no
limits. As most government leaders sought to direct resources to
essential health services, Becerra led a crusade to use the public
health emergency to expand the distribution of chemical abortions by
removing the FDA's Risk Evaluation and Mitigation Strategy (REMS)
protocol. Such a change to the REMS would lead to mail-order abortion
without physician oversight, a situation that could have dire
consequences for women and girls. The U.S. Supreme Court again ruled
against him in this regard in Food and Drug Administration v. American
College of Obstetricians and Gynecologists (FDA v. ACOG) in January
2021.
Becerra's confirmation would be a very divisive action coming from an
administration that pronounces the need for unity. He is an antagonist
to millions of Americans who care for mothers, their unborn children,
and who simply want to provide them with the right to choose life. As
such, he is an enemy of the health of women and the unborn.
As Secretary of HHS, Becerra would be uniquely positioned to pass
regulations that impact operations of pregnancy centers--particularly
those that are licensed medical clinics. This should be concerning to
all who care about providing abortion alternatives to mothers.
Becerra cannot be entrusted with our national health programs and
policies. He is not qualified to serve as Secretary of Health and Human
Services.
For these reasons, we ask you to reject his nomination.
Sincerely,
Thomas A. Glessner, J.D.
President
Anne O'Connor, J.D.
Vice-President for Legal Affairs
______
Prepared Statement of Hon. Ron Wyden,
a U.S. Senator From Oregon
The Finance Committee meets this morning for the second of three
nomination hearings this week. I'm pleased to welcome Attorney General
Xavier Becerra, President Biden's nominee to lead the Department of
Health and Human Services.
With a pandemic raging, so many Americans struggling to get by, and
our health-care system strained to the max, there may not be a higher-
stakes job in the executive branch outside of the presidency itself.
Attorney General Becerra brings more than 2 decades of experience
in the Congress. He was a senior member of the House Ways and Means
Committee, which overlaps with this committee on a lot of important
health-care subjects. He was closely involved in major accomplishments
on health care, including the ACA. For 4 years he's led the second-
largest department of justice in America, overseeing thousands of
employees and a billion-dollar budget. Anybody who discounts the
experience of leading a California agency that large and influential to
the fifth-largest economy in the world is straining awfully hard to
find something to critique.
AG Becerra defended the Affordable Care Act from absurd and
dangerous far-right attacks. When the pandemic hit, he went to bat for
Californians by increasing access and affordability for COVID
treatments, protecting workers from exposure, and securing key
safeguards for front-line health-care workers.
Having started my career in legal aid for seniors as the co-founder
of the Oregon Gray Panthers, I appreciate that AG Becerra got his start
in legal aid for the less fortunate as well. This is a nominee with the
right policy experience, the right leadership experience, and the right
experience fighting for the little guy. That's exactly what's needed at
Health and Human Services after 4 years of mismanagement that took us
in the wrong direction.
In this committee, a special focus of our work during this Congress
is going to be tackling inequality in every form. In America,
inequality is a killer. If you didn't believe it before the pandemic,
there can be no questioning it now.
People of modest means, people targeted by discrimination, people
marginalized in society--they're the Americans who've suffered
disproportionately in this pandemic. That's because they were
vulnerable before the pandemic too, and Federal policies did not do
enough to protect them.
I'll tick through a few examples. First, Americans are still
getting absolutely clobbered every time they walk up to the pharmacy
window to pick up their prescription drugs. In a country as wealthy as
ours, it is utterly shameful that you still hear about people rationing
their own medicine and suffering terrible consequences because they
can't afford their prescriptions.
Second, the pandemic has proven that there needs to be a new focus
on mental health in America. With so many lives lost and so many people
out of work, it shouldn't be any surprise that people in Oregon and
across the country are struggling when it comes to mental health.
Compared to physical health-care issues, mental health has really
gotten short shrift for too long. The law says they're equally
important, but that's not how they're handled in practice. I believe
that needs to change, and I'm going to talk more about that in Q&A.
Third, the pandemic has also shined a spotlight on a lot of long-
running disparities in health care in this country--many of them issues
that stretch back through the generations. One of them is maternal
health care. The American people want this to be a pro-family country.
It is totally unacceptable that pregnancy and childbirth and the
postpartum period are so dangerous to American women, particularly when
you compare this country to other wealthy nations.
This is a particularly serious problem for black and Native
American women, and it's getting worse as the years go on--not better.
In fact, here's a shocking statistic: women today are more likely to
die in childbirth than their mothers were a generation ago. Addressing
this crisis goes hand-in-hand with the need to expand and improve
women's health care overall, since the last 4 years have been a women's
health nightmare.
I'm looking forward to working with AG Becerra and the Biden
administration on those issues and more. It's been a difficult 4 years
for too many vulnerable Americans who struggle to pay for their
medications and find access to the health care they need.
If AG Becerra and his team start every day actually focused on
expanding affordable health care and improving human services instead
of limiting them, they'll already be doing better than the last
administration.
AG Becerra is highly qualified. He has a valuable range of
experience that will help him succeed in this job. And this is a
historic nomination, because AG Becerra would be the first Latino HHS
Secretary.
______
America's Essential Hospitals
401 Ninth St., NW, Suite 900
Washington, DC 20004
t: 202-585-0100
f: 202-585-0101
https://essentialhospitals.org/
February 1, 2021
The Honorable Patty Murray The Honorable Ron Wyden
Chair Chair
U.S. Senate U.S. Senate
Committee on Health, Education,
Labor, Committee on Finance
and Pensions Washington, DC 20510
Washington, DC 20510
The Honorable Richard Burr The Honorable Mike Crapo
Ranking Member Ranking Member
U.S. Senate U.S. Senate
Committee on Health, Education,
Labor, Committee on Finance
and Pensions Washington, DC 20510
Washington, DC 20510
Dear Chair Murray, Chair Wyden, and Ranking Members Burr and Crapo,
On behalf of our more than 300 member hospitals and health systems,
America's Essential Hospitals extends our support for the nomination
and confirmation of Xavier Becerra as Health and Human Services (HHS)
Secretary.
America's Essential Hospitals is the leading champion for hospitals and
health systems dedicated to high-quality care for all, including
vulnerable populations. Filling a vital role in their communities, our
more than 300 member hospitals provide a disproportionate share of the
nation's uncompensated care, and three-quarters of their patients are
uninsured or covered by Medicare or Medicaid. Our members provide
state-of-the-art, patient-centered care while operating on margins a
third that of other hospitals--2.5 percent on average compared with 7.6
percent for all hospitals nationwide.\1\
---------------------------------------------------------------------------
\1\ Clark D, Roberson B, Ramiah K. Essential Data: Our Hospitals,
Our Patients--Results of America's Essential Hospitals 2018 Annual
Member Characteristics Survey. America's Essential Hospitals. May 2020.
https://essentialdata.info. Accessed January 25, 2021.
We believe Becerra is uniquely qualified to lead HHS at this critical
time. He has worked on significant health care issues throughout his
career and has a deep understanding of the process and executive
decision-making that comes with serving in leadership positions.
Becerra has spent his career defending key programs of importance to
essential hospitals and their communities, including Medicare and
Medicaid. Most recently, in his role as attorney general of California,
Becerra defended the 340B Drug Pricing Program and championed important
protections for immigrant communities. During his tenure as a member of
Congress, Becerra demonstrated a deep commitment to ensuring access to
---------------------------------------------------------------------------
health care for all Americans.
We are confident Becerra will be a champion for the nation's health and
bring a comprehensive approach to combatting the COVID-19 public health
emergency. America's Essential Hospitals looks forward to working with
him to address the pressing health issues of importance to our member
hospitals and their communities. We urge the full Senate to approve his
nomination as soon as possible.
Sincerely,
Bruce Siegel, M.D., MPH
President and CEO
______
American Academy of Family Physicians
1133 Connecticut Avenue, NW, Suite 1100
Washington, DC 20036-4305
(800) 794-7481
(202) 232-9033
February 5, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chair Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20515 Washington, DC 20515
The Honorable Patty Murray The Honorable Richard Burr
Chair Ranking Member
U.S. Senate U.S. Senate
Health, Education, Labor, and
Pensions Committee Health, Education, Labor, and
Pensions Committee
Washington, DC 20515 Washington, DC 20515
Dear Chairman, Chairwoman, and Ranking Members:
On behalf of the American Academy of Family Physicians (AAFP),
representing more than 136,700 family physicians, residents, and
medical students across the country, I write to offer support for the
nomination of Xavier Becerra to serve as Secretary of the Department of
Health and Human Services (HHS).
Mr. Becerra has long been a champion of ensuring all Americans have
access to high-quality, affordable health care. As a member of
Congress, Representative Becerra helped to pass the Affordable Care Act
(ACA) and eliminate the flawed Medicare Sustainable Growth Rate. As
Attorney General of California, he defended the ACA against legal
challenges \1\ in the case of Texas v. United States. The AAFP supports
\2\ this shared vision for meaningful and affordable health care
coverage and stands ready to work with Mr. Becerra to further build on
the ACA's successes and further improve our health care system in his
new role with HHS.
---------------------------------------------------------------------------
\1\ https://www.aafp.org/news/government-medicine/
20180621amicusbrief.html.
\2\ https://www.aafp.org/news/media-center/statements/affordable-
care-act.html.
As the COVID-19 pandemic continues to threaten our communities, swift
action to confirm the Secretary of HHS is urgently needed to ensure the
agency is best-equipped to respond to the pandemic. Physicians and
patients alike are looking to HHS for clear public health guidance, and
they are counting on HHS to obtain and deliver COVID-19 vaccines to
---------------------------------------------------------------------------
save lives and keep our communities healthy.
Thank you for the opportunity to offer our support for the nomination
of Mr. Becerra for HHS Secretary. If you have additional questions,
please reach out to David Tully, Director of Government Relations, at
[email protected].
Sincerely,
Gary L. LeRoy, M.D., FAAFP
Board Chair
______
American College of Clinical Pharmacy
Government and Professional Affairs
1455 Pennsylvania Avenue, Suite 400
Washington, DC 20004-2514
202-621-1820
202-621-1819 [fax]
https://www.accp.com/
February 8, 2021
The Honorable Ron Wyden The Honorable Patty Murray
221 Dirksen Senate Office Bldg. 154 Russell Senate Office Building
Washington, DC 20510 Washington, DC 20510
8The Honorable Mike Crapo The Honorable Richard Burr
239 Dirksen Senate Office Building 217 Russell Senate Office Building
Washington, DC 20510 Washington, DC 20510
Dear Senators Wyden, Crapo, Murray and Burr:
On behalf of the American College of Clinical Pharmacy (ACCP) I am
writing in support of the nomination of Xavier Becerra as Secretary of
the Department of Health and Human Services (HHS).
ACCP is a professional and scientific society that provides leadership,
education, advocacy, and resources enabling clinical pharmacists to
achieve excellence in patient care practice and research. ACCP's
membership is composed of over 20,000 clinical pharmacists, residents,
fellows, students, scientists, educators and others who are committed
to excellence in clinical pharmacy practice and evidence-based
pharmacotherapy.
The COVID-19 pandemic has placed unprecedented burdens on our nation's
health delivery infrastructure. As communities across the country
struggle to respond to the COVID pandemic, a comprehensive strategy to
ensure a truly team-based,
patient-centered approach to patient care, consistent with evolving
integrated delivery models, must be prioritized.
Throughout the COVID pandemic, pharmacists have been at the forefront
of our nation's response efforts. This includes the vital work early in
the pandemic to help scale up testing capabilities, and now pharmacists
and pharmacies are at the center of the largest mass-vaccination in
history.
Beyond the urgent work of pharmacists on the front lines of the
pandemic response effort, clinical pharmacists typically practice as
fully integrated members of the health care team, working under formal
collaborative practice agreements or institutional privileges, to
assume full responsibility for managing patients' medication therapies.
Qualified clinical pharmacists are usually residency trained and are
certified as specialists by the Board of Pharmacy Specialties (BPS) to
fully manage complex drug therapies on behalf of chronically ill
patients as part of clinical care teams. In California, state pharmacy
practice regulations specifically recognize qualified clinical
providers as Advance Practice Pharmacists (APP) who are responsible for
delivering clinical services well beyond the important work of
dispensing medications.
Comprehensive medication management (CMM) refers to the direct patient
care process provided by clinical pharmacists working as formal members
of the patient's health care team that has been demonstrated to
significantly improve clinical outcomes and enhance the safety of
medication use by patients.
As we reach a new stage in the global fight to contain the COVID-19
pandemic and address the sequelae of undressed health issues resulting
from care avoidance during the pandemic, the issue of managing the safe
and appropriate delivery of medications across an entire population
takes center stage. This context provides a unique opportunity to
improve patient care and decrease overall healthcare spending by
advancing practice models that include CMM--the patient working in
collaboration with the physician and a qualified clinical pharmacist.
Thank you for your ongoing bi-partisan leadership on behalf of the
country at this time. We urge swift confirmation of Attorney General
Becerra as HHS Secretary. We would welcome the opportunity to meet with
your respective staff to provide expertise on comprehensive medication
management as we collectively work to advance health care delivery
models that ensure value and high quality patient outcomes.
Sincerely,
John McGlew
Director, Government Affairs
Cc: Michael S. Maddux, Pharm.D. FCCP, Executive Director
______
American College of Radiology
505 9th St., NW, Suite 910
Washington, DC 20004
202-223-1670
https://www.acr.org/
January 20, 2021
The Honorable Ron Wyden The Honorable Michael Crapo
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
Dear Senators Wyden and Crapo,
The American College of Radiology (ACR), a national medical
professional organization representing over 40,000 radiologists,
radiation oncologists, interventional radiologists, nuclear medicine
physicians and medical physicists, strongly supports the nomination of
Attorney General Xavier Becerra to be the next Secretary of Health and
Human Services (HHS).
As Attorney General of the state of California since 2017 and as a
member of the House of Representative s for over 20 years, Attorney
General Becerra has both the experience of running one of the largest
government agencies in the country as well as the proven ability to
navigate the challenges of the federal legislative and regulatory
processes. These skills, along with his proven track record of bringing
people together to solve big problems, will be critical as he addresses
the nation's worst health care crisis in over a century.
While in Congress and a member of the House Ways and Means Committee,
part of whose jurisdiction is healthcare, Attorney General Becerra
worked with the ACR to enact complex legislation to improve patient
care such as the inclusion of accreditation standards for those
facilities providing advanced imaging, as well as the mandatory
consultation of appropriate use criteria (AUC) prior to the ordering of
medical imaging services. Both efforts improved imaging quality and
safety and reduced cost to the Medicare system as well as to Medicare
beneficiaries.
Most notably, while in Congress Attorney General Becerra played a
prominent role in the drafting and enactment of the Patient Protection
and Affordable Care Act (PPACA), where he fought to expand Americans'
access to healthcare. As the California Attorney General, Becerra has
led the fight to protect the PPACA from being overturned in order to
preserve Americans' access to health insurance regardless of pre-
existing medical conditions, as well as continuing access to lifesaving
screening services, such as mammography, at no cost to the patient.
Therefore, for the reasons stated above, and countless more, the
American College of Radiology urges the Committee, as well as the full
Senate, to vote in favor of Attorney General Becerra's nomination for
Secretary of Health and Human Services.
The ACR looks forward to working with Mr. Becerra in his new role as
HHS Secretary and continuing its work with the Committee to improve
care and timely access to imaging services for its patients.
Sincerely,
Howard B. Fleishon, M.D., MMM, FACR
Chair, Board of Chancellors
Cc: Members, Committee on Finance
______
American Federation of State, County and
Municipal Employees, AFL-CIO
1625 L Street, NW
Washington, DC 20036-5687
TEL (202) 429-1000
FAX (202) 429-1293
TDD (202) 659-0446
WEB https://www.afscme.org/
February 22, 2021
Members of the Committee on Finance
United States Senate
Washington, DC 20510
Members of the Committee on Health, Education, Labor, and Pensions
United States Senate
Washington, DC 20510
Dear Senators:
On behalf of the 1.4 million members of the American Federation of
State, County and Municipal Employees (AFSCME), I write to express our
support for the nomination of Xavier Becerra to be Secretary of the
Department of Health and Human Services (HHS). This is a historic
confirmation at an unprecedented time. COVID-19 is rapidly becoming the
leading cause of death in our nation. The pandemic has laid bare and
deepened health inequities in our country. Our nation needs an
experienced champion like former Attorney General Becerra to reverse
the harms caused by the previous administration to Medicaid, Medicare,
and the Affordable Care Act, to lead a successful COVID-19 response,
and to continue to expand affordable health care access for everyone in
America.
Xavier Becerra is absolutely the right person for this job at this
crucial moment. His whole career has been focused on fairness and
equity. As HHS Secretary, he will ensure that our nation's COVID-19
response does not continue to compound health care inequities, but
instead that everyone can get fair access to health care without
discrimination, no matter where they live, what language they speak,
what gender they are or how much money they have.
He has an extensive knowledge of and commitment to the health care
laws he will be implementing as HHS Secretary. He helped lead passage
and implementation of the ACA and Medicaid expansion as a member of
Congress. As AG of California, he has been a champion of the ACA,
defending it against legal and administrative attacks.
His leadership shows that he understands and is willing to take on
ingrained distortions in our health care system that make care more
costly and harmful to patients. He has shown the fortitude needed to
stand up to the drug companies' ``pay for delay'' schemes \1\ that
unnecessarily delay access to potentially life-saving and less
expensive generic medications. He has held corporations accountable \2\
for peddling dangerous addictive drugs,\3\ and challenged efforts to
concentrate market place power to raise health care prices \4\ to the
disadvantage of patients and employers.
---------------------------------------------------------------------------
\1\ https://oag.ca.gov/news/press-releases/attorney-general-
becerra-applauds-ninth-circuit-ruling-denying-challenge.
\2\ https://oag.ca.gov/news/press-releases/attorney-general-
becerra-announces-573-million-nationwide-settlement-mckinsey.
\3\ https://oag.ca.gov/news/press-releases/attorney-general-
becerra-sues-opioid-manufacturer-purdue-pharma-its-illegal.
\4\ https://oag.ca.gov/system/files/attachments/press_releases/
Sutter%20Complaint.pdf.
Health care is a right, not a privilege. As HHS Secretary, Becerra
will strengthen and expand the pillars of our nation's health care
system--Medicaid, Medicare, and the Affordable Care Act. Our country
needs his trusted leadership on both the health care and human service
programs administered by HHS to ensure equity and fairness now during
the pandemic and as our country moves forward to rebuild our economy.
AFSCME urges you to promptly confirm Xavier Becerra to be the HHS
---------------------------------------------------------------------------
Secretary.
Sincerely,
Bailey K. Childers
Director of Federal Government Affairs
______
American Federation of Teachers
555 New Jersey Avenue, NW
Washington, DC 20001
202-879-4400
https://www.nft.org/
February 22, 2021
U.S. Senate
Committee on Finance
219 Dirksen Senate Office Building
Washington, DC 20510
Dear Senators:
On behalf of the 1.7 million members of the American Federation of
Teachers, I urge you to support the nomination of California Attorney
General Xavier Becerra to become secretary of the Department of Health
and Human Services.
Every person in America deserves the freedom to thrive, fueled by
economic and educational opportunity and justice, fairness and a voice
for all in our democracy. That requires not just addressing the
confluence of crises affecting our country--including COVID-19,
economic insecurity, a reckoning with racism, and threats to our
democracy such as failing to distinguish fact from fiction and
opinion--but also creating the conditions for opportunity and justice.
By prioritizing science, the inequities in our health-care system, and
protections and resources for health-care workers, Becerra will be a
true partner as we work to achieve this agenda.
The AFT represents nearly 200,000 health-care professionals, who are
directly affected by actions taken by HHS, while our educators daily
see the impact of healthcare on the educational attainment of students
living in poverty. Nominee Becerra's focus on equity comes from a basic
philosophy articulated when he said: ``For me, healthcare is a right.''
This crucial statement provides insight into his philosophy as
California attorney general, and into what it would be as a HHS
secretary. During his tenure as California's attorney general, he has
fought to save the Affordable Care Act, support reproductive rights and
ensure access to healthcare for immigrant families, while also seeking
to make healthcare affordable through reducing provider market
dominance.
As attorney general, Becerra manages more than 4,500 employees and a
substantial budget. He has extensive background on federal healthcare
policy from his time in Congress, including serving on the Committee on
Ways and Means. I worked with Becerra while he was in Congress and can
attest to both his mastery of policy and, even more crucially, his care
for constituents, healthcare professionals, children and the nation.
Xavier Becerra has the expertise, experience and world view to serve
the country exceptionally as the secretary of the Department of Health
and Human Services. I urge you to support his nomination. He will
provide the leadership we need to fight for the freedom to thrive for
our members, our families, our communities and all those we serve.
Sincerely,
Randi Weingarten
President
______
American Hospital Association
800 10th Street, NW
Two CityCenter, Suite 400
Washington, DC 20001-4956
(202) 638-1100
February 18, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden and Ranking Member Crapo:
On behalf of our nearly 5,000 member hospitals, health systems and
other health care organizations, our clinician partners, including more
than 270,000 affiliated physicians, 2 million nurses and other
caregivers--and the 43,000 health care leaders who belong to our
professional membership groups, the American Hospital Association (AHA)
is pleased to support the nomination of California Attorney General
Xavier Becerra to be the next Secretary of the Department of Health and
Human Services.
As California Attorney General, Becerra has led the effort to protect
the Affordable Care Act and its important protections and coverage for
patients. The AHA has worked with Becerra throughout his long career as
a former member of the U.S. House of Representatives, including as a
member of the Ways and Means Committee's health subcommittee. He has
been a champion for health care coverage and affordable health care,
which the AHA has long supported. Throughout his time in public
service, it is clear that Becerra has consistently made people across
America and their health a priority.
There are many critical priorities facing the nation and the health
care field. Nothing is more critical than the COVID-19 pandemic, and
making sure hospitals, health systems and our heroic front-line
caregivers have the resources and support they need to care for
patients and win the battle against the virus. The enduring challenges
of both caring for our non COVID patients and COVID patients,
maintaining a healthy workforce, as well as partnering to vaccinate our
country long term will require a significant partnership. We also need
to make important progress on advancing the transformation of health
care, ensuring access to coverage, making health care equitable to all
people in America and enhancing the quality of care.
The AHA looks forward to working closely with Becerra should he be
confirmed as the next Secretary of the Department of Health and Human
Services to achieve our mutual mission of advancing the health of the
patients and communities we are privileged to serve.
Sincerely,
Richard J. Pollack
President and CEO
______
American Kidney Fund
11921 Rockville Pike, Suite 300
Rockville, MD 20852
301-881-3052 voice
301-881-0898 fax
800-638-8299 toll-free
866-300-2900 Espanol
https://www.kidneyfund.org/
January 26, 2021
The Honorable Ron Wyden
Chairman
U.S. Senate
Committee on Finance
Washington, DC 20510
The Honorable Mike Crapo
Ranking Member
U.S. Senate
Committee on Finance
Washington, DC 20510
Dear Chairman Wyden and Ranking Member Crapo:
We are writing to share our support of the nomination of Xavier Becerra
for the Secretary of the U.S. Department of Health and Human Services.
Mr. Becerra has a long history of support for expanding access to
affordable health care in his role as a longtime member of the House of
Representatives and as the California Attorney General.
As the nation's leading independent nonprofit working on behalf of the
37 million Americans with kidney disease, the American Kidney Fund is
dedicated to ensuring that every kidney patient has access to health
care, and that every person at risk for kidney disease is empowered to
prevent it. AKF provides a complete spectrum of programs and services:
prevention outreach, top-rated health educational resources, and direct
financial assistance enabling the nation's low-income dialysis and
transplant patients to access lifesaving medical care.
HHS is one of the largest and most important federal agencies--
especially now, during the deadly COVID-19 pandemic--and Mr. Becerra's
experience as both a legislator and an executive give him the needed
expertise to lead during this crucial time. People with kidney disease
need a strong leader at HHS now more than ever.
Kidney disease and kidney failure, also known as end-stage renal
disease (ESRD), have a disproportionate impact on racial and ethnic
minorities. Compared to white Americans, Black Americans are 3.4 times
more likely to develop kidney failure; Hispanic Americans, American
Indians/Alaska Natives and Asian Americans are respectively 1.5 times,
1.9 times and 1.3 times more likely. These statistics--and more
importantly, people--have come into sharper focus as COVID-19 continues
to spread across the country, with those same communities facing higher
rates of hospitalizations and mortality during the pandemic. People
with underlying kidney disease and ESRD are higher risk for COVID-19
and death related to the disease. Additionally, COVID-19 itself can
also cause kidney damage.
We are honored to share our support for a dedicated and experienced
public servant like Xavier Becerra to lead HHS.
Sincerely,
LaVarne A. Burton Jerry D. Klepner
President and CEO Chairman, Board of Trustees
cc: Sean McCluskie
HHS Chief of Staff
______
American Medical Association
AMA PLAZA
330 N. Wabash Avenue, Suite 39300
Chicago, IL, 60611-5885
T (312) 464-5000
https://www.ama-assn.org/
January 21, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
219 Dirksen Senate Office Building 219 Dirksen Senate Office Building
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden and Ranking Member Crapo:
The American Medical Association (AMA) strongly supports Xavier Becerra
for the Secretary of the Department of Health and Human Services (HHS).
Throughout his career, Attorney General Becerra has worked to
strengthen our nation's health care system. During his time in
Congress, Mr. Becerra served on the important Ways and Means Committee,
which oversees Medicare and other important health care programs. Mr.
Becerra labored to strengthen Medicare and ensure its long-term
viability as well as address poverty issues for families that have the
potential to affect their health. In particular, the AMA worked with
Mr. Becerra to pass the Affordable Care Act (ACA) and to eliminate
Medicare's Sustainable Growth Rate (SGR) formula.
As California's Attorney General, Mr. Becerra worked extensively on a
series of health care issues of importance to the nation and to the
AMA. Mr. Becerra led a coalition of 17 states in defending the ACA in
the Federal District Court and the Fifth Circuit Court of Appeals case,
Texas v. U.S., which challenged the constitutionality of the ACA. Mr.
Becerra also led 20 states and DC in filing a petition to the U.S.
Supreme Court seeking review of the Fifth Circuit's decision in Texas
v. U.S. The decision held the individual mandate of the ACA
unconstitutional and called into question whether the remaining
provisions of the ACA could still stand, including those that protect
and provide coverage to Americans with pre-existing conditions. Also,
as California Attorney General, Mr. Becerra pursued antitrust
enforcement against hospital consolidations that distort the health
care marketplace; worked to protect access to reproductive health care
and for LGBTQ individuals; and joined other state Attorneys General in
suing the Trump administration over its public charge rule. In all
these cases, his efforts targeted at promoting public health and
protecting access to care for chronically underserved individuals and
populations.
The raging COVID-19 pandemic demands strong and consistent federal
leadership, and it is imperative that the Senate act quickly to confirm
Mr. Becerra to serve as Secretary of HHS. The AMA urges the Senate to
confirm his appointment immediately.
Sincerely,
James L. Madara, M.D.
______
American Nurses Association
8515 Georgia Avenue, Suite 400
Silver Spring, MD 20910
https://www.nursingworld.org
February 10, 2021
The Honorable Ron Wyden The Honorable Patty Murray
Chair Chair
U.S. Senate U.S. Senate
Committee on Finance Committee on Health, Education,
Labor,
219 Dirksen Senate Office Building and Pensions
Washington, DC 20510 428 Dirksen Senate Office Building
Washington, DC 20510
The Honorable Mike Crapo The Honorable Richard Burr
Ranking Member Ranking Member
United States Senate U.S. Senate
Committee on Finance Committee on Health, Education,
Labor,
219 Dirksen Senate Office Building and Pensions
Washington, DC 20510 428 Dirksen Senate Office Building
Washington, DC 20510
Dear Chairman Wyden, Chairwoman Murray, Ranking Member Crapo, and
Ranking Member Burr,
On behalf of the American Nurses Association (ANA), I offer our
wholehearted endorsement of California Attorney General Xavier Becerra
to become the Secretary of the U.S. Department of Health and Human
Services.
ANA is the premier organization representing the interests of the
nation's 4.2 million registered nurses, through its state and
constituent member associations, organizational affiliates, and
individual members. ANA members also include the four advanced practice
registered nurse roles (APRNs); Nurse practitioners (NPs), clinical
nurse specialists (CNSs), certified nurse-midwives (CNMs) and certified
registered nurse anesthetists (CRNAs). ANA is dedicated to partnering
with health care consumers, the Congress, and the Administration to
improve practices, policies, delivery models, outcomes, and access
across the health care continuum. ANA had the opportunity to work with
Congressman Becerra during his time in Congress and it is our
experience he shares our dedication to this cause.
While a member of the Health Subcommittee on the U.S. House Ways and
Means Committee, Mr. Becerra championed many issues important to
nurses, other health care providers, and patients. These included
repealing the sustainable growth rate, repealing the per-beneficiary
Medicare spending limits on therapy services, promoting value-based
payment models, lowering prescription drug prices, and making health
care more affordable and accessible to everyone.
As California Attorney General, Mr. Becerra has defended the Affordable
Care Act and essential health benefits. He fought against hospital
consolidation and short-term junk insurance plans which make health
care more expensive for consumers. His experience running the
Department of Justice in America's largest state instills confidence
that he is very capable of running one of the largest government
agencies in the world during the COVID-19 pandemic. Further he is a
historic choice whose own experiences allow him to personally
understand the health care disparities in our system that have ravaged
minority communities across the country.
If you have any questions or require additional information concerning
the above endorsement, please feel free to contact me or Sam Hewitt,
ANA's senior associate director of policy and government affairs at
[email protected].
Sincerely,
Ernest Grant, Ph.D., RN, FAAN
President
______
American Occupational Therapy Association, American Speech-Language-
Hearing Association, and American Physical Therapy Association
March 2, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden and Ranking Member Crapo:
The American Occupational Therapy Association, the American Speech-
Language-Hearing Association, and the American Physical Therapy
Association are writing to express our support for the confirmation of
Xavier Becerra as the U.S. Secretary of Health and Human Services.
During his 12 terms in Congress and as a member of the House Ways and
Means Committee, Attorney General Becerra spent much of his time
working on health care issues, including ensuring Medicare
beneficiaries have access to care. In 1997, Congress passed the
Balanced Budget Act, which led to the creation of the Medicare therapy
cap that set limits on reimbursement for outpatient physical therapy,
occupational therapy, and speech-language pathology services. The
therapy cap was intended as a temporary solution to control Medicare
costs but instead acted as a barrier to care for a wide spectrum of
Medicare beneficiaries needing rehabilitation services, from patients
who were recovering from a stroke or traumatic brain injury, to those
suffering from chronic conditions. The cap also created an
administrative burden that led to disruptions in patient care and
stress for patients.
While in Congress, Attorney General Becerra championed the elimination
of this arbitrary cap through his sponsorship of the Medicare Access to
Rehabilitation Services Act. Thanks to his leadership, Congress
eventually eliminated the hard caps on therapy services as part of the
Balanced Budget Act of 2018, ensuring Medicare beneficiaries have
access to medically necessary therapy services and preventing
disruptions in the continuum of care.
Attorney General Becerra also worked tirelessly to identify and support
appropriate Medicare payment for health care services and specifically
to avoid arbitrary payment cuts resulting from the flawed Sustainable
Growth Rate Formula (SGR). His support for the Medicare Access and CHIP
Reauthorization Act of 2015 (MACRA) eliminated the SGR and established
a more solid foundation for Medicare payments to enrolled providers.
Finally, as a U.S. representative and Attorney General of California,
Mr. Becerra has supported the Affordable Care Act's (ACA's) inclusion
of essential health benefits such as habilitative and rehabilitative
services and devices, which are vital to individuals in need of therapy
services. The essential health benefits, defined in Section 1302 of the
ACA, help ensure that Americans have access to comprehensive health
insurance, leading to improved health outcomes and ability to
participate in their communities.
We look forward to Mr. Becerra's continued leadership to ensure access
to occupational therapy, physical therapy, and speech-language
pathology services and support the confirmation of Attorney General
Xavier Becerra to lead the U. S. Department of Health and Human
Services as the country continues to address the array of challenges
the pandemic presents. Thank you for your consideration.
Sincerely,
Wendy C. Hildenbrand, Ph.D., MPH, OTR/L, FAOTA
AOTA President
Sharon L. Dunn PT, Ph.D.
Board-Certified Clinical Specialist in Orthopaedic Physical Therapy
APTA President
A. Lynn Williams, Ph.D., CCC-SLP
2021 ASHA President
______
American Physical Therapy Association
3030 Potomac Avenue, Suite 100
Alexandria, VA 22305-3085
703-684-2782
https://www.apta.org/
January 12, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden and Ranking Member Crapo:
The American Physical Therapy Association would like to express its
support for Xavier Becerra as the Biden Administration's nominee for
the position of Secretary of Health and Human Services.
APTA is a professional organization representing 100,000 member
physical therapists, physical therapist assistants, and students of
physical therapy. Building a community that advances the profession of
physical therapy to improve the health of society is our mission.
President-Elect Biden made a wise choice in the selection of California
Attorney General Xavier Becerra to lead the department at this time, as
the country continues to address the array of challenges the pandemic
presents. During his 12 terms in Congress and as a member of the House
Ways and Means Committee, Attorney General Becerra spent much of his
time working on health care issues impacting U.S. citizens.
As a congressman, Attorney General Becerra was a staunch advocate for
access to health care services. He helped lead a successful effort to
eliminate arbitrary caps on seniors' access to necessary outpatient
physical therapy services and championed legislation to ultimately
remedy this issue for millions of Medicare beneficiaries.
In addition to his experience on health care matters, Attorney General
Becerra brings his experience as an administrator, having run the
California Department of Justice since 2017. In this position he
addressed an array of health and other matters that prepare him well to
handle the significant challenges of running an agency as large and
diverse as the U.S. Department of Health and Human Services.
Finally, as a Latino he brings to the agency knowledge of the
disparities in access to health services in the U.S. He is well
positioned to address these disparities to ensure the improving health
of the nation.
Thank you for your attention to this matter. Should you have any
questions regarding our comments, please contact Justin Elliott, vice
president, government affairs, at [email protected] or 703-706-
3161. Thank you for your consideration.
Sincerely,
Sharon L. Dunn, PT, Ph.D.
Board-Certified Clinical Specialist in Orthopaedic Physical Therapy
President
______
American Public Health Association
800 I Street, NW
Washington, DC 20001-3710
202-777-2742
https://www.apha.org/
February 10, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chair Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
The Honorable Patty Murray The Honorable Richard Burr
Chair Ranking Member
U.S. Senate U.S. Senate
Committee on Health, Education, Committee on Health, Education,
Labor, and Pensions Labor, and Pensions
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden, Chairwoman Murray, and Ranking Members Crapo and
Burr:
On behalf of the American Public Health Association, a diverse
community of public health professionals who champion the health of all
people and communities, I write to express our full support for the
nomination of Xavier Becerra as Secretary of the U.S. Department of
Health and Human Services. He has both the knowledge and experience to
lead this vital agency at this critical time as we continue to address
the COVID-19 pandemic and the many other health challenges we face as a
nation.
As the attorney general of California, Becerra has played a leading
role in defending the Affordable Care Act, the crucial public health
law that has expanded health insurance coverage to millions and has
provided essential funding for the nation's public health system. He
has more than two decades of experience serving as a member of the
House of Representatives, which included serving on the House Ways and
Means Committee which has broad jurisdiction over the nation's health
care delivery system, including the ACA. In addition, he has been a
leading advocate in addressing important environmental health issues,
including climate change and environmental justice, during his time as
attorney general and as a member of Congress. He has consistently been
a champion for improving the health and well-being of the nation.
We are confident that Mr. Becerra has the leadership skills and
experience needed to lead the U.S. Department of Health and Human
Services. We strongly endorse his nomination and urge the Senate's
swift confirmation. We look forward to working with him and the rest of
the dedicated staff at HHS to address the many public health challenges
that we face as a nation. Please feel free to contact me with any
questions regarding our support for his nomination.
Sincerely,
Georges C. Benjamin, M.D.
Executive Director
______
American Society for Clinical Laboratory Science
1861 International Drive, Suite 200
McLean, Virginia 22102
https://ascls.org/
[email protected]
571-748-3770
fax 571-354-7570
January 21, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden and Ranking Member Crapo:
The American Society for Clinical Laboratory Science (ASCLS) would like
to express its support for Xavier Becerra as the Biden Administration's
nominee for the position of Secretary of U.S. Department of Health and
Human Services. ASCLS urges his swift confirmation by the U.S. Senate.
The mission of ASCLS is to make a positive impact in health care
through leadership that will assure excellence in the practice of
laboratory medicine. ASCLS represents medical laboratory scientists and
medical laboratory technicians who are the backbone of our nation's
diagnostic health care system.
President-Elect Biden made a wise choice in the selection of California
Attorney General Xavier Becerra to lead the department at this time as
the country continues to address the array of challenges the pandemic
presents. During his twelve terms in Congress, Attorney General Becerra
spent much of his time working on health care issues impacting U.S.
citizens as a member of the House Ways and Means Committee.
As a Congressman, Attorney General Becerra was a staunch advocate for
access to health care services. Clinical laboratory scientists have a
critical health care role to play and we must ensure access to clinical
laboratory services is unfettered especially during this coronavirus
(COVID-19) pandemic. The ongoing shortage of laboratory personnel in
the U.S. should be of great concern as we address the current pandemic
and future access to high quality laboratory diagnostic services.
In addition to his experience on health care matters, Attorney General
Becerra brings his experience as an administrator having run the
California Department of Justice since 2017. In this position he
addressed an array of health and other matters that prepare him well to
handle the significant challenges of running an agency as large and
diverse as the U.S. Department of Health and Human Services.
Finally, as the first Latino to head the agency, he brings to the
agency knowledge of the disparities in access to health services in the
U.S. He is well positioned to address these disparities, including
workforce disparities, to ensure the improving health of the nation.
Thank you for your attention to this matter.
Sincerely,
Maddie Josephs, MS, MLS (ASCP)
President
______
American Society for Radiation Oncology
251 18th St. South, 8th Floor
Arlington, VA 22202
Main: 703-502-1550
Fax: 703-502-7852
https://www.astro.org/
https://www.rtanswers.org/
January 20, 2020
The Honorable Ron Wyden The Honorable Mike Crapo
221 Dirksen Senate Office Bldg. 239 Dirksen Senate Office Building
Washington, DC 20510 Washington, DC 20510
The Honorable Patty Murray The Honorable Richard Burr
154 Russell Senate Office Building 217 Russell Senate Office Building
Washington, DC 20510 Washington, DC 20510
Dear Senators Wyden, Crapo, Murray and Burr:
The American Society for Radiation Oncology (ASTRO), on behalf of our
11,000 members of the radiation oncology team, strongly supports the
nomination of Xavier Becerra as Secretary of the Department of Health
and Human Services (HHS).
Attorney General Becerra is uniquely qualified to serve in this
position, as he has acquired a lifetime of personal and professional
experience and expertise helping Americans access vital health care
services. ASTRO has always appreciated the opportunity to work with
Attorney General Becerra to ensure that cancer patients, particularly
lower income Americans, have affordable health insurance and access to
the highest quality cancer care. We are confident that Attorney General
Becerra's continuous fight for those most at risk will translate
exceptionally well to meeting the serious health care needs of all
Americans, including those affected by the COVID-19 pandemic.
While serving in Congress for 24 years, Attorney General Becerra
distinguished himself as a foremost health care expert and leader,
championing critical issues such as the Affordable Care Act insurance
expansions, ensuring appropriate Medicare and Medicaid benefits and
reimbursement, tobacco prevention and control, reducing health
disparities, lowering drug prices, and more. Recently, Attorney General
Becerra has continued his extensive list of health care
accomplishments, including dedicating himself to ensuring that
Californians and all Americans receive the insurance benefits they
deserve and can access COVID-19 testing, vaccines, and treatment.
ASTRO is particularly excited to work with Attorney General Becerra to
advance health equity and reduce health care disparities, which have
been further exposed and exacerbated by the pandemic and are evident
across health care, including cancer care. Research consistently shows
that adequate health insurance is associated with better cancer
outcomes, but we know that many underserved cancer patients struggle to
access life-saving radiation treatments in their communities. Attorney
General Becerra understands the complexities associated with addressing
health care disparities, and he has a proven record of navigating the
legislative environment and agency bureaucracy for the benefit of
Americans. As the first Latino Secretary of HHS, he is uniquely
situated to help turn the tide against the persistent challenge of
disparities in care.
There is no time to waste in responding to the COVID-19 pandemic and
the myriad of health care challenges facing patients and providers.
ASTRO knows that we can count on Attorney General Becerra to stand up
for what is right. He brings unrivaled competency and unmatched passion
to the position.
He is deeply familiar with the central role physician's play in the
health care system, and their contribution to driving greater value in
health care delivery. Attorney General Becerra is a wonderful choice to
help us rebuild a frayed health care system and find ways to innovate
and improve moving forward.
The HHS portfolio is as broad and expansive as any in the federal
government, and there are few with the depth of experience to manage
operations and drive exceptional performance. Attorney General Becerra
is among the few with the extensive public service record of
accomplishments that perfectly matches the important duties of HHS
Secretary. ASTRO urges swift confirmation of Attorney General Becerra
as HHS Secretary.
Sincerely,
Laura I. Thevenot
Chief Executive Officer
______
American Society of Radiologic Technologists
15000 Central Avenue, SE
Albuquerque, NM 87123-3909
505-298-4500
800-444-2778
Fax 505-298-5063
https://www.asrt.org/
January 18, 2021
To whom it may concern:
ASRT Supports President-Elect Biden's Nomination of Xavier Becerra for
HHS Secretary
The American Society of Radiologic Technologists (ASRT) supports
President-elect Biden's nomination of California Attorney General
Xavier Becerra as Secretary of the United States Department of Health
and Human Services (HHS). During his time in Congress, former Rep.
Becerra was involved and instrumental (serving on the House Ways and
Means Committee) on a wide array of health care issues and worked
closely with the ASRT and the medical imaging community to improve the
American health care system and ensure patient access to high quality
imaging care. The ASRT looks forward to working with Mr. Becerra as the
head of HHS, Congress and other interested stakeholders to continue to
maintain the highest quality care to the patients we serve.
Sal Martino,
CEO and Executive Director
______
American Society for Reproductive Medicine
726 7th Street, SE
Washington, DC 20003
(202) 747-5261
https://www.asrm.org/
February 22, 2021
The Honorable Patty Murray
Chair
U.S. Senate
Committee on Health, Education, Labor, and Pensions
Washington, DC 20510
The Honorable Richard Burr
Ranking Member
U.S. Senate
Committee on Health, Education, Labor, and Pensions
Washington, DC 20510
Dear Chairperson Murray and Ranking Member Burr:
On behalf of the American Society for Reproductive Medicine, I write in
support of the nomination of Xavier Becerra to the role of Secretary of
Health and Human Services. Mr. Becerra has an established track record
as a healthcare champion; for example, having led 20 states and the
District of Columbia in a campaign to protect and uphold the Affordable
Care Act. As an organization committed to ensuring our health advisers
prioritize access to reproductive medicine, we are confident in Mr.
Becerra's ability to lead and look forward to working with him, once
confirmed.
The American Society for Reproductive Medicine (ASRM) has, for nearly a
century, been a global leader in multidisciplinary reproductive
medicine research, ethical practice, and education. ASRM's
approximately 8,000 distinguished members, which include obstetricians
and gynecologists, urologists, mental health professionals, and others,
represent more than 100 countries and impact and inform all aspects of
reproductive care and science worldwide.
ASRM is dedicated to the advancement of the science and practice of
reproductive medicine. The Society accomplishes its mission through the
pursuit of excellence in evidence-based, life-long education and
learning, through the advancement and support of innovative research,
through the development and dissemination of the highest ethical and
quality standards in patient care, and through advocacy on behalf of
physicians and affiliated healthcare providers and their patients.
As leaders in the field of reproductive medicine, we are invested in
ensuring the swift confirmation of qualified leaders equipped and
prepared to prioritize Americans' healthcare needs, including
reproductive medicine.
We appreciate your consideration and support of this nomination. Becca
O'Connor, ASRM's Director of Government Affairs, is prepared to respond
to any questions you might have about this and as you undertake the
important work of the 117th Congress. She can be reached at:
[email protected] or 617-270-4465.
Sincerely,
Hugh Taylor, M.D.
President
______
Association of American Medical Colleges
655 K Street, NW, Suite 100
Washington, DC 20001-2399
T 202-828-0400
https://www.aamc.org/
February 22, 2021
The Honorable Ron Wyden The Honorable Patty Murray
Chairman Chairwoman
U.S. Senate U.S. Senate
Committee on Finance Committee on Health, Education,
Labor,
221 Dirksen Senate Office Building and Pensions
Washington, DC 20510 154 Russell Senate Office Building
Washington, DC 20510
The Honorable Mike Crapo The Honorable Richard Burr
Ranking Member Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Health, Education,
Labor, and Pensions
239 Dirksen Senate Office Building 217 Russell Senate Office Building
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden, Chairwoman Murray, Ranking Member Crapo, and
Ranking Member Burr:
On behalf of the AAMC (Association of American Medical Colleges), I
write to urge you to support the nomination of the Honorable Xavier
Becerra, JD for Secretary of the U.S. Department of Health and Human
Services (HHS). Secretary-designate Becerra's experience in health
policy and patient advocacy makes him a well-qualified candidate to
serve in this role. In addition, his leadership experience will prove
useful as he guides the many agencies of HHS as the department not only
continues to respond to the COVID-19 pandemic, but also prepares for
future public health emergencies and addresses other critical health
care issues, including health coverage.
The AAMC is a not-for-profit association dedicated to transforming
health through medical education, health care, medical research, and
community collaborations. Its members are all 155 accredited U.S. and
17 accredited Canadian medical schools; more than 400 teaching
hospitals and health systems, including Department of Veterans Affairs
medical centers; and more than 70 academic societies. Through these
institutions and organizations, the AAMC leads and serves America's
medical schools and teaching hospitals and their more than 179,000
full-time faculty members, 92,000 medical students, 140,000 resident
physicians, and 60,000 graduate students and postdoctoral researchers
in the biomedical sciences.
HHS is critical to defeating COVID-19, as demonstrated already by the
creation of a COVID Response Team within the agency. HHS and its
agencies also are dedicated to promoting the nation's health and well-
being, including through medical research, patient care, the health
care workforce, and community health. Academic Medicine has been
defining the front lines in addressing the pandemic. In addition, the
missions of HHS and its agencies also are key to the mission of the
AAMC and are core for our member medical schools and teaching
hospitals. Secretary-designate Becerra's leadership experience--such as
the efforts to protect patients' access to health care and establish
health equity initiatives that he led during his tenure as Attorney
General of the State of California--will be an asset in this role. He
also brings health policy expertise from his experience on the House
Committee on Ways and Means where he championed affordable,
comprehensive health care coverage for patients.
As the challenges presented by the COVID-19 pandemic continue, we urge
the Senate to proceed quickly with Secretary-designate Becerra's
confirmation to ensure that HHS has leadership at the helm now to
coordinate an effective response to COVID as well as proceed on the
other pressing health care needs of the country. We look forward to
engaging with Secretary-designate Becerra to address important issues
facing the nation, including our mutual goal of improving the health of
people everywhere.
Please feel free to contact me or AAMC Chief Public Policy Officer
Karen Fisher, JD ([email protected]) if you have any questions or would
like any additional information.
Thank you,
David J. Skorton, M.D.
President and Chief Executive Officer
cc: Senate Majority Leader Chuck Schumer
Senate Minority Leader Mitch McConnell
______
Association of Clinical Research Professionals
99 Canal Center Plaza, Suite 150
Alexandria, VA 22314
https://acrpnet.org/
January 21, 2020
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden and Ranking Member Crapo:
The Association of Clinical Research Professionals (ACRP) would like to
express its support for Xavier Becerra as the Biden Administration's
nominee for the position of Secretary of U.S. Department of Health and
Human Services. HCAOA urges his swift confirmation by the U.S. Senate.
ACRP members are individuals working on research studies in humans or
with materials from humans. With over 13,000 members in the United
States, ACRP's diverse population work in a variety of practice
settings, roles, and specialty areas, with a wide range of experience
in the field. What's common about them all is their dedication and
commitment to promoting excellence in clinical research.
President-Elect Biden made a wise choice in the selection of California
Attorney General Xavier Becerra to lead the department at this time as
the country continues to address the array of challenges the pandemic
presents. During his twelve terms in Congress, Attorney General Becerra
spent much of his time working on health-related issues impacting U.S.
citizens as a member of the House Ways and Means Committee.
As a Congressman, Xavier Becerra was a staunch advocate for access to
health care. ACRP members are actively engaged in the clinical research
necessary to discover and improve health care treatment, devices, and
pharmaceuticals, to include vaccines. Much work lays ahead and ACRP is
committed to ensuring the clinical competency of all clinical research
professions.
Attorney General Becerra brings his experience as an administrator
having run the California Department of Justice since 2017. In this
position he addressed an array of health and other matters that prepare
him well to handle the significant challenges of running an agency as
large and diverse as the U.S. Department of Health and Human Services.
Finally, Attorney General Becerra brings to the agency knowledge of the
disparities in access to health services in the U.S. He is well
positioned to address these disparities. ACRP itself is undertaking
efforts to produce a more diverse workforce and looks forward to
working with the nominee to ensure the improving health of the nation.
Thank you for your attention to this matter.
Sincerely,
Jim Kremidas
Executive Director
______
Association of Clinicians for the Underserved
1575 I Street, NW, Suite 300
Washington, DC 20005
Tel: (844) 422-8247
Fax: (703) 562-8801
https://clinicians.org/
Statement on the nomination of Xavier Becerra as HHS Secretary
Washington, DC--January 21, 2021--The Association of Clinicians for the
Underserved (ACU) strongly supports the nomination of Xavier Becerra to
be the next Secretary of the United States Department of Health and
Human Services. ACU was fortunate to work with Xavier Becerra and his
colleagues during his tenure as a member of the US House of
Representatives on the passage of the Affordable Care Act. Mr.
Becerra's commitment to ensure affordable coverage and access to
healthcare for the those most in need represents exactly the type of
leadership and vision needed to lead our nation through this time of
challenge and crisis.
As the ACU network continues to grapple with the horrible strain and
dire impact of the COVID-19 pandemic, we are encouraged by the
leadership Mr. Becerra can bring to our nation in addressing health
equity, ensuring affordable healthcare access and coverage, and working
to build the healthcare workforce needed to support and transform our
healthcare system.
We are grateful for Mr. Becerra's long history of public service and
his dedicated work in support of America's underserved. The ACU
welcomes the opportunity to work closely with Mr. Becerra and all of
HHS to advance our shared goals and mission; to improve the health of
America's underserved populations and to enhance the development and
support of the clinicians who serve them.
# # #
The Association of Clinicians for the Underserved is a uniquely
transdisciplinary membership association uniting clinicians, advocates,
and organizations in the shared mission to improve the health of
America's underserved populations and to support the clinicians serving
them. ACU provides professional education, training and technical
assistance, and clinical tools and programs to thousands of clinicians
and organizations every year to improve health equity for the
underserved. To learn more about ACU, visit www.clinicians.org, like
ACU on Facebook, or follow us on Twitter.
______
Association for Community Affiliated Plans
1155 15th Street, NW, Suite 600
Washington, DC 20005
Tel. 202-204-7505
https://www.communityplans.net/
February 16, 2021
The Honorable Ron Wyden The Honorable Patty Murray
Chairman Chairman
U.S. Senate U.S. Senate
Committee on Finance Committee on Health, Education,
Labor,
Washington, DC 20510 and Pensions
Washington, DC 20510
The Honorable Mike Crapo The Honorable Richard Burr
Ranking Member Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Health, Education,
Labor,
Washington, DC 20510 and Pensions
Washington, DC 20510
Dear Senators Wyden, Crapo, Murray, and Burr:
The Association for Community Affiliated Plans (ACAP) is a national
trade association representing 78 not-for-profit Safety Net Health
Plans. Collectively, ACAP plans serve more than 20 million people
through Medicaid, Medicare, the Marketplaces, and other publicly
supported coverage programs. Our mission is to support our member
plans' efforts to improve the health and well-being of people with low
incomes and with significant health care needs.
We write to support the nomination of the Honorable Xavier Becerra for
Secretary of the Department of Health and Human Services (HHS).
Secretary-Nominee Becerra is unequivocally qualified to run HHS, as a
longtime supporter of equitable access to comprehensive, affordable
health coverage and care. Throughout his career in Washington, DC--with
20 years of experience on the House Committee on Ways and Means--and as
California's Attorney General, Xavier Becerra has not just led efforts
to support and protect the Affordable Care Act, but countless other
health care efforts. In addition to his significant policy and
operational knowledge of health care from his time in the U.S. House of
Representatives, his time as California's Attorney General
unequivocally demonstrated his ability to manage a large, bureaucratic
agency that oversees a wide swath of topics.
We encourage a swift confirmation of Mr. Becerra, so that he can
quickly get to work addressing the multitude of health care issues that
have befallen the American public--from the COVID-19 pandemic, to all-
too-frequent churn within the Medicaid program, to the loosening of ACA
rules that protect consumers from inadequate, junk insurance plans.
Throughout his career Mr. Becerra has been a stalwart supporter of
policies to improve the lives of lower-income and vulnerable
populations; we look forward to working with him and Congress to
further improve the lives of Americans nationwide.
Sincerely,
Margaret A Murray
CEO
______
Be a Hero
https://beaherofund.com/
February 22, 2021
The Honorable Ron Wyden
Chairman
Committee on Finance
United States Senate
Washington, DC 20510
Dear Chairman Wyden:
I write to urge the Committee to support Xavier Becerra, President
Biden's nominee to lead the Department of Health and Human Services.
During an infectious disease pandemic that has cost more than 500,000
lives in the United States, it is imperative that HHS is led by someone
who understands that SARS-CoV-2 doesn't discriminate based on income,
immigration papers, health history, and more--but our broken systems
do. We need a demonstrated health equity champion who can lead the
Department during an unprecedented challenge to health equity for
marginalized communities.
A child of an immigrant day labor and clerical worker, Xavier Becerra
has spent his career working to help more families access health care
and the services needed for their well-being. To name just a few of his
efforts, as a Member of Congress, Becerra helped expand Medicaid to
millions of vulnerable people through the Affordable Care Act. As
California Attorney General, he led a multi state coalition to defend
the health and well-being of children held in immigration detention.
And throughout his career, he has fought against the structural racism
that leads to disproportionately worse health outcomes for communities
of color.
In the coming months, we will hopefully see your work help eradicate a
deadly virus that has already destroyed so many lives. But too many
people are facing this pandemic while also facing barriers to accessing
health coverage and care. We can help ease that burden right now--we
need an experienced manager and policy leader who knows the impact
structural inequality has on everyday families and is willing to fight
to ensure that no family is left behind during this pandemic and
beyond. This begins with the committee's support for Xavier Becerra as
United States Secretary of Health and Human Services.
Thank you for your consideration of this crucial nomination. If you
would like more information or to discuss further, please contact
Matthew Cortland at matthew@
beaherofund.com.
Sincerely,
Ady Barkan
______
California Primary Care Association
1231 I Street, Suite 400
Sacramento, CA 95814
(916) 440-8170
https://www.cpca.org//
January 26, 2021
The Honorable Dianne Feinstein
331 Hart Senate Office Building
Washington, DC 20510
Re: Xavier Becerra's Nomination for Secretary of Health and Human
Services (HHS)--SUPPORT
Dear Senator Feinstein,
On behalf of the California Primary Care Association (CPCA)--
representing California's 1,370 community health centers (CHCs) which
serve 7.2 million Californians, I am writing to express our strong
support of Xavier Becerra's nomination for Secretary of Health and
Human Services (HHS). I have known Secretary-designate Becerra for many
years, and I think he is the perfect choice to lead HHS at this crucial
time. COVID-19 has reinforced the structural discrimination and racism
within our society, and CHCs have witnessed this uneven impact of
COVID-19 on their racial and ethnic minorities, homeless, and farm
worker patients. Xavier Becerra is uniquely positioned to bring the
tailored approach and leadership that is needed to support all
Americans through this unprecedented public health emergency and
guarantee a stronger health care delivery system when it is over.
With the Biden Administration refocusing the federal government's
COVID-19 response and building a new vaccination infrastructure that is
centered in community health centers, Becerra comes well-prepared to
see that vision forward. As congressman, Secretary-designate Becerra
represented a district that has 30 health centers with 57 sites.
Collectively, those health centers serve over 244,000 patients,
representing over one-quarter of the population of his former
congressional district. Nationwide, health centers serve almost 10% of
the population, so the Secretary-
designee's experience with health centers in his congressional district
will be important as he transitions to a national position.
Secretary-designate Becerra has always been a strong supporter of
health centers. He attended events at health centers in his former
congressional district and hosted regular policy roundtables for health
center leaders. More importantly, he fought for programs and funding
helpful to health centers through his position as a senior member of
the House Ways and Means Committee. He has also been involved in the
important discussions about the federal government's role in ensuring
coverage for all.
As Attorney General of California, Secretary-designate Becerra
continued his work in support of access and coverage, most notably as
leader in defending the Affordable Care Act through a legal challenge
that united 20 states and the District of Columbia, a case that will be
decided by the Supreme Court this Spring. Additionally, as Attorney
General, he worked with his peers across the country to make
pharmaceutical reforms and support a women's access to health care
services.
As COVID continues to ravage our country, with a disproportionate
impact on historically marginalized communities and communities of
color, it is imperative that Secretary-designate Becerra be confirmed
and on-the-job quickly. For that reasons, we respectfully request the
swift confirmation of Secretary-designate Becerra as Secretary of
Health and Human Services. I cannot recommend him more highly for this
position, and I look forward to working with him in his new role.
Thank you for your quick consideration of his nomination.
Sincerely,
Carmela Castellano Garcia, Esq.
President and CEO
______
Campaign for Tobacco-Free Kids
1400 I Street, NW, Suite 1200
Washington, DC 20005
Phone (202) 296-5469
Fax (202) 296-5427
https://www.tobaccofreekids.org/
February 12, 2021
The Honorable Ron Wyden
Chairman
Committee on Finance
United States Senate
Washington, DC 20510
Dear Chairman Wyden:
We write to express our strong support for the nomination of Xavier
Becerra to be Secretary of the Department of Health and Human Services.
He is highly qualified and has the experience necessary to address the
enormous health challenges facing our nation, including the death and
disease caused by tobacco use.
Mr. Becerra has an impressive record of protecting public health and
will be prepared on day one to address the COVID-19 pandemic and the
stark health disparities it has exposed, as well as tobacco use, which
heightens those disparities.
Tobacco use has long been the leading preventable cause of death in the
U.S., causing more than 480,000 deaths and an estimated $170 billion in
health care costs each year. High rates of e-cigarette use by youth is
a new challenge that is placing another generation at risk for nicotine
addiction and tobacco use. Tobacco use is also a significant
contributor to health disparities, as tobacco use and tobacco-caused
disease have become more concentrated among certain communities of
color, people with lower levels of income and education, people with a
behavioral health condition, and LGBT Americans. Exacerbating this
problem, cigarette smokers are at greater risk for severe illness from
COVID-19, which provides an urgent new reason to help tobacco users to
quit.
As the Attorney General of California, Mr. Becerra has demonstrated
leadership in protecting kids from tobacco. Recognizing that youth are
particularly vulnerable to nicotine use and addiction, he worked to
protect kids from e-cigarette marketing and tobacco imagery in streamed
video content. He also supported California's new law ending the sale
of flavored tobacco products, which are a key driver of youth tobacco
use. During his time in Congress, he supported the landmark law giving
FDA authority to oversee tobacco products, which includes a critical
requirement that new tobacco products undergo a public health review by
the agency before they can be marketed.
We believe Mr. Becerra will be a strong and effective leader of the
Department of Health and Human Services and will use his position to
prevent disease and save lives. We urge your Committee to favorably
report his nomination to the U.S. Senate and that he be quickly
confirmed.
Sincerely,
Matthew L. Myers
President
cc: The Honorable Mike Crapo, Ranking Member, Committee on Finance
______
Cancer Support Community
734 15th Street, NW, Suite 300
Washington, DC 20005
202-659-9709 Phone
202-974-7999 Fax
https://www.cancersupportcommunity.org/
February 8, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
219 Dirksen Senate Office Building 219 Dirksen Senate Office Building
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden and Ranking Member Crapo,
The Cancer Support Community (CSC), an international nonprofit
organization that provides support, education, and hope to cancer
patients, survivors, and their loved ones, supports the nomination of
the Honorable Xavier Becerra to serve as the next Secretary of the
United States Department of Health and Human Services (HHS). While
serving as a United States Congressman and as the Attorney General of
California, Mr. Becerra continuously protected the rights of patients
both state and nationwide. We are confident that he will do the same as
Secretary of HHS.
Throughout his career, Mr. Becerra has always put patients first,
including those impacted by cancer. Mr. Becerra was a proud co-sponsor
of the Patient Protection and Affordable Care Act (ACA) and actively
worked to pass this landmark legislation. As a member of Congress, he
steadfastly fought to protect and preserve the ACA by voting at least
nine times against efforts to repeal and replace the law. He also
sponsored the E-Centives Act, which provided incentives for Medicaid
providers to improve quality of care by implementing electronic health
records.
Most recently, as Attorney General of California, Mr. Becerra led a
coalition of over 20 state Attorneys General in defending the ACA
against an effort to repeal the entire law in the Supreme Court case,
California v. Texas. In their brief, the coalition underscored the
substantial advancements in access to health care made under the ACA,
including Medicaid expansion which has provided coverage to nearly 15
million Americans (Kaiser Family Foundation, 2020), and guaranteed
protections for as many as 133 million Americans with pre-existing
conditions, such as cancer (Department of Health and Human Services,
2017). Mr. Becerra has long stressed that the ACA is the backbone of
our health care system and that if it were to be struck down, it will
impact the ability of many Americans to access and afford health
coverage, especially during a global pandemic.
The COVID-19 pandemic has significantly strained our nation's health
care system and continues to have an enormous impact on the continuity
of care for people impacted by cancer. HHS needs a strong leader at the
helm who can implement policies that will protect patients both now
during these challenging times and in the future. Mr. Becerra's record
in advocating for policies that will strengthen the health and well-
being of patients makes him the right person for this ever important
position at this consequential time in history. Therefore, we urge you
to confirm Mr. Xavier Becerra as the next Secretary of HHS.
Thank you for your consideration. Should you have any questions about
our support for Mr. Becerra's nomination, please contact me at (202)
552-6762 or pwoods@
cancersupportcommunity.org.
Sincerely,
Phylicia L. Woods, JD, MSW
Executive Director--Cancer Policy Institute
References
Department of Health and Human Services. 2017. Health Insurance
Coverage for Americans with Pre-Existing Conditions: The Impact
of the Affordable Care Act. Retrieved from https://
aspe.hhs.gov/system/files/pdf/255396/Pre-ExistingCon
ditions.pdf.
Kaiser Family Foundation. 2020. Potential Impact of California v. Texas
Decision on Key Provisions of the Affordable Care Act.
Retrieved from https://www.kff.org/health-reform/issue-brief/
potential-impact-of-california-v-texas-decision-on-key-
provisions-of-the-affordable-care-act/.
______
Casa de Esperanza: National Latin@ Network
for Healthy Families and Communities
540 Fairview Avenue S., Suite 540
St. Paul, MN 55104
651-646-5553
www.casadeesperanza.org
February 12, 2021
U.S. Senate
Committee on Health, Education, Labor, and Pensions
428 Dirksen Senate Office Building
Washington, DC 20510
U.S. Senate
Committee on Finance
219 Dirksen Senate Office Building
Washington, DC 20510
Dear Chairwoman Murray, Chairman Wyden, Ranking Member Burr, Ranking
Member Crapo, and Committee Members:
On behalf of Casa de Esperanza: National Latin@ Network for Healthy
Families and Communities, I write this letter to express our support
and endorsement of Xavier Becerra as someone who is uniquely qualified
to lead the Department of Health and Human Services at this critical
time. His diverse experience has placed him at the forefront of efforts
to address the needs of poor and working families, legal efforts to
protect access to affordable health care, and a demonstrated commitment
to supporting survivors of intimate partner violence.
Casa de Esperanza is a national organization with almost 40 years of
experience in supporting Latin@ communities with regards to anti-
domestic and sexual violence, stalking, trafficking, and dating
violence. We were founded in 1982 in Minnesota to provide emergency
shelter and support services for women and children experiencing
domestic violence. In 2009 Casa de Esperanza launched the National
Latin@ Network for Healthy Families and Communities, which is a
national resource center that provides training and technical
assistance, research, and national policy advocacy focused on
addressing and preventing gender-based violence, primarily in Latin@
and immigrant communities. We are part of a network of domestic
violence programs that work collaboratively to promote practices and
strategies to improve our nation's response to domestic violence and
make safety and justice for all families a priority. Our efforts
involve working closely with the Family Violence Prevention and
Services Act (FVPSA) Program, located in the Family and Youth Services
Bureau (FYSB), Administration for Children and Families (ACF) of the
U.S. Department of Health and Human Services.
Domestic and sexual violence impacts all areas of the lives of
survivors and their children. The systems they access for help can
either support or cause further harm and trauma. A holistic approach to
domestic and sexual violence is needed to ensure the safety and well-
being of survivors and their families. This is especially critical as
the United States grapples with the COVID-19 pandemic. The inequities
in our nation are inescapable as Black, Latin@, Asian/Pacific Islander
and Native American communities bear the brunt of the pandemic's
economic and health damages. We are at a time where all of us must work
toward outcomes that benefit and are equitable for all. Leading us out
of this pandemic will require unwavering ethics, a leader with
integrity, and someone who understands complex bureaucratic systems, as
well as the issues everyday people are currently experiencing. Mr.
Becerra, through his long-term commitment to support families, women,
and children, has proven he is concerned about the same lived realities
of the communities we serve at Casa de Esperanza.
The Department of Health and Human Services (HHS) is the agency in the
federal executive branch most involved with addressing the nation's
human concerns. In one way or another, it touches the lives of more
people than any other federal agency. It is the agency that addresses
the health and well-being of all people, and within that has a
longstanding commitment of working to prevent family violence and
provide services, ever since the enactment of the Family Violence
Prevention and Services Act in 1984. HHS is the agency best positioned
to advancing a more holistic and equitable approach to improving
pathways to safety for survivors of domestic violence. It is more
important than ever that this department be comprised of leaders
committed to ending violence against women, addressing health equity,
and advancing racial equity. As such, there is no better candidate to
lead the Department of Health and Human Services than Xavier Becerra.
Mr. Becerra is a deeply qualified and passionate leader with a depth
and breadth of experience that spans three decades of working to
address violence against women and support survivors, ensure access to
healthcare, and protect Social Security and Medicare. In May of 2020,
as California Attorney General, Xavier Becerra called for the
reauthorization of the Violence Against Women Act, stating that
``[t]here's no place for violence against women anywhere.'' At the
California Department of Justice, Becerra ensured that they were doing
their part to support survivors of domestic and sexual violence and
prevent and respond to crimes against women. During COVID-19, Attorney
General Becerra stayed focused on the needs of survivors and worked to
ensure that they had access to critical services during state-wide
stay-at-home orders. At the California Department of Justice, Becerra
ensured that they were doing their part to support survivors of
domestic and sexual violence and prevent and respond to crimes against
women.'' During COVID-19, Attorney General Becerra stayed focused on
the needs of survivors and worked to ensure that they had access to
critical services during state-wide stay-at-home orders.
We urge the Senate Committees on Health, Education, Labor, and Pensions
and Finance to swiftly confirm Xavier Becerra as Secretary of the
Department of Health and Human Services.
Please feel free to contact me if you have any questions relating to
these comments.
Respectfully submitted,
Patricia Tototzintle
Chief Executive Officer
______
Center for Medicare Advocacy
1025 Connecticut Avenue, NW, Suite 709
Washington, DC 20036
(202) 293-5760
https://medicareadvocacy.org/
February 12, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
United States Senate United States Senate
Washington, DC 20510 Washington, DC 20510
The Honorable Patty Murray The Honorable Richard Burr
United State Senate United States Senate
Washington, DC 20510 Washington, DC 20510
Dear Senators Wyden, Crapo, Murray and Burr:
The Center for Medicare Advocacy (the Center) strongly supports the
nomination of California Attorney General Xavier Becerra for Secretary
of the Department of Health and Human Services (HHS). The Center,
founded in 1986, is a national, non-profit, non-partisan law
organization that works to advance access to comprehensive Medicare,
health equity, and quality health care.
Mr. Becerra has been a champion of expanding access to health care,
from his time in Congress to his most recent role as California's
Attorney General. During his twelve terms in Congress, including while
serving on the House Ways & Means Health Subcommittee, Mr. Becerra
worked to improve the Medicare program as well as health care access
more broadly.
Our organization strongly supported his introduction of the Medicare
Savings Programs Improvement Act of 2007 to expand cost-sharing
subsidies for low-income individuals dually eligible for Medicare and
Medicaid, many provisions of which were included in the Medicare
Improvements for Patients and Providers Act of 2008 and the Medicare
Access and CHIP Reauthorization Act of 2015. Among other things, he
also worked to eliminate the arbitrary caps on outpatient therapy,
expand Medicare coverage of medical nutrition services, and require the
HHS Secretary to conduct research on issues related to socioeconomic
status related to Medicare's value-based programs.
As Attorney General of California, he led a group of states defending
the Affordable Care Act (ACA) in California v. Texas; the Center was
honored to support this effort by submitting an amicus brief along with
AARP and Justice in Aging in support of California and the other
states.
In his role as California AG, Mr. Becerra was at the forefront of
challenges to policies that harm the health of older adults and people
with disabilities, such as the previous administration's expansion of
the ``public charge'' rule. As a strong advocate for residents of
nursing facilities, AG Becerra led 17 State Attorneys General in an
effort to stop the previous administration from rolling back regulatory
protections for nursing home residents, and later opposed proposed
revisions to the nursing facility Requirements of Participation that
would have scaled back appropriate oversight. Further, his demonstrated
commitment to equity includes protecting women and LGBTQ+ individuals
from unlawful discrimination in health care, and a recognition of the
unequal effect that environmental damage has on the health of people of
color and other communities.
AG Becerra's extensive legislative and executive experience make him
uniquely qualified to serve as Secretary of Health and Human Services.
Further, his personal experience as the proud son of immigrants will
help ground his efforts to address the disparities in our health system
laid bare by the COVID-19 pandemic.
Mr. Becerra is the right leader for HHS at this moment, not only for
overseeing the response to the COVID pandemic, but also for protecting
and building health care rights for Medicare beneficiaries, and for all
Americans. The Center for Medicare Advocacy enthusiastically supports
the nomination of Mr. Becerra. We urge his swift confirmation.
Sincerely,
Judith A. Stein
Executive Director/Attorney
______
Children's Hospital Association
600 13th Street, NW, Suite 500
Washington, DC 20005
p: 202-753-5500
f: 202-347-5147
https://www.childrenshospitals.org/
February 15, 2021
The Honorable Ron Wyden The Honorable Patty Murray
Chairman Chairman
U.S. Senate U.S. Senate
Committee on Finance Committee on Health, Education,
Labor,
Washington, DC 20510 and Pensions
Washington, DC 20510
The Honorable Mike Crapo The Honorable Richard Burr
Ranking Member Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Health, Education,
Labor,
Washington, DC 20510 and Pensions
Washington, DC 20510
Dear Senators Wyden, Crapo, Murray and Burr:
On behalf of the Children's Hospital Association, we write to express
our support for Xavier Becerra's confirmation as secretary of the U.S.
Department of Health and Human Services (HHS). His experience in
Congress, as attorney general of California and in support of health
care access and coverage will allow him to be an effective leader for
the department at this critical time. We also believe his commitment to
HHS programs will help us address the unique challenges children face,
especially as we battle the pandemic together.
It is important for HHS to have experienced leadership that is
committed to strengthening Medicaid and the Children's Health Insurance
Program (CHIP) and maintaining our nation's long-standing commitment to
children's health. Over 40 million children are enrolled in Medicaid
and CHIP. These programs provide affordable coverage with pediatric-
appropriate benefits to low-income children and are a lifeline for
children with special health care needs or complex conditions. The
Medicaid program provides critical support to states and the pediatric
health care system, including children's hospitals, and plays an
important role in ensuring children can access the care they uniquely
need. Throughout his tenure in Congress and as Attorney General of
California, secretary nominee Becerra has demonstrated a recognition of
the essential role that Medicaid and CHIP play in children's overall
health and well-being.
We believe HHS secretary nominee Becerra also recognizes the short-and
long-term implications of COVID-19 on children and will work with us to
address the impact. The pandemic has hit children's well-being hard and
directly, exacerbating what was already a growing national crisis:
rising and increasingly severe, mental, emotional and behavioral health
(MEB) challenges to children and youth due to traumatic stress such as
social isolation and family unemployment. While longer-term investments
in children's health and well-being are necessary, immediate steps must
be taken to better use existing provider capacity and telehealth to
more effectively address the crisis. HHS secretary nominee Becerra is
committed to improving care and supports for our nation's most
vulnerable children and will be a strong partner as we continue to
ensure every child has the best opportunity to thrive.
We stand ready to work with HHS secretary nominee Becerra on strategies
that will support the pediatric health care safety net--a safety net
that is struggling under incredible financial and operational
challenges brought about by the pandemic. Strengthening existing
payment systems through Medicaid and ensuring that ongoing relief
addresses the unique needs in the pediatric sector (which does not
benefit from relief funding through Medicare) is critical. We look
forward to partnering with the secretary nominee to ensure that
children's hospitals can continue providing needed specialized clinical
care, training and research that benefits all our nation's children.
We believe Xavier Becerra as HHS secretary will be able to partner
across the health care sector, states and communities to make health
equity a priority. Children's hospitals care for diverse populations of
children, including many from low-income families. They work within
their communities to address gaps in health and social supports. There
is more we all need to do to reduce disparities and inequities in our
current health care system and nation, and the Children's Hospital
Association and its members are eager to work collaboratively with the
secretary nominee, the Biden administration and Congress to address
these challenges.
We look forward to working with the new HHS secretary to ensure all
children across the country have the coverage and access to care they
need.
Thank you and very best wishes,
Mark Wietecha
Chief Executive Officer
______
The Children's Partnership
February 23, 2021
The Honorable Ron Wyden
Chairman
U.S. Senate
Committee on Finance
219 Dirksen Senate Office Building
Washington, DC 20510
The Honorable Mike Crapo
Ranking Member
U.S. Senate
Committee on Finance
219 Dirksen Senate Office Building
Washington, DC 2051O
RE: Hearing on Nominee Attorney General Xavier Becerra for US Secretary
of Health and Human Services
Dear Chairman Wyden and Ranking Member Crapo:
The Children's Partnership, a California-based children's policy and
advocacy organization committed to improving the health and well-being
of marginalized children where they live, learn and play, strongly
supports the nomination of California's Attorney General, Xavier
Becerra for the role of U.S. Secretary of Health and Human Services
(HHS).
Attorney General Becerra has spent his career fighting to expand
people's access to health care and protect underserved communities,
taking on powerful special interests to get results. A former Member of
Congress who helped pass the Affordable Care Act, and an Attorney
General who has fought to defend it against persistent attacks, Becerra
has a long track record of advocating for everyone to have access to
quality, affordable health care and getting results, which is exactly
what we need in an HHS Secretary as we claw back from a pandemic that
has killed half a million Americans and infected 14 million Americans.
Specifically, among children, Latinx, Black, Native American and
Pacific Islander children make up nearly 70% of cases, despite making
up slightly over 50% of California's population of children.
As Attorney General, Mr. Becerra led the defense of the Affordable Care
Act in the Supreme Court, and has taken on powerful special interests
who prey on people's health, from the drug companies responsible for
the opioid epidemic to the tobacco industry. He also led a multi-state
coalition to protect the health and welfare of immigrant children being
held in detention - actions that brought back painful memories of the
darkest times in US history when Black children were separated from
their parents due to slavery, when indigenous children were sent to
boarding schools hundreds of miles away from their families, and when
Japanese-American families were separated in internment camps.
During this especially challenging time, Attorney General Becerra is
also a proven leader on COVID-19 who has taken action to keep people
safe and protect Americans during the pandemic. He used his powers as
Attorney General to protect workers from exposure to COVID-19, secure
key safeguards for frontline health care workers' rights, and stand up
for homeowners trying to make their mortgage payments during the
downturn. He understands that the pandemic is impacting all American
families but is having disproportionate impacts on communities of color
and low-income Americans and that our collective efforts must center
their needs in order to build back effectively and equitably from this
crisis.
As the first Latino ever to run the Department of Health and Human
Services, Attorney General Becerra will be intensely focused on
addressing persistent health disparities, which have led to even worse
outcomes for communities of color during the COVID-19 pandemic. He
understands that structural racism in our country too often dictates
where you live, what you eat, the air you breathe and the water you
drink. It is what drives communities of color to suffer from higher
rates of chronic conditions, including heart disease, diabetes and
asthma. His history of representing marginalized communities in
Congress and as Attorney General of California has instilled in him a
career-long passion and policy for ensuring no community is left behind
in the promise of America.
With a proven record successfully managing a large and complex agency,
he is uniquely qualified for the job and is a historic pick ready to
run HHS on day one. Having led the second largest Department of Justice
in America behind only the federal DOJ, he has the proven capacity to
lead a complex agency that has to manage many critical issues at the
same time, a necessary qualification as we confront the pandemic.
His depth of experience will also make him an effective secretary.
Having served in the U.S. House of Representatives for more than 20
years, he knows how to work with Congress and has a proven track record
of bringing people together to solve big problems. He recognizes that
he is fighting for the well-being of all American families and as such
will work in a bipartisan manner to listen effectively to all parties
in Congress.
Having been born into a working-class California family, the son of
immigrants with a father who worked the fields and in construction to
build roads and a mother who came to this country from Mexico when she
was 18, he also has first-hand perspective on the American family
experience. He carries this perspective with him in his work and will
do the same in his role as the U.S. Secretary of Health and Human
Services.
For these reasons, we strongly urge you to support the nomination of
Attorney General Xavier Becerra for the position of U.S. Secretary of
Health and Human Services. He will be bring his values of equity,
inclusion and health care as a human right to serve as an effective
leader for the health and well-being of all families in America.
Sincerely,
Mayra E. Alvarez, MHA
President
______
Coalition of Filipino Americans and Friends of Xavier Becerra
2443 Park Oak Drive
Hollywood, CA 90068
Telephone Number: (323) 467-5243
January 23, 2021
The Honorable Ron Wyden
Chairman
U.S. Senate
Committee on Finance
Washington DC 20510
The Honorable Mike Crapo
Ranking Member
U.S. Senate
Committee on Finance
Washington, DC 20510-6200
RE: Support for the Approval of Xavier Becerra as U.S. Secretary of
Health and Human Services
Dear Senator Wyden:
We, the undersigned below, and on behalf of the more than 374,000,
Filipino Americans residing in Los Angeles County, request that you, to
approve the nomination of Xavier Becerra, as the new U.S. Secretary of
Health and Human Services. Mr. Becerra is a dedicated person, who will
restore calmness, and will ensure fairness in providing healthcare to
all the citizens of the United States of America. He will ensure
continued protection of the people, especially of those who in need to
improve the quality of care, and medicine that are cost effective. He
will do a good job, and will deliver, equality to all people regardless
of race because, it is the right thing to do.
Mr. Becerra helped the thousands of Filipino WWII veterans to fight on
their struggle for justice. In 1942, the late President Franklin Delano
Roosevelt and the 77th U.S. Congress, granted full benefits to Filipino
American World War II Veterans who fought under the U.S. Armed Forces.
Then, without their knowledge, the 79th U.S. Congress passed the
Rescission Act of 1946 denying their rights and privileges. Finally, in
2009, working closely with the Office of U.S. Congressman Xavier
Becerra, the Filipino Veterans Equity Compensation Fund, was passed
through both houses of Congress and was signed into law by President
Barrack Obama.
We all love him for his passion and dedication to correct the injustice
done to the Filipino American Veterans in passing the Rescission Act of
1946.
Mr. Becerra is the right person for the job, and you will make the
right decision to approve his position as the US Secretary of Health
and Human Services. Please do not hesitate to contact us if you have
any questions or need additional information. Thank you.
Respectfully Yours,
Susan Espiritu Dilkes
Community Activist
Retired/Exe. Director, Filipino American Service Group Inc.
Email: [email protected]
Supporters (organization name for recognition only; signatures on file)
Anna Lourdes Armada Chickey, M.D.
President, Philippine Heritage Institute
Bryan Jones
Executive Director, The HOOP Foundation Inc.
Cora Oriel
Owner, Publisher, Asian Journal Newspaper
Board Member, Asian Business Association
Eric Lachica
Executive Director, American Coalition for Filipino Veterans Inc.
Felicitas A. dela Cruz, DNSc, R.N., FAANP, Professor
Executive Director, Office of Assessment and Evaluation
Director, Center for the Study of Health Disparities
School of Nursing, Azusa Pacific University
Josie Estaris-Jesus, BSN, R.N., MA
Past President & Advisor, Philippine Nurses Association of Southern
California
Retiree, Nursing Administration
Licerio Castro, M.D.
President, Philippine Medical Association of Southern California
Lucy Babaran, R.N., MBA
Executive Director, United Specialist Healthcare Foundation
Nena Zosa
Founder of Philippine Medical Association Auxiliary of Southern
California
R. Bong Vergara, MSW
Executive Director, Conscious Youth Promoting Health & Environmental
Readiness
Salvador Abiera, M.D.
President, University of Santo Thomas Medical Alumni Association of
Southern California
Individuals:
Jeanette Sayno, Bilingual Outreach Personnel, Eagle Rock, CA
Jennifer Deborah Agbayani, Pre-School Teacher, Eagle Rock, CA
Joselito Babaran, M.D., San Fernando Valley, CA
Kathrina Abrot, Youth Community Organizer, Los Angeles, CA
Marian Gomez Espiritu, Accountant, Valencia, CA
Marilou Dischoso, M.D., Los Angeles, CA
Lawrence Espiritu, Retired, Computer Technician, Valencia, CA
Lydia Solis, Filipino American Journalist, San Dimas, CA
Footnote: 2010 census data; https://en.m.Wikipedia.org/wiki/
Demographics_of_Filipino_Americans.
Cc: Xavier Becerra
Supporters
______
Commonwealth Care Alliance
30 Winter Street
Boston, MA 02108
Tel: 617-426-0600
Fax: 617-426-3097
https://www.commonwealthcarealliance.org/
March 1, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden and Ranking Member Crapo:
On behalf of the Commonwealth Care Alliance (CCA), a not-for-profit
health care organization dedicated to improving care for people
enrolled in both Medicare and Medicaid, I would like to express our
strong support for the nomination and confirmation of Xavier Becerra to
serve as Secretary of the United States Department of Health and Human
Services.
Established in 2003, CCA serves individuals who have complex medical,
behavioral health and social needs. With more than 38,000 members, our
mission is to improve the health and well-being of people with
significant needs by innovating, coordinating and providing the highest
quality, individualized care.
Throughout his distinguished career, Secretary-designate Becerra has
demonstrated his long-standing commitment to expanding access to high-
quality health care. He was a leader in crafting the landmark
Affordable Care Act during his time in Congress, which has helped
millions of Americans obtain health care coverage.
Secretary-designate Becerra is also a champion for improving public
health and has been a leader in addressing the many challenges that
confront our nation, including achieving health care equity and
ensuring all patients have access to affordable medications. Secretary-
designate Becerra's proven leadership, experience and expertise are
also critical to guide him as the nation continues to battle the COVID-
19 pandemic.
Our organization stands ready to work with Secretary-designate Becerra
to address the ongoing challenges our nation faces and to ensure all
patients, including those who have complex and significant health care
needs, have access to high-quality health care. We urge the Committee
to approve Secretary-designate Becerra's nomination and we support his
confirmation by the full United States Senate.
Yours sincerely,
Christopher D. Palmieri
President and Chief Executive Officer
______
Community Catalyst
One Federal Street
Boston, MA 02110
Main: 617-338-6035
Fax: 617-451-5838
www.communitycatalyst.org
February 22, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chair Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee Finance
221 Dirksen Senate Office Building 239 Dirksen Senate Office Building
Washington, DC 20510 Washington, DC 20510
Dear Senators Wyden and Crapo:
As advocacy organizations committed to advancing health equity, we
submit the following letter in support of the nomination of Attorney
General Xavier Becerra for Secretary of the U.S. Department of Health
and Human Services (HHS).
Attorney General Becerra is a demonstrated leader in the fight for
quality, affordable health care, immigrant rights and the principles of
equity and justice upon which our health system must be based. As a
member of Congress from 1993-2017, Attorney General Becerra fought
tirelessly to protect and expand access to affordable health care for
all people, which included his leadership in the passage of the
Affordable Care Act (ACA). Since then, as California's Attorney
General, he has continued his tireless work to protect people's health,
most notably as the lead defender of the ACA in the California v. Texas
lawsuit, currently before the Supreme Court. He is also a longstanding
champion for protecting and expanding access to sexual and reproductive
health, including abortion, which is critical for advancing health
equity.
Now, more than ever, we need a proven champion of health equity leading
HHS. The COVID-19 pandemic has shed light on the deep inequities that
leave many Black and brown people without resources or recourse to
protect their families. In particular, the pandemic has had a
disproportionate and devastating impact on Black, Latinx, Indigenous,
Asian American, and Pacific Islander communities, who face alarming
rates of infection and death due to discriminatory barriers to safe
work places, health coverage, and care. It has also exposed how our
health system fails LGBTQ+ people, immigrants, people with
disabilities, older adults, and every intersection thereof. We are
confident that as HHS Secretary, Attorney General Becerra will take
quick and decisive action to mitigate the harm the pandemic has caused
as well to address the underlying inequities that keep our systems from
serving the public fairly and well.
We further expect Attorney General Becerra to continue his commitment
to working with advocates, policy makers, and agency staff to build on
the important foundation the ACA has laid, including in the areas of
expanded coverage, increased affordability, and improved access to
quality care for all people. His leadership and expertise will also be
particularly valuable in developing and implementing a plan to reverse
anti-immigrant policies, including public charge rules and non-
discrimination protections for people with limited English proficiency,
and to rebuilding trust between our government and immigrant
communities going forward.
Attorney General Becerra is the right leader for the moment. We
enthusiastically support his nomination and look forward to working
with him to move our nation's health system forward with health equity
and the needs of historically excluded and under-resourced communities
at the center.
Thank you,
National
Community Catalyst
State
California
California Pan-Ethnic Health
Network Health Access California
Colorado
Colorado Consumer Health Initiative Colorado Organization for Latina
Opportunity and Reproductive Rights
Florida
Florida Policy Institute Florida Health Justice Project
Georgia
The Arc Georgia Georgians for a Healthy Future
Illinois
Shriver Center for Poverty Law EverThrive Illinois
Indiana
Hoosier Action
Kentucky
Kentucky Voices for Health Kentucky Equal Justice Center
Massachusetts
Health Care for All Massachusetts Advocates
Maryland
Maryland Citizens' Health
Initiative
Maine
Consumers for Affordable Health
Care Maine Equal Justice
Michigan
Arab Community Center for Economic
and Social Services (ACCESS)
Minnesota
TakeAction Minnesota
Mississippi
Mississippi Center for Justice
Missouri
Missouri Health Care For All
North Carolina
NC Justice Center North Carolina AIDS Action Network
New Jersey
New Jersey Citizen Action Salvation and Social Justice
Nevada
Children's Advocacy Alliance
New York
Progressive Doctors Raising Women's Voices for the
Health Care We Need
Make the Road New York
Ohio
Universal Health Care Action
Network of Ohio
Oklahoma
Oklahoma Policy Institute
Pennsylvania
Pennsylvania Health Access Network CASA
Rhode Island
Economic Progress Institute
South Carolina
SC Appleseed Legal Justice Center
Tennessee
Tennessee Justice Center Tennessee Disability Coalition
Tennessee Health Care Campaign
Utah
Utah Health Policy Project
Virginia
Virginia Organizing Virginia Poverty Law Center
Washington
Northwest Health Law Advocates
Wisconsin
Citizen Action of Wisconsin Kids Forward
West Virginia
West Virginians for Affordable
Health Care WV FREE
______
DataRobot
March 1, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chair Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Dear Senator Wyden and Senator Crapo:
DataRobot, one of the leading artificial intelligence (AI) firms in
America, is proud to offer our strong support for Secretary-designate
Xavier Becerra and hope that he will be promptly confirmed by the
United State Senate.
During the Secretary-designate's testimony, he repeatedly stressed the
need for a data-driven pandemic response that prioritizes fairness and
equity. This approach is not only welcomed, but essential as we
continue to fight the COVID-19 pandemic and future pandemics.
Over the last year, DataRobot put hundreds of our data scientists to
work around the clock analyzing COVID-19 data to help bring an end to
the pandemic with a focus on improving health equity. As one example,
we worked with the National Institutes of Health (NIH) to help bring
diversity to clinical trial recruitment in Operation Warp Speed. Using
our AI solution, one vaccine manufacturer increased the percentage of
Black and Hispanic participants recruited on a weekly basis by 400%.
To realize Secretary-designate Becerra's vision of equity during the
pandemic response, the government needs quality data. Currently, only
about 10% of antigen tests results are being reported, and only 57% of
those results have crucial race and ethnicity data attached. While PCR
test results are being reported at a much better rate of around 95%,
only 52% of those results have race and ethnicity data.
The data we do have indicates that the Hispanic community has been
systemically under-tested during the pandemic. In the northeast, for
instance, the Hispanic population accounts for nearly 24% of the COVID-
19 cases but only 9% of the tests administered.
Secretary-designate Becerra stated it well during his confirmation
hearings: we need to collect better data. DataRobot looks forward to
working with Mr. Becerra to help improve the quality of COVID-19 data
so that vulnerable communities can be identified sooner and resources
prioritized more efficiently.
Secretary-designate Becerra repeatedly stressed using science to guide
policy in his testimony. DataRobot stands ready to assist Secretary-
designate with cutting edge data science to help achieve fair and
equitable outcomes during the COVID-19 pandemic, future pandemics and
in other health care priorities for America.
With a distinguished career in public service, and a data-driven
commitment to tackling the pandemic in an equitable manner, Secretary-
designate Becerra is extremely well-suited for the job. We urge the
Committee--and the full Senate--to approve his nomination without
delay.
Sincerely,
Steven E. Moore
Vice President, Global Government Affairs
PS--Feel free to reach out with any questions at [email protected].
______
Dental Trade Alliance
4350 North Fairfax Drive, Suite 220
Arlington, VA 22203
(703) 379-7755
https://dentaltradealliance.org/
January 20, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden and Ranking Member Crapo:
The Dental Trade Alliance (DTA) would like to express its support for
Xavier Becerra as the Biden Administration's nominee for the position
of Secretary of U.S. Department of Health and Human Services.
The DTA represents dental product distributors, dental laboratories and
manufacturers. By providing the best equipment, materials and services
to dentists and oral care professionals, we are partners in improving
the oral health of all Americans.
President-Elect Biden made a wise choice in the selection of California
Attorney General Xavier Becerra to lead the department at this time as
the country continues to address the array of challenges the pandemic
presents. During his twelve terms in Congress, Attorney General Becerra
spent much of his time working on health care issues impacting U.S.
citizens as a member of the House Ways and Means Committee.
In addition to his experience on health care matters, Attorney General
Becerra brings his experience as an administrator having run the
California Department of Justice since 2017. In this position he
addressed an array of health and other matters that prepare him well to
handle the significant challenges of running an agency as large and
diverse as the U.S. Department of Health and Human Services.
Should you have any questions please contact Patrick Cooney, DTA
Federal Affairs Representative at 202-413-2629 or via email at
[email protected].
Thank you for your attention to this matter.
Sincerely,
Greg Chavez
Chief Executive Officer
______
Families USA
1225 New York Avenue, NW, Suite 800
Washington, DC 20005
main 202-628-3030
fax 202-347-241
https://familiesusa.org/
February 22, 2021
The Honorable Ron Wyden The Honorable Patty Murray
Chair Chair
U.S. Senate U.S. Senate
Committee on Finance Committee on Health, Education,
Labor,
and Pensions
Washington, DC 20510 Washington, DC 20510
The Honorable Mike Crapo The Honorable Richard Burr
Ranking Member Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Health, Education,
Labor,
and Pensions
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden, Chairwoman Murray, Ranking Member Crapo, and
Ranking Member Burr:
On behalf of Families USA, one of the nation's leading health care
consumer and justice organizations dedicated to high quality,
affordable health care and improved health for all, we are honored to
support your consideration of President Biden's nomination of
California Attorney General Xavier Becerra to serve as the next United
States Secretary of Health and Human Services (HHS). Attorney General
Becerra has dedicated his career to fighting for improved health
equity, rooting out industry abuses that contribute to sky-rocketing
health care costs, and ensuring every person in America has affordable
access to high-quality health care. At a time when our nation's health
and health care is under unprecedented strain, Mr. Becerra's expertise
on health care issues and his extensive and consistent track record of
championing better health and health care for all in our nation make
him uniquely qualified to serve as HHS Secretary.
During his long and distinguished tenure on the House Ways and Means
Committee, AG Becerra was instrumental in protecting Medicare coverage
for seniors and drafting the Affordable Care Act (ACA), expanding
health care access to millions of people while securing critical
consumer protections. As Attorney General of California, he continued
this important work, leading the charge to defend the essential
coverage protections provided under the ACA from political attacks in
the California v. Texas case currently being reviewed by the Supreme
Court.
AG Becerra has been a stalwart defender of equitable access to health.
He led the fight against the Trump Administration's ``Health Care
Refusal Rule'' which would have disproportionally harmed people of
color, LGTBQ communities, and women seeking health care services by
allowing medical staff to refuse life-saving care to patients at their
discretion. He has championed bipartisan immigration reform efforts to
find commonsense solutions that ensure no one is denied basic
healthcare because of who they are or where they are from.
AG Becerra has also consistently and fearlessly taken on powerful
special interests in order to put access and affordability for
individuals and families at the center of our health care system. He
has been a champion for lower drug costs, ending the opioid epidemic,
and toppling health system monopolies that create perverse incentives
that block consumer access to high-quality, high-value, affordable
care. He took bold action to end ``pay for delay'' practices by
pharmaceutical companies that make backroom deals to delay generic
drugs from entering the market--deals that put the interests of
industry over those of consumers. AG Becerra sought accountability for
the drug companies responsible for the opioid crisis and won landmark
settlements to be used to fund future opioid treatment. He won a
groundbreaking settlement from Sutter Health, Northern California's
largest hospital system, for overcharging patients through price
gouging and monopolistic behavior--one of the largest legal actions
against anti-competitive behavior in the health care sector.
As the COVID-19 health crisis continues to expose serious flaws in our
health care system, it is absolutely essential to confirm a Secretary
of Health and Human Services whose understanding of the scope of
opportunities and challenges we face is beyond reproach. AG Becerra is
strong leader who, I am confident, would help pave the country's way
toward health and economic recovery.
I urge you and your colleagues in the Senate to move swiftly on AG
Becerra's nomination so that the important work of addressing the
COVID-19 crisis and building a better, stronger, and more equitable
health care system can move forward in earnest.
Please don't hesitate to contact me if I can provide any additional
information.
Sincerely,
Frederick Isasi
Executive Director
______
Federation of American Hospitals
750 9th Street, NW, Suite 600
Washington, DC 20001
202-624-1500
FAX 202-737-6462
https://www.fah.org/
February 12, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chair Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
The Honorable Patty Murray The Honorable Richard Burr
Chair Ranking Member
U.S. Senate U.S. Senate
Committee on Health, Education,
Labor, Committee on Health, Education,
Labor,
and Pensions and Pensions
Washington, DC 20510 Washington, DC 20510
Dear Chairs Wyden and Murray & Ranking Members Crapo and Burr:
On behalf of the Federation of American Hospitals (FAH), the
national representative for over 1,000 leading tax-paying hospitals and
health systems throughout the United States, I would like to express
our strong support for the nomination and confirmation of California
Attorney General Xavier Becerra to serve as the next Secretary of the
U.S. Department of Health and Human Services (HHS).
FAH members provide patients and communities with access to high-
quality, affordable care in both urban and rural America. Our members
include teaching and non-teaching, acute, inpatient rehabilitation,
behavioral health, and long-term care hospitals and provide a wide
range of inpatient, ambulatory, post-acute, emergency, children's, and
cancer services.
Throughout his distinguished career in government at both the
federal and state level, Secretary-designate Becerra has demonstrated
his capability to lead HHS at one of the most pivotal and challenging
moments in our nation's history. Having the pleasure of knowing him for
more than twenty years, I am confident that Secretary-designate
Becerra's proven leadership, experience and expertise will successfully
guide him as the nation seeks to defeat COVID-19.
Along with efforts to overcome the pandemic, Secretary-designate
Becerra has the first-hand experience necessary to bolster and
strengthen the Affordable Care Act (ACA)--from helping to craft the
landmark legislation to defending it as Attorney General of California.
Secretary-designate Becerra has a keen understanding of how the ACA, if
fully and properly implemented, can reach its true potential.
Secretary-designate Becerra is, first and foremost, a champion for
patients. A seasoned public servant, his lifelong commitment and
dedication to public health will help him confront the many challenges
that face us, from achieving health equity to reducing the cost of
prescription drugs to reinforcing access to care in rural and
underserved communities. He is highly qualified, time-tested, and will
be ready on day 1.
The Federation of American Hospitals urges the Senate Finance and
HELP Committees to approve Secretary-designate Becerra's nomination
expeditiously, and we support his confirmation by the full U.S. Senate.
If you have any questions or wish to speak further, please do not
hesitate to reach out to me at 202-624-1534.
Sincerely,
Charles N. Kahn III
President and CEO
First Focus on Children
1400 I Street, NW, Suite 650
Washington, DC 20005
t: 202-657-0670
f: 202-657-0671
https://firstfocus.org/
February 16, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chair Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20515 Washington, DC 20515
The Honorable Patty Murray The Honorable Richard Burr
Chair Ranking Member
U.S. Senate U.S. Senate
Committee on Health, Education,
Labor, Committee on Health, Education,
Labor,
and Pensions and Pensions
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden, Ranking Member Crapo, Chairwoman Murray and
Ranking Member Burr:
I am writing on behalf of First Focus Campaign for Children, a
bipartisan children's advocacy organization dedicated to making
children and families a priority in federal budget and policy
decisions, to express our strong support for confirming California
Attorney General Xavier Becerra for Secretary of the U.S. Department of
Health and Human Services (HHS).
As an organization dedicated to improving the health, economic
security, child safety and protection, and overall well-being of
America's children, we applaud Attorney General Becerra's long history
of leadership in prioritizing children's needs, and have recognized him
several times as a First Focus Champion for Children for his long-
standing work across the full array of these issues. HHS is critical to
the well-being of our nation's children and it is important that the
Secretary of HHS be familiar with the full range of HHS programs that
impacts children, and we believe Attorney General Becerra will be.
Now, more than ever, the full array of issues that HHS oversees are
critical to children. The COVID-19 outbreak and the resulting economic
crisis are falling hardest on the most vulnerable among us, including
our nation's children. It is disrupting every facet of children's lives
and we cannot yet know all of the negative and long-lasting
implications it will have on children's healthy development and future
success. The programs and services within HHS directly affect
children's lives more than any other Department. Therefore, during this
critical time, HHS needs a leader who not only has the ability to
manage and direct the array of programs, but who also understands and
cares about children and their health and well-being.
Clearly, HHS has a critical role in ensuring that this historic public
health pandemic does not threaten our children's future outcomes.
Moreover, after two decades of progress in reducing the uninsured rate
of our nation's children, the uninsured rate has risen in each of the
last four years. Attorney General Becerra has a strong knowledge of the
health care programs run by HHS from his time in Congress and as
Attorney General, and he would play a critical role in helping get our
nation back on track to ensuring all children have health coverage in
this country. HHS also houses the Maternal and Child Health Bureau that
provides expertise and oversees programs dedicated to improving
maternal and child health services at a time when infant and maternal
mortality rates and child suicide rates all desperately need attention.
Although health care is a critical part of HHS, it is important to note
that HHS is not just a health agency. HHS also manages an array of
human services issues, including poverty and family supports. Due to
the pandemic and economic recession, for example, we know that at least
an additional 2.5 million children have fallen into poverty since May
2020,\1\ and through the administration of the cash assistance, child
support, utility assistance, and other critical income supports for
children and families, HHS leadership plays a key role in reducing
child poverty and mitigating the impact of the pandemic on family
economic security.
---------------------------------------------------------------------------
\1\ Jason DeParle, ``8 Million Have Slipped into Poverty Since May
as Federal Aid Has Dried Up,'' New York Times, October 15, 2020,
https://www.nytimes.com/2020/10/15/us/politics/federal-aid-poverty-
levels.html.
Through the Administration for Children and Families (ACF) at HHS,
early childhood programs are instrumental in positive outcomes in
children and families' lives as well, and we look forward to Attorney
General Becerra continuing to prioritize these at HHS. HHS administers
programs vital in the lives of our youngest children and their families
including the Child Care and Development Block Grant, Early Head Start
and Head Start, and the Maternal, Infant, and Early Childhood Home
Visiting Program. These programs and others at the department need a
strong leader who recognizes the connections between programs and the
---------------------------------------------------------------------------
children who participate in them.
ACF also oversees a number of other programs that Attorney General
Becerra had oversight over while serving on the House Ways and Means
Committee and that he was involved with as Attorney General, including
those addressing the child welfare system and foster care and programs
related to runaway youth and social services. The Children's Bureau
funds and supports states as they provide case management to more than
670,000 children that are in the foster care system each year and the
Runaway and Homeless Youth program supports outreach, shelter services,
and transitional programing for the 1.6 million to 2.8 million youth
who run away or are ``thrown away'' annually. Coordination across HHS
programs is essential for children and youth's time away from safe,
supportive, and permanent families to be rare, brief, and non-
recurring.
HHS also has a critical role in reaching out to all communities that
use the federal assistance programs, including children of immigrants
and their families. Many of these children and families, as a result of
the prior administration's public charge rule, avoided health insurance
and other life-sustaining programs \2\ for which they were eligible,
including during the pandemic when families need assistance most. HHS
leadership is critical to ensure that the agency effectively
communicates with children and their families, in partnership with
local organizations, about eligibility for HHS programs and services,
and supports them in enrolling in programs for which they are eligible.
Attorney General Becerra's personal experience as a child of immigrants
and experience as Attorney General of California make him well equipped
to ensure consideration of the needs of children of immigrants and
their families throughout HHS.
---------------------------------------------------------------------------
\2\ First Focus on Children, ``Fact Sheet: The Public Charge Rule
Harms Children,'' February 2020, https://firstfocus.org/wp-content/
uploads/2020/02/FACT-SHEET-Public-Charge_2-20.
pdf.
The Office of Refugee Resettlement (ORR) Unaccompanied Children's
Program within HHS is responsible for the short-term care of
unaccompanied children who arrive at the border without a parent or
legal guardian. Its mandate is to place children in the least
restrictive setting in their best interests and facilitate the prompt
and safe release of children to a sponsor, typically family. After many
years of ORR's increased entanglement with immigration enforcement to
the detriment of children's safety and well-being, we look forward to
Attorney General Becerra's leadership to ensure that child well-being
---------------------------------------------------------------------------
is central to all the agency's departments.
Attorney General Becerra is completely knowledgeable with respect to
all of these programs that are in the jurisdiction of the Department of
Health and Human Services from his time working on Capitol Hill and as
California's Attorney General. We urge the Committees and the Senate to
swiftly confirm him as Secretary of HHS.
Sincerely,
Bruce Lesley
President
______
Futures Without Violence
February 12, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
The Honorable Patty Murray The Honorable Richard Burr
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Health, Education,
Labor, Committee on Health, Education,
Labor,
and Pensions and Pensions
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden, Chairman Murray, Ranking Member Crapo, and Ranking
Member Burr:
Futures Without Violence is a national social justice organization
focused on preventing violence against women and children utilizing
public health approaches that build strong, safe and healthy families
and communities. We understand deeply how trauma, adversity and
exposure to violence in childhood can have severe lifelong consequences
that not only reproduce violence in families but also cost our nation's
health care system significantly.
Because of this we write you today in strong support of the nomination
of Xavier Becerra to be the next Secretary for the Department of Health
and Human Services. As a California-based organization, we have seen
first-hand his commitment to protecting the safety of all people from
violence and his commitment to ensuring all people have access to
health care, including women and our most vulnerable. We look forward
to working with him to address the health consequences of violence,
improve access to health care for all survivors of violence, including
immigrant and LGTBQ survivors, advance health equity, and utilize the
untapped potential of the Administration for Children and Families to
reduce trauma and violence and help families who are struggling heal
and thrive.
Xavier Becerra is a highly qualified and passionate leader with
demonstrated depth and breadth of experience spanning three decades. As
Attorney General of California, he joined with Attorneys General from
across the country in 2018 and 2020 to advocate for the reauthorization
of the Violence Against Women Act. His defense of the Affordable Care
Act has meant essential health care access and coverage for many
previously uninsured people, including those experiencing sexual and
domestic violence. For victims of violence, health care is even more
essential given the toll it takes on the body and the critical role
providers play in helping connect them to an advocate or someone who
can help them. The ACA specifically includes screening and counseling
for women who are victims of interpersonal violence as part of a well-
woman visit, and the ACA also included groundbreaking home visiting
programs that helped vulnerable new mothers and babies, including with
support to address domestic violence.
As a Member of Congress, he was a strong supporter of legislation to
help abused and neglected children and voted for the first Violence
Against Women Act that included health care and youth-focused
prevention programs. Throughout his tenure in Congress, he demonstrated
year after year an understanding and commitment to health care access
and the importance of programs that help lift up mental health and the
needs of vulnerable children and families.
As America works to mitigate and recover from the harm of the COVID
pandemic, it is essential that HHS have a leader who understands both
the health and human services needs of our nation, and understands
clearly that the toll of this virus has not been spread evenly. We
believe for these reasons that Xavier Becerra is uniquely qualified to
lead the Department of Health and Human Services and encourage you to
quickly advance his nomination.
Sincerely,
Esta Soler
President and Founder
______
Home Care Association of America
444 North Capitol Street, NW, Suite 428
Washington, DC 20001
(202) 508-3870
https://www.hcaoa.org/
January 26, 2020
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden and Ranking Member Crapo:
The Home Care Association of America (HCAOA) would like to express its
support for Xavier Becerra as the Biden Administration's nominee for
the position of Secretary of U.S. Department of Health and Human
Services. HCAOA urges his swift confirmation by the U.S. Senate.
The Home Care Association of America (HCAOA) represents over 3,000 home
care providers across the nation that provide personal care services in
the homes of millions of older Americans, individuals with disabilities
and children with special needs. Our members and their staff enter the
community each day to provide care that will enable seniors to remain
in their homes and prevent further spread of COVID-19.
President-Elect Biden made a wise choice in the selection of California
Attorney General Xavier Becerra to lead the department at this time as
the country continues to address the array of challenges the pandemic
presents. During his twelve terms in Congress, Attorney General Becerra
spent much of his time working on health-related issues impacting U.S.
citizens as a member of the House Ways and Means Committee.
As a Congressman, Xavier Becerra was a staunch advocate for access to
health care services. Personal care and companionship services provided
by qualified home care providers play an important role in protecting
seniors and individuals with disabilities. Access to these services
diminishes the likelihood of costly hospitalization by ensuring seniors
have appropriate nutrition and by helping prevent falls.
Attorney General Becerra brings his experience as an administrator
having run the California Department of Justice since 2017. In this
position he addressed an array of health and other matters that prepare
him well to handle the significant challenges of running an agency as
large and diverse as the U.S. Department of Health and Human Services.
Finally, the nominee brings to the agency knowledge of the disparities
in access to health services in the U.S. He is well positioned to
address these disparities, including workforce disparities, to ensure
the improving health of the nation.
Thank you for your attention to this matter.
Sincerely,
Vicki Hoak,
Executive Director
______
International Association of Forensic Nurses
6755 Business Parkway, Suite 303
Elkridge, MD 21075
https://www.forensicnurses.org/
January 20, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden and Ranking Member Crapo:
The International Association of Forensic Nurses (IAFN) would like to
express its support for Xavier Becerra as the Biden Administration's
nominee for the position of Secretary of Health and Human Services.
IAFN urges his swift confirmation by the U.S. Senate.
IAFN is an international membership organization comprised of forensic
nurses working around the world and other professionals who support and
complement the work of forensic nursing. Our mission is to provide
leadership in forensic nursing practice by developing, promoting, and
disseminating information internationally about forensic nursing
science. Forensic nurses are on the front lines of caring for victims
of sexual assault, domestic violence, and elder abuse in our nation's
health care system.
President-Elect Biden made a wise choice in the selection of California
Attorney General Xavier Becerra to lead the department at this time as
the country continues to address the array of challenges the pandemic
presents. During his twelve terms in Congress, Attorney General Becerra
spent much of his time working on health care issues impacting U.S.
citizens as a member of the House Ways and Means Committee.
As a Congressman, Attorney General Becerra was a staunch advocate for
access to health care services. Forensic nurses have a critical health
care role to play and we must ensure that victims of abuse and violence
have available services in their communities.
In addition to his experience on health care matters, Attorney General
Becerra brings his experience as an administrator having run the
California Department of Justice since 2017. In this position he
addressed an array of health and other matters that prepare him well to
handle the significant challenges of running an agency as large and
diverse as the U.S. Department of Health and Human Services.
Finally, he brings to the agency knowledge of the disparities in access
to health services in the U.S. He is well positioned to address these
disparities, including workforce disparities, to ensure the improving
health of the nation.
Thank you for your attention to this matter.
Sincerely,
Jennifer Pierce-Weeks
CEO
______
Lambda Legal et al.
February 22, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
The Honorable Patty Murray The Honorable Richard Burr
Chair Ranking Member
United States Senate United States Senate
Committee on Health, Education,
Labor, Committee on Health, Education,
Labor,
and Pensions and Pensions
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden, Ranking Member Crapo, Chair Murray, and Ranking
Member Burr,
On behalf of Lambda Legal, the Human Rights Campaign, the National
Center for Lesbian Rights and the 15 undersigned organizations
representing the interests of lesbian, gay, bisexual, transgender, and
queer (LGBTQ) people and everyone living with HIV, we write to express
our strong support for the nomination of California Attorney General
Xavier Becerra to be the next Secretary of the United States Department
of Health and Human Services (HHS).
Our country is amid a public health crisis. We presently are confronted
by the unprecedented challenges created by the COVID-19 pandemic, as
well as the many structural barriers that diminish people's access to
health care and exacerbate longstanding health inequities. It is
therefore critical that HHS be led by a person with proven leadership
ability, a deep understanding of our health care system and the need
for equitable access to health care and human services, and an
appreciation of the needs of communities of color and LGBTQ people.
Attorney General Becerra is such person.
Attorney General Becerra possesses a keen understanding of our health
care system. As a member of Congress, Attorney General Becerra worked
on the passage of the Affordable Care Act, reducing health disparities,
lowering drug prices, and more. As Attorney General, he has been a
leader in ensuring the implementation and preservation of the
Affordable Care Act, which has expanded access to health coverage for
millions of Americans, by fighting off legal challenges against the
Affordable Care Act, including in Texas v. United States. His
leadership in these cases required not only a profound understanding of
the law, but also insight in the many intricacies of the Affordable
Care Act and our health care system.
Attorney General Becerra has also been a stalwart supporter of LGBTQ
people's right to equality and equitable access to care. Specifically,
with regards to health care, Attorney General Becerra has brought legal
challenges to administrative actions and regulations that would have
resulted in diminished access to care for LGBTQ people and other
minorities, such as: regulations eliminating antidiscrimination
protections under the Affordable Care Act for LGBTQ people and people
with limited English proficiency, among others; regulations seeking to
inappropriately expand who could refuse to provide care to people based
on religious or moral objections, which would have disproportionately
LGBTQ people and those seeking reproductive health care; and actions
denying access to care to our country's transgender servicemembers.
What is more, Attorney General Becerra has not only demonstrated his
ability to lead a large government agency, like the California Attorney
General's Office, but also shown that he can listen to and work with a
broad range of stakeholders. His work seeking equity and justice for
all Californians and all persons in America is to be admired. Indeed,
he has led multiple coalitions of attorneys general in commenting to
proposed HHS regulations.
Put simply, we believe Attorney General Becerra is the right person to
lead HHS, especially at this particular moment in time. His commitment
to civil rights, health care equity, and the rights of LGBTQ people and
everyone living with HIV is without a question.
Sincerely,
Lambda Legal Defense and Education Fund, Inc.
Human Rights Campaign
National Center for Lesbian Rights
BiNet USA
Center for Disability Rights
Center for LGBTQ Economic Advancement & Research
CenterLink: The Community of LGBT Centers
Equality California
Family Equality
Fenway Health
FORGE, Inc.
GLMA: Health Professionals Advancing LGBTQ Equality
National Coalition for LGBT Health
National Equality Action Team (NEAT)
National LGBT Cancer Network
Silver State Equality--Nevada
URGE: Unite for Reproductive and Gender Equity
Whitman-Walker Institute
______
Leadership Conference on Civil and Human Rights et al.
1620 L Street, NW, Suite 1100
Washington, DC 20036
202-466-3311 voice
202-466-3435 fax
https://civilrights.org/
February 22, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
United States Senate United States Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
The Honorable Patty Murray The Honorable Richard Burr
Chair Ranking Member
United States Senate United States Senate
Committee on Health, Education,
Labor, Committee on Health, Education,
Labor,
and Pensions and Pensions
Washington DC 20510 Washington, DC 20510
Dear Chairman Wyden, Ranking Member Crapo, Chair Murray, and Ranking
Member Burr,
The Leadership Conference on Civil and Human Rights and the 31
undersigned organizations dedicated to the universal values of dignity,
equity, justice, and inclusion in health care, write in strong support
of the nomination of California Attorney General Xavier Becerra to be
the next Secretary of the United States Department of Health and Human
Services (HHS).
In the midst of a pandemic that has compounded our preexisting public
health crisis of structural racism and its resulting deep health
inequities, it is imperative that the next leader of HHS be someone
with a full understanding of how equity, justice, and health care are
inextricably linked. Attorney General Becerra has consistently
demonstrated that he is that person:
During his time as a member of Congress, Attorney General
Becerra served on the House Ways and Means Committee, where he
developed deep expertise on the Affordable Care Act (ACA). His
leadership in later defending the ACA against legal challenges is a key
reason why the ACA, the greatest advance in access to health care for a
generation, is still in effect.
Becerra is committed to putting patients first, and as attorney
general, has worked to ensure nondiscrimination protections in access
to care, particularly for women, LGBTQ individuals, people of color,
older adults, and individuals in rural and low-income communities. In
addition, he has shown strong support for reproductive rights,
including for access to birth control and abortion services.
Becerra led the country in defending against the harmful Public
Charge rule and attacks on the Deferred Action for Childhood Arrivals
(DACA) program, showing his dedication to protecting the rights of
immigrants and their families.
Becerra has worked tirelessly to help ensure the availability of
affordable prescription drugs, once again demonstrating his commitment
to providing equitable access to care.
As attorney general, Becerra established the Bureau of
Disability Rights within the Civil Rights Enforcement Section of the
California Department of Justice, the latest example in his long record
of working for disability justice.
Becerra's record also indicates that he would bring to the
position a deep understanding of the ways in which access to social and
economic opportunities and resources contribute to health and health
outcomes. For example, Becerra has shown a deep commitment to ensuring
fair housing, most recently opposing efforts to weaken federal
protections against housing discrimination as well as efforts to cut
off housing assistance eligibility, which threatened vulnerable
families with eviction. He also established the Worker Rights and Fair
Labor Section within the California Department of Justice to help
protect the health, safety, and rights of working people, linking the
creation of the new section to the urgent need to address the impact of
the COVID-19 pandemic on working people.
We cannot afford to have our next Secretary of Health and Human
Services learning about our country's deepened health inequities on the
job. Following the injustices and harms inflicted on some of our most
vulnerable communities over the last four years, it is critical that
the next Secretary of Health and Human Services be a person well-
equipped to handle our country's deep health inequities. In order to
emerge from this pandemic with healthier, stronger, more resilient
communities, we need a Secretary of HHS who has fought for, and will
prioritize health care access and equity for all people in America. For
this reason, we urge you to support the confirmation of Attorney
General Xavier Becerra to be the next Secretary of HHS.
If you have any questions, please contact Gaylynn Burroughs, senior
policy counsel at The Leadership Conference, at
[email protected], or the co-chairs of The Leadership
Conference Health Care Task Force: Sinsi Hernandez-Cancio, vice
president for health justice at the National Partnership for Women and
Families at [email protected] and Mara Youdelman, managing
attorney at the National Health Law Program, at
[email protected].
Sincerely,
The Leadership Conference on Civil and Human Rights
National Health Law Program
National Partnership for Women and Families
Asian Americans Advancing Justice (AAJC)
Association of Asian Pacific Community Health Organizations (AAPCHO)
Association of People Supporting Employment First (APSE)
Autistic Self Advocacy Network
Bazelon Center for Mental Health Law
Center for Law and Social Policy (CLASP)
Clearinghouse on Women's Issues
Disability Rights Education and Defense Fund (DREDF)
Equality California
Families USA
Family Equality
Feminist Majority Foundation
Hispanic Federation
Human Rights Campaign
Justice in Aging
Lawyers' Committee for Civil Rights Under Law
National Action Network
National Center for Lesbian Rights
National Education Association
National Hispanic Media Coalition
National Immigration Law Center
National Organization for Women
National Urban League
National Women's Law Center
Planned Parenthood Federation of America
Reproductive Health Access Project
SEIU
Silver State Equality--Nevada
The International Union, United Automobile, Aerospace and Agricultural
Implement Workers of America (UAW)
______
LeadingAge
2519 Connecticut Avenue, NW
Washington, DC 20008-1520
P 202-783-2242
F 202-783-2255
https://leadingage.org/
The Honorable Ron Wyden The Honorable Patty Murray
Chair Chair
United States Senate United States Senate
Committee on Finance Committee on Health, Education,
Labor,
and Pensions
Washington, DC 20510 Washington, DC 20510
February 11, 2021
Dear Chair Wyden and Murray:
LeadingAge fully supports the nomination of Xavier Becerra as Secretary
of the US Department of Health and Human Services and encourages the
Committees to support his nomination. We worked closely with his office
on long-term services and supports financing when he was a member of
Congress and appreciated his understanding of, and commitment to
addressing, the challenges facing our country to ensure that all older
persons can age well wherever they call home.
LeadingAge represents more than 5,000 nonprofit aging services
providers and other mission-minded organizations. Alongside our members
and 38 state partners, we use applied research, advocacy, education,
and community-building to make America a better place to grow old. Our
membership encompasses the entire continuum of aging, including nursing
homes, home and community-based services providers, hospice and
affordable senior housing providers.
We support the nomination of Secretary-Nominee Becerra to be the next
HHS Secretary to advocate for and carry out the robust health care
platform outlined by President Joe Biden. We have confidence that he
has the health care expertise and experience managing large systems
that are critical to successfully leading HHS and that he will work
with Congress to take quick action on such issues as:
Beating COVID-19, by ensuring implementation of the Executive
Orders mandating increased production of protective equipment, ensuring
access to vaccinations and testing for all older persons and the front-
line staff who serve them, and implementing the provisions in the CARES
Act and other COVID-related legislation.
Taking strong steps to promote racial equity by addressing stark
economic disparities.
Implementing the Administration's commitment to advancing HCBS
to ensure that older persons have access to quality health care in the
community.
Implementing the Administration's commitment to addressing the
needs of family caregivers.
Advancing LGBTQ+ equality for older adults.
Acting swiftly to fully integrate HHS/CMS and HUD collaboration
on housing and services, as directed by Congress in the fiscal year
2020 HUD appropriations bill.
LeadingAge urges the swift approval of Mr. Becerra to be HHS Secretary.
Please reach out to LeadingAge senior vice president for policy, Ruth
Katz, [email protected] with any questions.
Sincerely,
Katie Smith Sloan
President and CEO
______
Little Lobbyists
https://littlelobbyists.org/
February 18, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chairperson Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
219 Dirksen Senate Office Building 219 Dirksen Senate Office Building
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden and Ranking Member Crapo,
Little Lobbyists is a family-led organization advocating for the health
care, education, and community inclusion children with complex medical
needs and disabilities require to survive and thrive. The U.S.
Department of Health and Human Services is an agency charged with
protecting the health of all Americans, as such its leader must center
the rights of patients and endeavor to ensure access to health care for
all. We believe Xavier Becerra will dutifully and effectively enact
this charge, and we write today in support of his swift confirmation as
Secretary of Health and Human Services.
For the past four years, families of children with complex medical
needs and disabilities have lived in fear. In 2017, Little Lobbyists
was formed as a direct response to the threat posed to our children's
health and well-being by the Trump Administration's effort to repeal
and defund the Affordable Care Act, Medicaid, and Medicare. Although
their initial effort narrowly failed in 2017, President Trump and his
Administration continued their relentless attack on our health-care
system in myriad ways, including: executive orders weakening our health
insurance protections, policies making Medicaid more difficult for
families to access, a failed federal response to the COVID-19 pandemic
crisis, and support for a lawsuit to overthrow the entire Affordable
Care Act--including protections for people with pre-existing
conditions, bans against lifetime caps on care, Medicaid expansion, and
more--which is currently before the U.S. Supreme Court. In this last
example, it was the Secretary Designate of HHS Xavier Becerra, in his
role as Attorney General of California, who led a coalition of 14
states and the District of Columbia to file a motion to intervene in
Texas et al. v. United States et al. to defend the Affordable Care
Act.\1\ It was also Attorney General Becerra who led the defense of the
Affordable Care Act before the Supreme Court this past fall, standing
up to ensure our children will continue to have access to the health
care they need to survive and thrive.
---------------------------------------------------------------------------
\1\ Attorney General Becerra, joined by 16 AGs, ``Moves to Defend
the Affordable Care Act Against Federal Lawsuit Filed in Texas,'' State
of California, Department of Justice, Office of the Attorney General.
Prior to becoming California's Attorney General, Mr. Becerra was a
member of Congress, serving as a senior member of the House Ways and
Means committee, overseeing Medicare, Medicaid and other health
programs.\2\ He represented a largely Latino district with the second
highest uninsured rate in the country,\3\ which inspired him to help
write and pass the Affordable Care Act.\4\ In his role as California's
Attorney General, Mr. Becerra led the second-largest Justice Department
in the nation, as well as a multi-state coalition to protect the health
and welfare of immigrant children being held in detention.
---------------------------------------------------------------------------
\2\ https://history.house.gov/People/Detail/9147.
\3\ ``California: Affordable Care Act (ACA) Impacts on Insurance
Coverage by Congressional District,'' SHADAC.
\4\ Xavier Becerra, Congress.gov, Library of Congress.
Little Lobbyists knows that representation matters. We need leaders
with the insight that comes from the lived experience of diverse and
marginalized communities. If confirmed, Xavier Becerra would be the
first Latino to lead the Department of Health and Human Services.
Representation that reflects the diversity of our great country is
---------------------------------------------------------------------------
imperative.
Mr. Becerra has already met with and intently listened to diverse
groups of stakeholders, including members of the disability community.
We appreciated that he understood the great importance of issues, like
Medicaid, which our children rely on to access the home and community
based services they need. However, Medicaid was under constant attack
during the previous administration's tenure, putting the lives and
freedoms of our children at risk. In our meeting, we were also able to
impress upon Mr. Becerra the disproportionate impact of the COVID-19
pandemic on people with disabilities, including barriers to care,
reduced access to home and community based services, and inequities in
the distribution of the vaccine. These issues, and many more, are
urgent matters that we trust the Secretary Designate will prioritize
and act on immediately with the input of those directly affected.
Little Lobbyists strongly supports Xavier Becerra's nomination to serve
as Secretary of Health and Human Services. Based on his history, his
experience, and his willingness to bring those most impacted to the
table, we believe Xavier Becerra will continue to be a champion in our
fight to protect and strengthen the health care our children, and all
Americans, need to survive and thrive. In our nation's history there
has hardly been a more critical time, or a more imperative need, for
the Department of Health and Human Services to have strong leadership.
We urge the committee to act quickly to confirm Xavier Becerra as
Secretary of Health and Human Services.
Thank you for all you do for our families,
Erin Gabriel
Director of Advocacy
______
Lower Drug Prices Now
https://www.lowerdrugpricesnow.org/
The Honorable Ron Wyden
Chairman
U.S. Senate
Committee on Finance
219 Dirksen Senate Office Building
Washington, DC 20510
The Honorable Mike Crapo
Ranking Member
U.S. Senate
Committee on Finance
219 Dirksen Senate Office Building
Washington, DC 20510
February 22, 2021
Dear Senate Finance Committee Leaders:
On behalf of Lower Drug Prices Now, a coalition of labor unions,
community organizations, think tanks and advocacy groups that represent
millions of people who are struggling with high prescription drug
prices, I'm writing to urge you to swiftly confirm Attorney General
Xavier Becerra as Health and Human Services (HHS) Secretary. Mr.
Becerra is eminently qualified for the position. In today's public
health and economic crisis, there is no time for delay in installing a
leader at HHS who can lead the nation toward effective response and
recovery as the nation reaches another dismal milestone: 500,000 COVID
deaths.
As Congressman, Mr. Becerra was a key leader in passing the largest
health care reform of the last 50 years, the Affordable Care Act. He
was also a key protector of the law, defending it in court in order to
protect coverage for millions and pre-existing condition protections
for hundreds of millions. Without the ACA, countless Americans would
lose access to coverage and to prescription drug medicines that are
covered as an essential health benefit under the law. Seniors would
lose billions in discounts in Part D and millions of Medicare
recipients would end up back in the Part D donut hole that the ACA
closed after a decade of implementation.
In his role leading a massive state agency in the largest state in the
Union, AG Becerra has the experience of overseeing an agency larger
than some departments in the federal government. He is well able to
manage complex agencies and ensure that moving parts work together to
serve the best interests of constituents. Protecting patients and
ensuring access to healthcare and affordable medicines have been Mr.
Becerra's priorities throughout his career. His record on making
medicines more accessible and affordable through drug corporation
accountability speaks for itself.
Over two decades in Congress, Mr. Becerra sponsored legislation that
would lift the ban on negotiating prices on drugs in Medicare,
supported bills that would cap or lower out of pocket costs for
seniors, and worked with colleagues to increase transparency and
accountability for prescription drug corporations.
In his time as Attorney General of California, Mr. Becerra earned a
reputation as a champion of patients and consumers by taking on
prescription drug corporation abuses, from rampant price gouging to pay
for delay tactics that circumvent competition and allow drug
corporations to maintain monopoly control over prices. His leadership
on drug corporation accountability has helped California and also
advanced national efforts to hold drug manufacturers accountable for an
array of practices that have devastating consequences for millions of
people who are forced to ration or go without medicine.
Mr. Becerra joined with a bi-partisan coalition of state Attorneys
General to investigate the role and culpability of opioid manufacturers
in fueling the man-made opioid epidemic that has devastated communities
from coast to coast. He worked with AGs across the nation to support
Congressional action that would stop the harmful distribution of
synthetic opioids. In response to COVID needs, AG Becerra also worked
with a bi-partisan group of Attorneys General to urge HHS to make
Remdisivir more available for patients in need.
We strongly urge members of the Finance Committee to vote in support of
this nomination and to quickly confirm Mr. Becerra as HHS Secretary. We
are confident that he has the legislative, legal and regulatory
expertise to excel in this role and that he will prioritize patients
and consumers over special interests. We look forward to working with
him to ensure access to affordable medicines for all in his role as
Secretary.
Thanks for your consideration.
Sincerely,
Margarida Jorge
Campaign Director
______
Mental Health America
500 Montgomery Street, Suite 820
Alexandria, VA 22314
P: 703-684-7722
F: 703-684-5968
www.mhanational.org
February 22, 2021
U.S. Senate
Committee on Finance
Dear Chairman Wyden, Ranking Member Crapo, and Members of the
Committee:
We are pleased to support the nomination of Xavier Becerra as Secretary
of Health and Human Services.
Mental Health America is the nation's leading community-based nonprofit
dedicated to addressing the needs of those living with mental illness
and promoting the overall mental health of all. We advocate for the
inclusion of mental health as a part of overall health. Our mission is
driven by a focus on prevention for all, early identification and
intervention for those at risk, and integrated services for those who
need them, with recovery as the goal. We have argued that mental health
conditions are the only chronic conditions that, as a matter of public
policy, we have waited until stage four--the crisis stage--to treat,
and that as we do with every other condition, we must act before Stage
4 to advance mental health and recovery.
We support Attorney General Becerra's nomination because we believe
that he had demonstrated a decades-long commitment as a public official
to promoting the health and well-being of the population. As a member
of Congress, he sponsored and supported legislation that has proven
essential on the journey to health equity for all our people, including
those affected by mental illnesses. As the Attorney General of
California, his efforts in support of enforcing mental health parity,
for example, are well-known and critically important. So, too, were his
efforts throughout his career to build an Affordable Care Act that did
not leave essential benefits for people with mental health conditions
behind. His efforts to promote community health centers has also led to
increased access to mental healthcare through integrated health and
behavioral health services as part of their comprehensive primary care
mandate.
Attorney General Becerra's background in lawmaking, enforcement, and
government make him an outstanding choice to lead the Department of
Health and Human Services. In his past work, he has demonstrated the
skills of focusing on the most critical problems and learning from all
stakeholders. These are the critical skills and talents needed to lead
a large, complex, governmental agency and direct its energies to
serving all those in need. We strongly support his nomination and urge
you to quickly confirm him as HHS Secretary given the unprecedented
health, including mental health, needs of the country at this time.
Sincerely,
Paul Gionfriddo (he/him/his)
President and CEO
______
Medical Imaging and Technology Alliance
1300 North 17th Street, Suite 900
Arlington, Virginia 22209
Tel: 703-841-3200
Fax: 703-841-3392
https://www.medicalimaging.org/
January 19, 2021
The Honorable Patty Murray The Honorable Richard Burr
U.S. Senate U.S. Senate
Washington, DC 20510 Washington, DC 20510
Dear Senator Murray and Senator Burr:
As the leading trade association representing the manufacturers of
medical imaging equipment, contrast agents, radiopharmaceuticals, and
focused ultrasound devices, the Medical Imaging and Technology Alliance
(MITA) supports the nomination of Xavier Becerra as Secretary of the
Department of Health and Human Services (HHS).
His State and Federal government service, and especially his 24 years
in Congress, has given Attorney General Becerra a deep understanding of
the complexities and challenges of our health care system. He has been
a champion for healthcare access, ensuring patients receive safe high-
quality scans through accreditation of imaging centers. He also
recognizes the importance of appropriate reimbursement for healthcare
providers. MITA counts on the Senate to confirm Attorney General
Becerra and we and our Members look forward to working with him in his
new role at the earliest opportunity.
If you have any questions, please contact Holly Grosholz, Senior
Manager, Government Relations at 703-841-3228 or by email at
[email protected].
Sincerely,
Patrick Hope
Executive Director
______
NARAL Pro-Choice America
February 16, 2021
Dear Senator,
We write on behalf of our 2.5 million member-activists to express our
support for the nomination of Xavier Becerra to the position of U.S.
Secretary of Health and Human Services. In order to be qualified to
lead the Department of Health and Human Services, a nominee must be
someone who prioritizes public health and bases decisions on evidence
not ideology. Attorney General Becerra's record makes clear that he is
such a nominee.
As both attorney general of California and a member of the U.S. House
of Representatives, Attorney General Becerra acted to protect access to
healthcare and reproductive freedom, including abortion and
contraception. As attorney general, he opposed abortion bans and
burdensome restrictions on abortion, medically unnecessary restrictions
on medication abortion during the COVID-19 pandemic, and a rule
promulgated by the Trump administration which prevents patients in the
Title X family planning program from getting full and accurate
healthcare information and adds new restrictions to exclude providers
that also provide abortion care from the program. While serving in the
House of Representatives, Attorney General Becerra voted in favor of
the Affordable Care Act, voted to protect funding for Planned
Parenthood, and voted against bans on abortion and abortion coverage.
Now more than ever executive agencies need leaders who are fair-minded
and committed to their agency's core mission. For these reasons, we
urge Senators to support this nomination.
Sincerely,
NARAL Pro-Choice America
______
National Alliance to End Sexual Violence
1875 Connecticut Avenue, NW, Floor 10
Washington, DC 20009
(202) 869-8520
https://endsexualviolence.org/
U.S. Senate
Committee on Health, Education, Labor, and Pensions
U.S. Senate
Committee on Finance
Senate Dirksen Office Building
Washington, DC 20510
February 11, 2021
Dear Chairwoman Murray, Chairman Wyden, Ranking Member Burr, Ranking
Member Crapo, and Committee Members:
The National Alliance to End Sexual Violence (NAESV) is the voice in
Washington, DC for the 56 state and territorial sexual assault
coalitions and over 1500 local programs working to end sexual violence
and support survivors. The local programs we serve see the widespread
and devastating consequences of sexual violence for survivors every
day. On their behalf, I write to urge you to confirm the appointment of
Xavier Becerra as Secretary of Health and Human Services (HHS).
According to the National Intimate Partner and Sexual Violence Survey:
21% of women and 3% of men reported completed or attempted rape
ever in their lifetime.
Among victims of rape, 43% (11 million) of females and 51% (1.5
million) of males reported it occurred for the first time between the
ages of 11-17.\1\
---------------------------------------------------------------------------
\1\ https://www.cdc.gov/violenceprevention/pdf/2015data-
brief508.pdf.
The estimated lifetime cost of rape is $122,461 per survivor, or a
population-based economic burden of nearly $3.1 trillion (2014 U.S.
dollars) over survivors' lifetimes. This estimate included $1.2
trillion (39%) in medical costs; and $1.6 trillion (52%) in lost work
productivity among survivors and perpetrators.\2\
---------------------------------------------------------------------------
\2\ http://www.ajpmonline.org/article/S0749-3797(16)30615-8/
abstract.
The short- and long-term effects of sexual violence can undermine a
person's physical and mental health. Based on an analysis of studies
from 1980-2008, survivors of sexual violence have a significantly
higher prevalence of anxiety, depression, eating disorders, post-
traumatic stress disorder, and suicide attempts.\3\ According to the
2005 Behavioral Risk Factor Surveillance System, survivors of sexual
violence are more likely to suffer from asthma and joint conditions.
Studies have also found an increased risk of cervical cancer and
sexually transmitted diseases.\4\
---------------------------------------------------------------------------
\3\ Ibid.
\4\ Ibid.
Many survivors encounter the problems of homelessness, substance use
disorders, mental health problems, trafficking experiences, and chronic
health conditions. The issue of sexual violence cuts across many HHS
bureaus, programs, and offices: programs in the Family and Youth Bureau
including Family Violence Prevention Services (FVPSA), Homeless &
Runaway Youth, and Adolescent Pregnancy Prevention; the Office on
Trafficking in Persons; the Substance Abuse and Mental Health Services
Administration; and the CDC where the Rape Prevention & Education
---------------------------------------------------------------------------
Program (RPE) is housed.
Xavier Becerra is a demonstrated leader who brings decades of health
policy experience addressing violence against women and support
services, ensuring access to healthcare, and protecting Social Security
and Medicare. His long history of defending and protecting the
Affordable Care Act has provided essential health care access and
coverage for many previously uninsured people, including those
experiencing sexual violence and trauma. His commitment to gender
equity and women's health, and specifically reproductive health,
positions him well to develop and promote polices that will positively
impact survivors of sexual violence and further the administration's
commitment to ending gender-based violence. As District Attorney of
California, he joined with Attorneys General across the country in 2018
and 2020 to advocate for the reauthorization of the Violence Against
Women act, including provisions strengthen protections for the most
marginalized and vulnerable members of our communities. During the
current COVID-19 pandemic, he prioritized the needs of survivors
experiencing even greater isolation to ensure they had access to
critical services in California.
For the past decade, our nation has experienced a deep reckoning with
the devastating depth and breadth of the problem of sexual violence.
Under the leadership of Xavier Becerra, HHS can reach farther in
meeting the needs of survivors and preventing sexual violence. His
legal background and efforts with his expansive understanding of health
and welfare issues is the perfect mix of experience to meet the needs
of an agency that affects all members of our communities.
Sincerely,
Monika Johnson Hostler
President
______
National Alliance of Safety-Net Hospitals
21351 Gentry Drive, Suite 210
Sterling, VA 20166
Phone: 703-444-0989
https://safetynetalliance.org/
January 25, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chair Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden and Ranking Member Crapo:
The National Alliance of Safety-Net Hospitals is pleased to express our
support for the confirmation of Xavier Becerra to serve as the next
Secretary of the Department of Health and Human Services.
Private safety-net hospitals--large hospitals that serve large numbers
of low-income, low-income elderly, Medicaid, and uninsured patients--
play a special role in the broader American health care system. That
role has always been critical, and it has been magnified during the
current COVID-19 crisis. We worked with Mr. Becerra when he was a
member of Congress and served on the House Ways and Means Committee and
can attest to his understanding of the distinct challenges low-income
and underserved communities face and his sincere interest in using
public policy to help address those challenges. We would welcome an
opportunity to work with a Secretary who understands these challenges
and also understands the underlying health equity challenges that we
must address as a nation.
For these reasons, NASH enthusiastically support Mr. Becerra's
nomination to be Secretary of Health and Human Services and urges you
to vote to recommend his nomination to the entire Senate.
Sincerely,
Ellen Kugler, Esq.
Executive Director
______
National Alliance of State and Territorial AIDS Directors
444 North Capitol Street, NW, Suite 339
Washington, DC 20001
(202) 434-8090
https://www.nastad.org/
February 22, 2021
U.S. Senate
Committee on Finance
219 Dirksen Senate Office Building
Washington, DC 20510
U.S. Senate
Committee on Health, Education, Labor, and Pensions
428 Dirksen Senate Office Building
Washington, DC 20510
Dear Committee Members,
On behalf of NASTAD (National Alliance of State and Territorial AIDS
Directors), a leading non-partisan non-profit association that
represents governmental public health officials who administer HIV and
hepatitis programs in the U.S., I would like to offer our
organization's support for Xavier Becerra to serve as the next
Secretary of the Department of Health and Human Services (HHS). Based
on his demonstrated leadership, expertise, and vision, NASTAD believes
Mr. Becerra is an excellent candidate for this important role.
Mr. Becerra has proven to be a strong leader during his tenure as
Attorney General of California. While serving the state, Mr. Becerra
reached a settlement over a breach of patient confidentiality for 1,991
Californians who received mailings that revealed the recipient was
taking HIV-related medication. Mr. Becerra also led the charge to
protect the Affordable Care Act (ACA), legislation that led to a
substantial decline in uninsurance rates among people living with HIV.
Through his legal actions, Mr. Becerra has shown that he prioritizes
patients' rights, equity, and access in health care. These commitments
will be incredibly important as Mr. Becerra works to contain and end
the COVID-19 pandemic that has highlighted American health inequities.
With over 20 years public service experience in Congress, Mr. Becerra
worked to represent his constitutes and strengthen health care in
America as a senior member of the Ways and Means Subcommittee on
Health. Mr. Becerra is a dedicated public servant who understands that
truly protecting health requires leadership that addresses the social
and structural determinants of health including gender inequality,
homophobia, and poverty.
Mr. Becerra is uniquely suited to serve as the next HHS Secretary. His
public service record as an advocate for improved health care access
makes Mr. Becerra an exemplary nominee.
Sincerely,
Stephen Lee, M.D., MBA, DHSM
Executive Director
______
National Alliance on Mental Illness
4301 Wilson Boulevard, Suite 300
Arlington, VA 22203
(703) 524-7600
https://www.nami.org/
February 23, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
RE: NAMI Support for HHS Secretary Nominee Xavier Becerra
Dear Chairman Wyden and Ranking Member Crapo:
On behalf of the National Alliance on Mental Illness (NAMI), I am
writing in support of confirmation of California Attorney General
Xavier Becerra as the next Secretary of the U.S. Department of Health
and Human Services (HHS). As the nation's largest grassroots mental
health organization dedicated to building better lives for the millions
of Americans affected by mental illness, NAMI is pleased to support
this important nomination.
Attorney General Becerra has been a true leader on mental health and
addiction issues, tirelessly defending the ACA and working to enforce
federal & state mental health parity laws. As California's Attorney
General he led efforts on the part of states to challenge measures
taken by the previous Administration to undermine a series of patient
protections in the Affordable Care Act (ACA). Under his leadership,
California also stepped up enforcement and compliance with respect to
the Mental Health Parity and Addiction Equity Act (MHPAEA) ensuring
more equitable coverage of mental illness treatment.
In his 24 years as a Member of the House of Representatives,
Congressman Becerra established a significant record of accomplishment
in crafting legislation to expand access to mental health treatment.
This includes improvements to the Medicare program including enhanced
protections for low income beneficiaries that are concurrently eligible
for Medicaid. He also led a number of efforts in Congress to prevent
cuts to the Social Security Disability Insurance (SSDI) program that
many people living with mental illness rely on.
NAMI is proud to support Attorney General Becerra's confirmation as HHS
Secretary. We urge the Committee move expeditiously on his nomination.
Sincerely,
Daniel H. Gillison, Jr.
CEO
______
National Association of Community Health Centers
7501 Wisconsin Ave., Suite 1100W
Bethesda, MD 20814
301-347-0400 TEL
301-347-0459 FAX
https://www.nachc.org/
February 11, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
The Honorable Patty Murray The Honorable Richard Burr
Chairwoman Ranking Member
U.S. Senate U.S. Senate
Committee on Health, Education,
Labor, and Pensions Committee on Health, Education,
Labor, and Pensions
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden, Ranking Member Crapo, Chairwoman Murray and
Ranking Member Burr:
On behalf of Community Health Centers and the 30 million patients they
serve, I want to express my support for Attorney General Xavier
Becerra's nomination to be the Secretary of the Department of Health
and Human Services (HHS). The COVID-19 pandemic continues to challenge
health centers across the country and strong leadership at the
department is necessary to tackle this ongoing crisis.
Attorney General Becerra has a long-established relationship with
California health centers and NACHC. As a former Member of Congress
from Los Angeles, and a member of the House Ways and Means Committee,
he consistently sought feedback from local health center leadership
through roundtable events and regular communications with the Los
Angeles Community Clinic Consortium.
Additionally, he regularly attended health center events throughout the
district and then acted to support health center priorities. These
connections were incredibly important since his congressional district
included 30 health centers that collectively serve nearly 250,000
patients. NACHC was pleased to recognize this work in support of health
centers by awarding Becerra with the Distinguished Community Health
Advocate Award during his time in Congress.
Federally qualified health centers across the country are working every
day to help address the COVID-19 pandemic. To date, over 8 million
health center patients have been tested for COVID-19, 13% have tested
positive and 140,000 immunizations have been initiated. A significant
number of these patients are racial and/or ethnic minorities, who are
bearing a disproportionate brunt of this crisis. Attorney General
Becerra's experience representing one of the most diverse Congressional
Districts will be critical to ensuring that all Americans have access
to COVID-19 testing and vaccines.
NACHC appreciates the expanded role that the Biden Administration
envisions for health centers and looks forward to working with Attorney
General Becerra should he be confirmed. His commitment to equitable
access to health care and experience at the state and federal levels
make him an ideal choice at this critical moment. Thank you in advance
for your consideration.
Sincerely,
Tom Van Coverden
President and CEO
______
National Association of State
Mental Health Program Directors
66 Canal Center Plaza, Suite 302
Alexandria, VA 22314
(703) 739-9333
Fax (703) 548-9517
February 23, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
219 Dirksen Senate Office Building 219 Dirksen Senate Office Building
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden and Senator Crapo:
The National Association of Mental Health Program Directors (NASMHPD)--
the organization representing the state executives responsible for the
$41 billion public mental health service delivery systems serving 7.5
million people annually in 50 states, 5 territories, and the District
of Columbia--is writing to recommend a nominee for Secretary of Health
and Human Services. State Mental Health Authority priorities focus on
improving services in the mental health and substance use disorder
field, particularly within the Medicaid and Medicare programs, and the
Affordable Care Act insurance program, and this nominee has shown
experience in supporting these priorities.
NASMPHD recommends Attorney General Xavier Becerra of California who
has shown vast experience in handling the broad array of issues under
HHS purview. As Attorney General, he has worked to enforce the mental
health parity laws he helped to pass in Congress to ensure that
insurance companies expand provider networks and guarantee equal
treatment for mental health conditions in insurance plans. In Congress,
he was active in the passing of the Affordable Care Act, specifically
focusing on strengthening Medicare benefits, and expanding the
Children's Health Insurance Program. These are vital in order to
provide for the essential care needed by those with mental health and
substance abuse disorders, and so that health insurance coverage for
mental health and substance use disorder services is no more
restrictive than coverage for medical/surgical services.
Attorney General Becerra has also shown the leadership and demonstrated
a track record of advocating for access to quality, affordable health
care which is essential as our nation continues to deal with the COVID-
19 public health emergency that has contributed to mental health
crises. With the creation of the 988 suicide prevention hotline, it is
more important than ever to improve the system to provide access to
crisis services for those in mental health crisis, and to be diverted
away from hospital emergency departments and jails where their needs
will not be met. A strength of Attorney General Becerra is being a
champion for reducing the health inequities that have been problematic,
and exacerbated by the COVID-19 public health emergency, so that all
have quality care readily available.
Thank you for considering this recommendation on the confirmation of
Attorney General Becerra for the position of Secretary of Health and
Human Services.
Sincerely,
Brian M. Hepburn, M.D.
Executive Director
______
National Center for Lesbian Rights
1300 Pennsylvania Ave., NW, #190-706
Washington DC 20004
February 22, 2021
Honorable Ron Wyden
Chair
U.S. Senate
Committee on Finance
Honorable Mike Crapo
Ranking Member
U.S. Senate
Committee on Finance
Honorable Patty Murray
Chair
U.S. Senate
Committee on Health, Education, Labor, and Pensions
Honorable Richard Burr
Ranking Member
U.S. Senate
Committee on Health, Education, Labor, and Pensions
Dear Chair Wyden, Ranking Member Crapo, Chair Murray, and Ranking
Member Burr,
The National Center for Lesbian Rights (NCLR) is pleased to support the
nomination of California Attorney General Xavier Becerra to serve as
Secretary of the U.S. Department of Health and Human Services (HHS).
NCLR is a non-profit, public interest law firm that litigates
precedent-setting cases at the trial and appellate court levels,
advocates for equitable public policies affecting the lesbian, gay,
bisexual, transgender, and queer (LGBTQ) community, provides free legal
assistance to LGBTQ people and their advocates, and conducts community
education on LGBTQ issues. NCLR has been advancing the civil and human
rights of LGBTQ people and their families across the United States
through litigation, legislation, policy, and public education since its
founding in 1977.
While NCLR is a national organization, our headquarters and roots are
in San Francisco. In addition to our advocacy work at the federal
level, we also engage in legal and policy work within California, and
thus have extensive familiarity with Attorney General Becerra's track
record. The nation would be fortunate to have Mr. Becerra in a
leadership role at this unprecedented time, when addressing systemic
injustices and a global pandemic will be at the top of the agenda for
the new HHS secretary.
Attorney General Becerra is a longstanding friend and ally to the LGBTQ
community, including back when it was far less socially and politically
popular to take such a position. During his congressional tenure he
voted for marriage equality, against discrimination in military
service, and for inclusion of LGBTQ people in hate crimes laws. His
commitment to equality continued when he became California's attorney
general, and we were honored to join forces with his office in
litigating against former President Trump's unlawful ban on transgender
persons serving in the military.
No less important is Mr. Becerra's staunch defense of access to the
full range of reproductive health care, including contraception and
abortion. As someone with a deep commitment to health care access, he
understands that this includes reproductive health care. Mr. Becerra
helped to bring the Affordable Care Act into being and has been at the
forefront of defending it from legal attack. He has also worked to
protect the rights of immigrants and their families, people with
disabilities, and so many more.
Xavier Becerra is the leader we need right now to helm the Department
of Health and Human Services as we navigate out of the pandemic and
toward a more just and equitable future for all in this nation. We urge
the Senate to move quickly on his confirmation.
Should you have any questions regarding this letter, please do not
hesitate to contact me at [email protected].
Sincerely,
Julianna S. Gonen, Ph.D., JD
Policy Director
______
National Coalition Against Domestic Violence
1140 3rd St., NE, 2nd floor
Washington, DC 20002
202-714-7662
www.ncadv.org
February 12, 2021
U.S. Senate
Committee on Health, Education, Labor, and Pensions
U.S. Senate
Committee on Finance
Dirksen Senate Office Building
Washington, DC 20510
Dear Chairwoman Murray, Chairman Wyden, Ranking Member Burr, Ranking
Member Crapo, and Committee Members:
The National Coalition Against Domestic Violence (NCADV) writes to you
to urge you to confirm California Attorney General Xavier Becerra
(Becerra) to be the Secretary of the Department of Health and Human
Services (HHS). NCADV is the nation's oldest national grassroots
domestic violence organization, representing domestic violence programs
and survivors directly. Established in 1978, mission is to lead,
mobilize and raise our voices to support efforts that demand a change
of conditions that lead to domestic violence such as patriarchy,
privilege, racism, sexism, and classism. We are dedicated to supporting
survivors and holding offenders accountable and supporting advocates.
NCADV envisions a national culture in which we are all safe, empowered
and free from domestic violence, and Becerra's record proves that he
will promote such a culture as Secretary of HHS. Domestic violence
impacts every person in America. With one in four women and one in ten
men experiencing intimate partner violence,\1\ everyone is acquainted
with someone who has experienced violence--whether they know it or not.
Black and Native women experience the highest rates of intimate partner
violence,\2\ and they systems that ought to protect them are often
actively hostile. White supremacy is a feature of all of these systems.
Women who are financially unstable, and who may rely on government
assistance such as that overseen by HHS, are also particularly
vulnerable to intimate partner violence--or are financially unstable as
a result of the violence they experienced.
---------------------------------------------------------------------------
\1\ Smith, S.G., Zhang, X., Basile, K.C., Merrick, M.T., Wang, J.,
Kresnow, M., and Chen, J. (2018). ``The National Intimate Partner and
Sexual Violence Survey: 2015 Data Brief--Updated Release.'' Atlanta:
National Center for Injury Prevention and Control, Centers for Disease
Control and Prevention. Retrieved from https://www.cdc.gov/
violenceprevention/pdf/2015data-brief508.pdf.
\2\ Smith, S.G., Chen, J., Basile, K.C., Gilbert, L.K., Merrick,
M.T., Patel, N., Walling, M., and Jain, A. (2017). ``The National
Intimate Partner and Sexual Violence Survey (NISVS): 2010-2012 State
Report.'' Atlanta: National Center for Injury Prevention and Control,
Centers for Disease Control and Prevention. Retrieved from https://
www.cdc.gov/violenceprevention/pdf/NISVS-StateReportBook.pdf.
Programs within HHS are a literal lifeline for countless survivors. The
Family Violence Prevention and Services Act (FVPSA) is the only
dedicated funding source for domestic violence programs and is housed
in HHS. Survivors rely on a host of other HHS programs, including
programs that are necessary for them to rebuild their financial
stability after leaving an abusive relationship such as Temporary
Assistance to Needy Families and childcare assistance. HHS programs are
integral to the health and well-being of survivors. With experience
both as a legislator in the United States House of Representatives and
as an executive as the Attorney General of California, Becerra is
---------------------------------------------------------------------------
uniquely qualified to lead the agency.
Intimate partner violence is nothing short of a public health crisis,
and the domestic violence epidemic is only exacerbated by the COVID-19
pandemic, as survivors face added barriers to leaving abusive
relationships, including the potential of losing healthcare coverage.
Becerra has a proven record of fighting for access to healthcare for
all Americans. This includes leading the legal campaign to prevent the
Affordable Care Act from being dismantled, thereby protecting millions
of survivors' access to healthcare.
In both elected and appointed positions, he has been a champion for
women and for lower-income families. In 2020, he said, ``There is no
place for violence against women anywhere.''\3\ We agree with him, and
we know that he will continue to be a champion for survivors as
Secretary.
---------------------------------------------------------------------------
\3\ State of California Department of Justice (2020, May 4).
``Attorney General Becerra Urges Congress to Renew Protections Under
the Violence Against Women Act'' [Press release]. https://oag.ca.gov/
news/press-releases/attorney-general-becerra-urges-congress-renew-
protections-under-violence-against.
Thus, we urge the Senate Committee on Health, Education, Labor, and
Pensions and the Senate Committee on Finance to expeditiously confirm
Attorney General Becerra to be the Secretary of the Department of
---------------------------------------------------------------------------
Health and Human Services.
Sincerely,
The National Coalition Against Domestic Violence
______
National Committee to Preserve Social Security and Medicare
111 K Street, NE, Suite 700
Washington, DC 20002
202-216-0420
https://www.ncpssm.org/
February 22, 2021
U.S. Senate
Committee on Finance
Washington, DC 20510
Dear Senators:
It is with great pleasure that I write to endorse the nomination of
Xavier Becerra to lead the U.S. Department of Health and Human
Services.
Throughout his long and distinguished career in public service, Mr.
Becerra has demonstrated his capabilities in the health care arena,
from taking on a corporate health care giant that illegally drove up
prices, to helping secure passage of the Affordable Care Act and later
defending it in court. He knows the plight of Americans who lack access
to affordable health care coverage and understands the government's
fundamental responsibility overseeing the financing and delivery of
services through large, federal agencies.
Mr. Becerra's deep background in health care policy and human services
programs, his knowledge of underserved and vulnerable populations, his
commitment to fiscal responsibility for both taxpayers and the
government, combined with his leadership skills and willingness to
listen to all stakeholders makes him the ideal Secretary to oversee
HHS.
Attorney General Becerra's experience as a legislator and executive
leaves little room for doubt about his ability to help the Biden
Administration successfully guide this nation out of the COVID pandemic
and into a stronger era of health and human services delivery for all
Americans.
Sincerely,
Max Richtman
President and CEO
______
National Council on Aging
251 18th Street South, Suite 500
Arlington, VA 22202
Phone 571-527-3900
Fax: 571-527-3901
ncoa.org
February 18, 2021
The Honorable Patty Murray The Honorable Richard Burr
Chair Ranking Member
U.S. Senate U.S. Senate
Committee on Health, Education,
Labor, and Pensions Committee on Health, Education,
Labor, and Pensions
Washington, DC 20510 Washington, DC 20510
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
United States Senate United States Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
Dear Chair Murray, Ranking Member Burr, Chairman Wyden, and Ranking
Member Crapo:
I am writing to express support from the National Council on Aging
(NCOA) for the nomination of California Attorney General Xavier Becerra
as the next Secretary of the U.S. Department of Health and Human
Services (HHS).
NCOA is a trusted national leader working to ensure that every person
can age well. Since 1950, our mission has not changed: Improve the
lives of millions of older adults, especially those who are struggling.
NCOA empowers people with the best solutions to improve their own
health and economic security--and we strengthen government programs
that we all depend on as we age.
Attorney General Becerra has been a longstanding champion for
affordable health coverage and access, particularly for Americans in
greatest need. He has deep knowledge and passion for improving health
care for patients and consumers, not powerful special interests.
As a 12-term member of Congress and a member of the House Ways and
Means Committee's Health Subcommittee, Becerra demonstrated his
expertise on a broad range of critical health care issues facing our
nation. While playing a leadership role in providing health coverage to
millions of uninsured and underinsured Americans under the Affordable
Care Act and championing improvements to women's health, he also
authored Medicare proposals focused on improving care for beneficiaries
in need, including those that would:
Increase access to physical therapy by repealing arbitrary
limits on Medicare coverage for outpatient rehabilitation therapy;
Expand Medicare coverage of medical nutrition services; and
Strengthen low-income Medicare beneficiary protections and
assistance.
NCOA had the privilege of working closely with then-Rep. Becerra and
his staff on legislation he introduced in 2007 and 2009 to make health
care more affordable for low-income Medicare beneficiaries whose fixed
incomes made it difficult to afford rising health care costs. His
Medicare Savings Program Improvement Act would have made it easier to
meet stringent asset test eligibility requirements. These restrictions
continue to unfairly penalize low-income older adults who did the right
thing during their working years by putting away a modest nest egg of
savings, thereby disqualifying them from receiving the help they need.
Becerra also recognized the need to improve protections against
increasing copayments and deductibles only available for low-income
older Americans with annual incomes below 100% of poverty ($12,880 in
current dollars).
More recently, as Attorney General of the largest state in the nation
and managing 4,800 employees, Becerra has continued to be deeply
involved in crafting health policies that benefit consumers, including:
Taking action to make hospital care more affordable and increase
transparency and competition by addressing monopolistic practices that
drive up prices and exploit market power for profit;
Reducing prescription drug costs by addressing anti-competitive
pay-for-delay agreements, through which brand name drug companies have
been able to delay the entrance of less expensive generics into the
market; and
Leading a multistate coalition to fight against the Trump
Administration's ``Healthcare Refusal Rule,'' which would
disproportionately impact communities of color, LGBTQ+ communities, and
women seeking health care services by allowing medical staff to refuse
life-saving care to patients based on personal objection.
Attorney General Becerra's knowledge and experience will help our
nation to effectively address our current public health crisis.
Becerra's degrees in economics and law from Stanford University have
helped provide him with an in-depth understanding of health care
financing issues and how complex health laws and regulations impact
those in need.
His skills and experience in working with Congress cannot be
underestimated. There is much that must and can be done to improve our
flawed health care system, such as promoting equity, addressing health
disparities, and overcoming barriers to care. His understanding of what
can and cannot be done, and how to combine good policy and good
politics are desperately needed to effectively address these serious
challenges.
Finally, his appointment would be historic. A former chair of the
Congressional Hispanic Caucus, Becerra was the first Latinx person to
serve as a member of the powerful Committee on Ways and Means and would
be the first to serve as Secretary of HHS.
Attorney General Becerra is highly qualified to lead America's efforts
to improve our flawed health care system for Americans of all ages.
NCOA strongly urges members of the Senate Finance Committee to vote in
favor of and for the Senate to promptly confirm his nomination.
Sincerely,
Ramsey Alwin
President and CEO
______
National Council of Jewish Women
2055 L St., NW, Suite 650
Washington, DC 20036
T: 202-296-2588
https://www.ncjw.org/
February 19, 2021
U.S. Senate
Committee on Health, Education, Labor, and Pensions
U.S. Senate
Committee on Finance
Dirksen Senate Office Building
Washington DC, 20510
Dear Chairwoman Murray, Chairman Wyden, Ranking Member Burr, Ranking
Member Crapo, and Committee Members:
On behalf of the 180,000 advocates of National Council of Jewish Women
(NCJW), I write to express our strong support for the nomination of
Xavier Becerra to serve as Secretary of the US Department of Health and
Human Services (HHS). As a national grassroots organization fighting
for social justice on behalf of women, children, and families, we know
that Attorney General Becerra would be a champion for essential health
care access and coverage at a time when we need it most.
Throughout his career, Attorney General Becerra has been a vocal
supporter of women's health in particular. While in the US House of
Representatives, Attorney General Becerra supported the Affordable Care
Act (ACA) and the Lilly Ledbetter Fair Pay Act of 2019, among other
important bills impacting reproductive and economic justice. He also
opposed the racist and discriminatory Prenatal Nondiscrimination Act,
which would have imposed civil and criminal penalties on anyone
knowingly attempting to perform a sex-selective abortion.
As California's top law enforcement official, Attorney General Becerra
has prioritized the needs of domestic violence and sexual assault
survivors experiencing even greater isolation during the pandemic. He
has also helped to lead legal fights across the nation, championing
access to health care and dismantling barriers for women struggling to
get medical services. Whether leading 20 states and the District of
Columbia in an effort to protect the ACA, ensuring that everyone can
receive birth control at no cost, or blocking the murder prosecution of
a woman whose consumption of methamphetamine during pregnancy
tragically resulted in stillbirth, Attorney General Becerra has
demonstrated his commitment to protecting our critical rights.
The Secretary of HHS certainly does not have an easy job, particularly
as this nation faces a once-in-a-century pandemic. Fortunately,
Attorney General Becerra's depth and breadth of experience more than
prepare him to lead this agency and fulfill its mission ``to enhance
the health and well-being of all Americans.'' As Becerra has noted, the
ACA ``has been life-changing and now through this pandemic, we can all
see the value in having greater access to quality health care at
affordable prices.'' Becerra's words and actions gives us confidence
that he shares our values. We trust that he will not only tackle COVID-
19, but will also restore and strengthen our health care system to meet
the many and disparate needs at this moment in time and in the future.
As Jews, we believe in the ultimate moral imperative to protect every
single person's health, the obligation to care for our bodies and to
ensure others can do the same through access to quality care. We
believe in compassion and dignity for all and are committed to ensuring
equity and justice for the most marginalized members of our society.
Xavier Becerra shares these values and NCJW urges his swift
confirmation as Secretary of Health and Human Services.
Please reach out to me by email ([email protected]) if you have any
questions.
Sincerely,
Jody Rabhan
Chief Policy Officer
______
National Health Law Program
1444 I Street, NW, Suite 1105
Washington, DC 20005
(202) 289-7661
https://healthlaw.org/
February 22, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
The Honorable Patty Murray The Honorable Richard Burr
Chair Ranking Member
U.S. Senate U.S. Senate
Committee on Health, Education,
Labor, and Pensions Committee on Health, Education,
Labor, and Pensions
Washington DC 20510 Washington, DC 20510
Dear Chairman Wyden, Ranking Member Crapo, Chair Murray, and Ranking
Member Burr,
On behalf of the National Health Law Program, we write to encourage you
to support Xavier Becerra's confirmation as the next Secretary of the
United States Department of Health and Human Services (HHS). As long-
time advocates for the health rights of low-income individuals and
families, we know that Attorney General Becerra has the skills, drive,
and empathy to guide HHS.
Attorney General Becerra has taken on threats to health care with
vision and boldness, both as a Member of Congress and as Attorney
General of California. Throughout his career, he has championed access
to health care for those who need it most: low-income individuals and
families; Black, Indigenous, and people of color (BIPOC); people with
disabilities; children; women; immigrants; members of the LGBTQ-GNC
community; people with limited-English proficiency; and those at the
intersections of multiple identities. AG Becerra possesses both a keen
understanding of the law and a deep recognition of the challenges faced
by everyday people. While a Member of Congress, AG Becerra sponsored
and supported the Affordable Care Act. As Attorney General of
California, he has led the fight against the latest effort to have the
federal courts strike down the law. He has worked to block federal
regulations and policies that encourage discrimination in health care
delivery--especially against women, LGBTQ-GNC individuals, and those
seeking reproductive health care.
The challenges facing this nation are multifold, both acute and long-
simmering. The pandemic has exposed flagrant flaws in our health care
system and painfully revealed America's entrenched health inequities.
President Biden was wise to nominate Xavier Becerra to be his
lieutenant in addressing them. There is much work to do, and we are
confident that AG Becerra will face those challenges with
thoughtfulness and fearless energy. As an organization with deep roots
in California, we will miss his leadership in Sacramento, but we look
forward to working with him in this new capacity. We encourage the
Senate to confirm his nomination swiftly and resolutely.
If you have any questions, please contact Kim Lewis
([email protected]) or Mara Youdelman, Managing Attorney (Washington,
DC) ([email protected]).
Sincerely,
Elizabeth G. Taylor
Executive Director
Kim Lewis
Managing Attorney, California
______
National Mobility Equipment Dealers Association
3327 W. Bearss Ave.
Tampa, FL 33618
813-264-2697
www.nmeda.org
February 2, 2021
To Whom It May Concern:
The National Mobility Equipment Dealers Association (NMEDA) submits
this statement in support of Xavier Becerra's nomination for Secretary
of the U.S. Department of Health and Human Services. During his tenure
in the House of Representatives, Congressman Becerra demonstrated a
thorough understanding of federal programs that support the aging and
disability communities--most notably the Social Security Disability
Insurance, Medicare, and Medicaid programs--and made significant and
meaningful contributions to disability-related policies. NMEDA is
confident that Mr. Becerra's leadership will advance and strengthen
HHS's commitment to the empowerment, integration, independence, and
health and well-being of American seniors and people with disabilities.
Respectfully Submitted,
Danny Langfield
Chief Executive Officer
______
National Organization for Rare Disorders
1779 Massachusetts Avenue, NW, Suite 500
Washington, DC 20036
T 202-588-5700
F 202-588-5701
https://rarediseases.org/
February 11, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
219 Dirksen Senate Office Building 219 Dirksen Senate Office Building
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden, Ranking Member Crapo, and Members of the Senate
Finance Committee,
The National Organization for Rare Disorders (NORD) writes to express
our support for the nomination of Xavier Becerra as the next Secretary
of the Department of Health and Human Services (HHS). NORD is a unique
federation of over 325 voluntary health organizations dedicated to
helping the 25-30 million Americans living with a rare disease. NORD is
committed to the identification, treatment, and cure of rare disorders
through programs of education, advocacy, research, and patient
services. We believe that all patients should have access to quality,
accessible, and affordable health coverage that is best suited to their
medical needs.
Attorney General Becerra has spent a career in both Washington and
California advancing policies that have improved access to affordable
and comprehensive health care. As a member of Congress for more than 20
years, Representative Becerra served on the House Ways and Means
Committee, where he focused on strengthening the programs that patients
with rare diseases depend on and played an integral role in the passage
of the Affordable Care Act (ACA). Mr. Becerra has continued to act has
a champion for patients as Attorney General of California, spearheading
efforts to safeguard the patient protections enshrined within the ACA,
including leading a coalition of 17 states to defend the law before the
Supreme Court. We are confident that his experience will enable to him
to effectively lead HHS and support the implementation of policies that
can help address pressing health needs of the rare disease community.
Should Attorney General Becerra be confirmed, he will be tasked with
addressing many of our nation's most urgent health challenges. Over the
past several years, many essential guardrails that protect patients and
their families have been eroded while insurance practices that
disproportionately discriminate against patients with pre-existing
conditions have proliferated. Upon confirmation, Attorney General
Becerra and the Department must take immediate steps to restore
protections and resources that help patients get high-quality insurance
coverage that meets their needs. In addition, we hope Attorney General
Becerra will strengthen the vital Medicaid and Medicare programs upon
which so many in the rare disease community rely. Medicaid, in
particular, is an invaluable safety net for rare disease patients who
often find their financial lives upended by the debilitating nature of
their diseases, but its core objective of serving the health and
wellness needs of its beneficiaries has been undermined in recent years
through federal government approval of several harmful Section 1115
waivers. NORD looks forward to working with HHS to reinforce the
objectives of the Medicaid program and continue to develop new and
innovative payment models to reward the delivery of high-quality care
to patients.
This nomination is occurring during an unprecedented national public
health crisis. The devastating impact of COVID-19 means that it is more
important than ever that the Department of Health and Human Services
has strong and continuous leadership. In addition to overseeing the
distribution of vaccines for COVID-19 and coordinating our public
health agencies, as Secretary, Attorney General Becerra must address
the systemic racism and pervasive inequality within our health care
system that has only been exacerbated by this crisis. The COVID-19
pandemic has been particularly challenging for the rare disease
community, as many rare disease patients are immune-compromised,
putting them at high risk of infection and serious illness. Our
community cannot afford for there to be any interruption in the
operations of the Department during this pandemic.
NORD believes that Attorney General Becerra's lifetime of public
service and commitment to patients with pre-existing conditions makes
him the right candidate for this role. We look forward to working
alongside Attorney General Becerra to ensure that health care is
accessible, comprehensive, and affordable for patients with rare
disorders. We urge this committee to take swift action to advance Mr.
Becerra's nomination before the full Senate so that the critical work
of the Department may proceed without any delay. For questions
regarding NORD or our support, please contact Rachel Sher, Vice
President of Policy and Regulatory Affairs, at [email protected],
or 202-588-5700.
Sincerely,
Peter L. Saltonstall
President and Chief Executive Officer
______
National Organization of Social Security
Claimants' Representatives
January 21, 2021
The Honorable Ron Wyden The Honorable Michael Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
Dear Senators Wyden and Crapo:
The National Organization of Social Security Claimants' Representatives
(NOSSCR) strongly supports the nomination of Xavier Becerra to be
Secretary of the Department of Health and Human Services (DHHS). NOSSCR
is a specialized bar association for attorneys and advocates who
represent Social Security Disability Insurance (SSDI) and Supplemental
Security Income (SSI) claimants throughout the adjudication process and
in federal court. Founded in 1979, NOSSCR is a national organization
with a current membership of over 2,500 members from the private and
nonprofit sectors and is committed to the highest quality
representation for claimants and beneficiaries. NOSSCR's mission is to
advocate for improvements in Social Security disability programs and to
ensure that individuals with disabilities applying for SSDI and SSI
benefits have access to highly qualified representation and receive
fair decisions.
As both Ranking Member and as a member of the House of Representative's
Ways and Means Social Security Subcommittee, Attorney General Becerra
championed important pieces of legislation affecting the lives of
millions of beneficiaries of Social Security Disability, SSI, Medicare
and Medicaid. NOSSCR awarded then Congressman Becerra our ``Award for
Excellence in Social Security Disability Advocacy.'' Attorney General
Becerra understands beneficiaries' needs and the interaction between
Social Security benefits, Medicare and Medicaid health insurance, and
an individual's overall well-being.
As both California's Attorney General and as a former twelve-term
Member of the House of Representatives, Attorney General Becerra will
be ready to lead the DHHS on day one. Attorney General Becerra's
experience and leadership will help the nation turn the corner on the
COVID-19 epidemic while protecting and enhancing our nation's SSI and
SSDI programs. NOSSCR enthusiastically supports Attorney General
Becerra's nomination and calls for the Senate Finance Committee to move
his confirmation forward without delay.
Sincerely,
Barbara Silverstone
Executive Director
______
National Resource Center on Domestic Violence
6041 Linglestown Road
Harrisburg, PA 17112
Ph: 800-537-2238
Fax: 717-545-9456
February 12, 2021
U.S. Senate
Committee on Finance
U.S. Senate
Committee on Health, Education, Labor, and Pensions
Dirksen Senate Office Building
Washington, DC 20510
Dear Chairman Wyden, Ranking Member Crapo, Chairwoman Murray, Ranking
Member Crapo, and Ranking Member Burr:
On behalf of the National Resource Center on Domestic Violence (NRCDV),
I write today in support of the nomination of Xavier Becerra to lead
the Department of Health and Human Services (HHS). His diverse
experience on and around the issues affecting domestic violence
survivors makes him uniquely qualified to become the Secretary of HHS
during this critical time.
The NRCDV has worked, for the past 25 years, to strengthen the capacity
of programs responding to domestic violence victims and their families
by promoting effective public policy, institutional response and
research, and engagement in prevention. Today NRCDV works with many
other organizations and partners who bring various expertise,
backgrounds, and perspectives, to improve community response to
domestic violence and, ultimately, prevent its occurrence. We are part
of a network of domestic violence programs that work collaboratively to
promote practices and strategies to improve our nation's response to
domestic violence and make safety and justice for all families a
priority.
We believe that Domestic violence impacts all areas of the lives of
survivors and their children and the systems they access for help can
either support or cause further harm. A holistic approach to domestic
violence is needed to ensure the safety and well-being of survivors and
their families. This is especially critical as the United States
grapples with the COVID-19 pandemic. The inequities in our nation are
inescapable as Black, Latino, Asian and Native American communities
bear the brunt of the pandemic's economic and health damages. Through
all this, women, broadly, and survivors and their families are more
severely affected. The devastation of this moment compels us to
reimagine what kind of America we want to become after the pandemic--
one that is more equitable for all people.
The Department of Health and Human Services (HHS) is the agency in the
Federal executive branch most involved with the Nation's human
concerns. In one way or another, it touches the lives of more Americans
than any other Federal agency. It is a department of people serving
people, from newborn infants to persons requiring health services to
our most elderly citizens. It is the agency that addresses the health
and well-being of Americans and within that addresses the issues of
Family Violence. HHS is the agency best positioned to advancing a more
holistic and equitable approach to Domestic Violence. It is more
important than ever that this department be comprised of leaders
committed to ending violence against women, addressing white supremacy
and advancing racial equity. As such, there is no better candidate to
lead the Department of Health and Human Services than Xavier Becerra.
Xavier Becerra is a deeply qualified and passionate leader with a depth
and breadth of experience that spans three decades of working to
address violence against women and support survivors, ensure access to
healthcare, protect Social Security, and Medicare. In May of 2020 as
California Attorney General, Xavier Becerra called for the
reauthorization of the Violence Against Women Act stating that
``[t]here's no place for violence against women anywhere.'' At the
California Department of Justice, Becerra ensured that they were doing
their part to support survivors of domestic and sexual violence and
prevent and respond to crimes against women.'' During COVID-19,
Attorney General Becerra stayed focused on the needs of survivors and
worked to ensure that they had access to critical services during
state-wide stay-at-home orders.
Xavier Becerra has been at the forefront of legal efforts to protect
the Affordable Care Act and a vocal advocate for women's health.
Through appointed and elected office Xavier Becerra worked to combat
poverty among working families, and as a legal services lawyer Becerra
fought for the rights of people with mental health disabilities. At a
time where the US is facing so many challenges, we have a nominee with
a vast array of experience which positions Xavier Becerra to be the
best suited leader. His legal background and efforts with his expansive
understanding of health and welfare issues is the perfect mix of
experience to meet the needs of an agency that touches the greatest
number of lives.
We urge the Senate Committees on Health, Education, Labor and Pensions
and Finance swiftly confirm Xavier Becerra as Secretary of the
Department of Health and Human Services.
Sincerely,
Farzana Q. Safiullah
Chief Executive Officer
______
Oglala Sioux Tribe
P.O. Box 2070
Pine Ridge, SD 57770
Direct: 605-867-8487
Fax: 605-867-6076
Office of the President
Kevin Killer
January 28, 2021
The Honorable John Thune
U.S. Senate
511 Dirksen Senate Office Building
Washington, DC 20510
Re: Support for Xavier Becerra to be Secretary of the Department of
Health and Human Services
Dear Senator Thune:
On behalf of the Oglala Sioux Tribe I write in support of the
confirmation of California Attorney General Xavier Becerra as Secretary
of the Department of Health and Human Services (HHS).
The Oglala Sioux Tribe is a part of the Oceti Sakowin (Seven
Council Fires, known as the Great Sioux Nation) and a signatory to the
Treaty with the Teton of 1815, 7 Stat. 125 (July 19, 1815), the Treaty
of Fort Laramie of 1851, 1 Stat. 749 (September 17, 1851), and the
Treaty of Fort Laramie of 1868, 15 Stat. 635 (April 29, 1868). The
Tribe is one of the largest land-based tribes in the United States. Our
Tribe's Pine Ridge Indian Reservation is comprised of 3,155,200 acres
of land in southwestern South Dakota, roughly the size of Connecticut.
Our Reservation, however, is extremely rural and remote, and we are in
need of adequate housing, economic development, job opportunities,
community development and infrastructure, and quality health care. It
is critical that nominees to cabinet positions fully understand the
challenges facing our people and Indian Country as a whole.
Mr. Becerra has a long track record of supporting tribal
sovereignty, honoring treaties, and supporting improved health for
American Indians and Alaska Natives (AI/ANs). We believe that as HHS
Secretary, he will advance the health of all Americans, including
indigenous peoples and adeptly serve the health needs of the nation.
HHS has many programs that are responsible for fulfilling the trust
responsibility toward tribal nations. As you know, Indian Health
Service (IHS) is housed at HHS, which has the primary responsibility
for providing health care to AI/ANs. However, IHS is not the only
agency at HHS serving tribal communities. Virtually all HHS operating
divisions including the Centers for Disease Control and Prevention;
Centers for Medicare and Medicaid Services; the Substance Abuse and
Mental Health Services Administration and the Health Resources and
Services Administration all have important roles to play in ensuring
that AI/ANs are included fairly and treated as sovereign nations in any
action by the Department.
Our IHS Pine Ridge Service Unit is notoriously underfunded and
understaffed. This is alarming and anxiety-producing under normal
conditions. In a pandemic, it is downright terrifying. We have a
desperate need for: health care professionals; health care facility
administrators and office workers; emergency medical services (EMS)
(ambulance) personnel and equipment; hospital and health clinic
equipment, including personal protective equipment (PPE) and
ventilators. Having a capable Secretary who fully understands these
challenges and these needs will be crucial in this Administration. We
believe that Mr. Becerra's decades long experience as a policy maker
will mean that he can bring creative solutions to addressing some of
these complex issues for our health system.
During his tenure as Attorney General of California, Mr. Becerra
led a 20 state coalition to defend the Affordable Care Act (ACA) in
Texas v. U.S. Overturning the ACA in the courts would not only create
chaos for America's health system, but could have disastrous impacts
for Indian Country as well. As you are aware, the Indian Health Care
Improvement Act was permanently reauthorized as part of the ACA, and
overturning the law would likely create serious uncertainty for the
Indian health system and undo over a decade of process for AI/AN
health. There are also other critical protections and benefits for AI/
ANs in the ACA outside of the IHCIA. His leadership in protecting this
important law will be critical as HHS looks to undertake a new era of
health policy making.
As Attorney General of California, Mr. Becerra demonstrated his
support for tribal nations. He led a bipartisan coalition of 27
attorneys general in filing an amicus brief to defend the Indian Child
Welfare Act in Brackeen v. Bernhardt. In filing this brief, he said,
``we are proud to lead the way in defending the rights of Native
American children and families.'' His leadership on this issue clearly
reveals his belief in strong tribal nations, and we are confident that
as HHS Secretary he will continue to uphold laws passed by Congress
which are critical to tribal nations and AI/AN people.
Mr. Becerra also had a strong record of supporting tribal
communities during his tenure in Congress. He signed on to legislation
that would renew the Special Diabetes Program for Indians, the Violence
Against Women Act, and other legislation supporting tribes. As a member
of the Ways and Means Committee, he was the lead sponsor on bipartisan
legislation \1\ to exclude from gross income certain medical care or
benefits provided to American Indians, clearly demonstrating his
leadership on tribal sovereignty and the federal trust responsibility
for health.
---------------------------------------------------------------------------
\1\ 111th Congress--H.R. 3608, Tribal Health Benefits Clarification
Act.
Mr. Becerra has had a decades-long career where he has demonstrated
his commitment to upholding tribal sovereignty and the treaty and trust
responsibility for AI/AN health. His Tweet from November 30, 2020
summarizes it well: ``The California Department of Justice is committed
to supporting tribal sovereignty, preserving Native American culture,
and fighting to improve the health, safety and welfare of our Native
American brothers and sisters.'' Should he be confirmed as HHS
Secretary, we believe that he will carry this commitment forward at the
---------------------------------------------------------------------------
Department.
We respectfully request that you vote to confirm to Mr. Xavier
Becerra for the position of Secretary of HHS in the Biden
Administration. We believe that he would serve as an excellent partner
with Indian Country and work tirelessly to fulfill the federal trust
responsibility for health, and it is our hope that you feel the same.
Sincerely,
Kevin Killer
President
______
Oregon Primary Care Association
335 SW 5th Ave., Suite 200
Portland OR 97204
503-228-8852 office
503-228-9887 fax
www.orpca.org
February 5, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
United States Senate United States Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
Re: Xavier Becerra's Nomination for Secretary of Health and Human
Services (HHS)--Support
Dear Chairman Wyden and Ranking Member Crapo,
On behalf of the Oregon Primary Care Association (OPCA)--representing
Oregon's 33 community health centers (CHCs) who serve over 466,00
Oregonians, I am writing to express our strong support of Xavier
Becerra's nomination for Secretary of Health and Human Services (HHS).
Our trusted colleagues to the south, at the California Primary Care
Association, speak highly of Secretary-designate Becerra and his
ability to lead HHS at this crucial time.
COVID-19 has reinforced the structural discrimination and racism within
our society, and CHCs have witnessed this uneven impact of COVID-19 on
their racial and ethnic minorities, homeless, and farm worker patients.
Xavier Becerra is uniquely positioned to bring the tailored approach
and leadership that is needed to support all Americans through this
unprecedented public health emergency and guarantee a stronger health
care delivery system when it is over.
With the Biden Administration refocusing the federal government's
COVID-19 response and building a new vaccination infrastructure that is
centered in community health centers, Becerra comes well prepared to
see that vision forward. As congressman, Secretary-designate Becerra
represented a district that has 30 health centers with 57 sites. The
Secretary-designee's experience with health centers in his
congressional district (where over one quarter of the population of his
former district accessed care at a health center) will be important as
he transitions to a national position. Nationally, and in Oregon,
health centers serve almost 10% of the population (9% of Oregonians
access care at a health center).
Secretary-designate Becerra has always been a strong supporter of
health centers. He attended events at health centers in his former
congressional district and hosted regular policy roundtables for health
center leaders. More importantly, he fought for programs and funding
helpful to health centers through his position as a senior member of
the House Ways and Means Committee. He has also been involved in the
important discussions about the federal government's role in ensuring
coverage for all.
As COVID-19 continues to ravage our country, with a disproportionate
impact on historically marginalized communities and communities of
color, it is imperative that Secretary-designate Becerra be confirmed
and on-the-job quickly. For these reasons, we respectfully request the
swift confirmation of Secretary-designate Becerra as Secretary of
Health and Human Services.
Thank you for your quick consideration of his nomination.
Sincerely,
Joan Watson-Patko
Executive Director
______
Patients Rising
February 17, 2021
The Honorable Charles Schumer The Honorable Mitch McConnell
Majority Leader Minority Leader
U.S. Senate U.S. Senate
322 Hart Senate Office Building 317 Russell Senate Office Building
Washington, DC 20510 Washington, DC 20510
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
219 Dirksen Senate Office Building 219 Dirksen Senate Office Building
Washington, DC 20510 Washington, DC 20510
Dear Leader Schumer, Leader McConnell, Chairman Wyden and Ranking
Member Crapo:
On behalf of Patients Rising, the organization representing the voice
of millions of Americans living with chronic illness, I write to raise
awareness of our priorities during the Congressional hearings on the
nomination of Xavier Becerra to serve as Secretary of Health and Human
Services.
Patients Rising is a 100,000 member-organization of patients and
caregivers living with chronic illness. We work with patients to
advocate for access to the treatments, innovations and care they need.
Our numerous patient programs and initiatives, including Patients
Rising Concierge, Patients Rising University, Voices of Value, and
Patients Rising NOW, educate patients about the legislative process and
empower them to advocate for reforms to advance patient access,
affordability, and transparency in healthcare.
The U.S. Department of Health and Human Services oversees the health
and well-being of Americans. Together, with patients and the federal
government, we share the agency's objective to advance sound, sustained
advances in the sciences underlying medicine, public health, and social
services. Our organization has engaged with HHS in the past to inform
them of the impact of healthcare policies on Americans with chronic
disease. These include our concern around their copay accumulator and
six protected classes policies, as well as our enthusiastic support of
the transparency rule.
For Patients Rising, our pro-patient agenda addresses critical
priorities to work with the Department of HHS and Congress. The
Secretary-designate should work to get patients out of the middle of
the drug price wars.
Patients Rising supports a nominee who will empower patients and their
families by:
Addressing the root causes of financial toxicity that harm
patients by bringing the issue of poor benefit design and not just the
costs themselves to the healthcare finance conversation.
Allow for and provide additional financial tools and options for
patients to make their healthcare dollars stretch further.
Strengthen the Essential Health Benefits and hold health plans
accountable for covering a broad range of therapies and treatments with
nominal out-of-pocket cost to patients.
Give patients more control by making a variety of health plans
available to them, including a public option.
Patients Rising supports a nominee who will support the advancement of
medical innovation by:
To speed up development and approvals of new medicines, empower
regulators at the FDA to more rapidly incorporate advances in
regulatory science, such as biomarkers, patient-reported outcomes, real
world data, and simultaneous review.
Develop pathways for the FDA and states to approve access to new
therapies.
Eliminate the Most Favored Nations rule, which threatens access
to lifesaving medications for Medicare Part B patients and does little
to lower the overall cost of drugs for a majority of Americans.
Patients Rising supports a nominee who truly wants to reform healthcare
finance in the interest of patients and their families:
Ensure states have the tools and flexibilities to offer a range
of health insurance products to meet the coverage needs of their
residents.
Ensure that plans regulated under ERISA cannot avoid compliance
with state-based regulations.
Establish a healthcare finance and payment model that rewards
improvements in the long-term care of patients.
Stop incorporating flawed coverage recommendations based on
inappropriate measurements--including the use of Quality Adjusted Life
Year (QALY).
Patients Rising is engaged on all issues impacting patients with
chronic disease and looks forward to working with the Department of HHS
and the Committee on these issues during the 117th Congress. If you
have any questions, please do not hesitate to reach out to me at
[email protected] or at 202-750-4331.
Sincerely,
Terry Wilcox
Executive Director, Patients Rising and Patients Rising Now
______
People's Action
Chicago, IL | Washington, DC
www.peoplesaction.org
February 19, 2021
The Honorable Charles Schumer The Honorable Mitch McConnell
Majority Leader Minority Leader
U.S. Senate U.S. Senate
Washington, DC 20510 Washington, DC 20510
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
Dear Majority Leader Schumer, Minority Leader McConnell, Chairman and
Ranking Member of the Senate Finance Committee, Senator Wyden and
Senator Crapo,
We the undersigned organizations representing millions of members and
supporters write to express our enthusiastic support for an urgent and
historic confirmation of Attorney General Xavier Becerra as Secretary
of the Department of Health and Human Services. In the midst of a
global pandemic following the deadliest year in U.S. history, we call
on the U.S. Senate Finance committeeto advance the confirmation of
Attorney General Becerra to the full Senate for confirmation without
hesitation. The people of the United States need AG Becerra, an
outstanding leader, at the helm of the Department of Health and Human
Services immediately.
As a 12 term Congressman and current California State Attorney General,
Becerra has been a champion of expanding healthcare to more people,
eliminating barriers to accessing care, and protecting patient's
rights. He played a leading role in the construction and passage of the
Patient Protection and Affordable Care Act, resulting in over 20
million people in the United States gaining access to healthcare
coverage. He has championed protections against discrimination of
women, people who are LGBTQ+, and people of color in healthcare.
Attorney General Becerra has proven that he is willing to take on the
healthcare industry in order to protect all people and our rights to
quality, affordable, and accessible healthcare. He has challenged
harmful practices such as the pharmaceutical industry's ``pay for
delay,'' which unnecessarily delayed the introduction of potentially
life-saving generic medication. He has won major settlements over
exorbitant prices and anti-competitive practices, for example Sutter
Health, one of the largest healthcare chains in California. He sued
Purdue Pharma and McKinsey and Co. for their roles in creating the
national overdose crisis.
The people of the United States deserve a champion who will take on the
healthcare industry and AG Becerra has proven that he is unafraid to
stand up to corporate America in pursuit of justice and health equity
for all patients.
As the head of a massive state agency in the largest state, AG Becerra
has the experience of overseeing an agency larger than some federal
departments. If confirmed, Xavier Becerra would be the first Latino to
lead the Department of Health and Human Services, making his
confirmation both critical and historic.
As Secretary of the Department of Health and Human Services, AG Becerra
would be an outstanding pick to direct the urgent task of overseeing
the agency that will guide the nation out of this pandemic. Further, we
are confident that he will be proactive in establishing a resilient
public healthcare system to meet the future needs of the nation.
We strongly urge members of the Finance Committee to vote ``yes'' on
this nomination, so that AG Becerra may be confirmed by the U.S.
Senate. The people of the United States need a leader with extensive
direct experience improving our nation's healthcare system, and one who
is dedicated to ensuring we all have the healthcare coverage and
services we need and deserve.
Sincerely,
People's Action
AFSCME American Family Voices
American Federation of Teachers Arkansas Community Organizations
Blue Future Brain Mind Self Adaptability
Institute
Brave New Films Business Leaders for Health Care
Transformation
California Alliance for Retired California Democratic Party Senior
Americans Caucus
California OneCare California Progressive Alliance
CARA Center for Coalfield Justice
Center for Law and Social Policy Center for LGBTQ Economic
(CLASP) Advancement and Research
Center for Popular Democracy Action Churches United For Fair Housing
Action
Coalition on Human Needs Common Defense
Communications Workers of America Communities United
Connecticut Citizen Action Group Criminalization of Poverty Project
(CCAG) at the Institute for Policy
Studies
DelACA (Delaware Alliance for Demand Progress
Community Advancement)
Equality California Family Equality
Generation Progress Hayward Area Democratic Club
Health Access California Health Care for All--California
Health Care for America Now Health Care Voter
Healthcare Action Committee Healthcare for All Working Group,
Sonoma County, CA
Healthy California Now Hispanic Federation
Hometown Action Indivisible
Indivisible Healdsburg Inland Equity Partnership
Iowa Citizens for Community Jane Addams Senior Caucus
Improvement
Justice for Migrant Women Justice Is Global
Long Beach Area Peace Network Long Beach Medicare for All
Coalition
LULAC Maine People's Alliance
Make the Road Nevada Michigan United
Missouri Jobs with Justice National Council of Jewish Women
National Harm Reduction Coalition National Health Care for the
Homeless Council
National Partnership for Women and National Union of Healthcare
Families Workers
New American Leaders New Hampshire Youth Movement
New Jersey Citizen Action ONE Northside
OneAmerica OWL SacCap
Physicians fora National Health Progressive Democrats of America
Program, California chapter
Progressive Leadership Alliance of Progressive Maryland
Nevada
Public Advocacy for Kids (PAK) Public Citizen
R2H Action [Right to Health] Rights and Democracy NH
Rights and Democracy VT River Valley Organizing
San Francisco Gray Panthers Santa Clara County Single Payer
Health Care Coalition
Silver State Equality--Nevada Small Business for America's Future
Social Security Works South Bay Progressive Alliance
Students for Sensible Drug Policy The People's Lobby
Therapists for Single Payer United Vision for Idaho
University of Washington VOCAL--NY
Voice for Refuge Action Fund Washington Community Action Network
We All Rise Yolo Progressives
Young Invincible
______
Port Gamble S'klallam Tribe
January 27, 2021
The Honorable Patty Murray
U.S. Senate
154 Russell Senate Office Building
Washington, DC 20510
Re: Support for Xavier Becerra to be Secretary of the Department of
Health and Human Services
Dear Senator Murray:
On behalf of the Port Gamble S'Klallam Tribe I write in support of
the confirmation of California Attorney General Xavier Becerra as
Secretary of the Department of Health and Human Services (HHS). Mr.
Becerra has a long track record of supporting tribal sovereignty,
honoring treaties, and supporting improved health for American Indians
and Alaska Natives (AI/ANs). We believe that as HHS Secretary, he will
advance the health of all Americans, including indigenous peoples and
adeptly serve the health needs of the nation.
HHS has many programs that are responsible for fulfilling the trust
responsibility toward tribal nations. As you know, Indian Health
Service (IHS) is housed at HHS, which has the primary responsibility
for providing health care to AI/ANs. However, IHS is not the only
agency at HHS serving tribal communities. Virtually all HHS operating
divisions including the Centers for Disease Control and Prevention;
Centers for Medicare and Medicaid Services; the Substance Abuse and
Mental Health Services Administration and the Health Resources and
Services Administration all have important roles to play in ensuring
that AI/ANs are included fairly and treated as sovereign nations in any
action by the Department. Having a capable Secretary who fully
understands tribal sovereignty and the federal trust responsibility for
health will be crucial in this Administration.
Mr. Becerra has demonstrated his commitment to tribal nations
during his tenure as Attorney General of California. He led a
bipartisan coalition of 27 attorneys general in filing an amicus brief
to defend the Indian Child Welfare Act in Brackeen v. Bernhardt. In
filing this brief, he said, ``we are proud to lead the way in defending
the rights of Native American children and families.'' His leadership
on this issue, clearly shows his belief in strong tribal nations, and
we are confident that as HHS Secretary he will continue to uphold laws
passed by Congress which are critical to tribal nations and AI/AN
people.
Also during his tenure as Attorney General of California, Mr.
Becerra led a 20 state coalition to defend the Affordable Care Act
(ACA) in Texas v. U.S. Overturning the ACA in the courts would not only
create chaos for America's health system, but could have disastrous
impacts for Indian Country as well. As you are aware, the Indian Health
Care Improvement Act was permanently reauthorized as part of the ACA,
and overturning the law would likely create serious uncertainty for the
Indian health system and undo over a decade of process for AI/AN
health. There are also other critical protections and benefits for AI/
ANs in the ACA outside of the IHCIA. His leadership in protecting this
important law will be critical as HHS looks to undertake a new era of
health policy making.
During his tenure in Congress, Mr. Becerra also had a strong record
of supporting tribal communities. He signed on to legislation that
would renew the Special Diabetes Program for Indians, the Violence
Against Women Act, and legislation affirming the authority of the
Secretary of the Interior to take land into trust for Indian tribes (or
so-called ``Carceri Fix''). As a member of the Ways and Means
Committee, he was the lead sponsor on bipartisan legislation \1\ to
exclude from gross income for certain medical care or benefits provided
to American Indians clearly demonstrating his leadership on tribal
sovereignty and the federal trust responsibility for health.
---------------------------------------------------------------------------
\1\ 111th Congress--H.R. 3608, Tribal Health Benefits Clarification
Act
Mr. Becerra has had a decades-long career where he has demonstrated
his commitment to upholding tribal sovereignty and the treaty and trust
responsibility for AI/AN health. His Tweet from November 30, 2020
summarizes it well: ``The California Department of Justice is committed
to supporting tribal sovereignty, preserving Native American culture,
and fighting to improve the health, safety and welfare of our Native
American brothers and sisters.'' Should he be confirmed as HHS
Secretary, we believe that he will carry this commitment forward at the
---------------------------------------------------------------------------
Department.
We respectfully request that you vote to confirm to Mr. Xavier
Becerra for the position of Secretary of HHS in the Biden
Administration. We firmly believe that he would serve as an exceptional
partner with Indian Country and work tirelessly to fulfill the federal
trust responsibility for health--it is our hope that you feel the same.
Respectfully submitted,
Jeromy Sullivan
Chairman
______
Private Essential Access Community Hospitals
1107 9th Street, Suite 1001
Sacramento, CA 95814
916.446.6000
https://www.peachinc.org/
January 25, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chair Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden and Ranking Member Crapo:
Private Essential Access Community Hospitals (PEACH), a state-wide
association representing California's private community safety-net
hospitals, is pleased to convey our support for former California
congressman Xavier Becerra's nomination to serve as our next Secretary
of the Department of Health and Human Services.
As a 12-term member of Congress, Mr. Becerra represented a district
that included a number of private safety-net hospitals and came to
understand the needs of the low-income, underserved communities those
hospitals serve. During that time Mr. Becerra served on the House Ways
and Means Committee and showed a commitment to developing and
supporting public policies that reflected his understanding of the
distinct challenges low-income and underserved communities face and
made a difference in the lives of the people he represented. We are
confident he would do the same as Secretary of Health and Human
Services, including pursuing a much-needed effort to address the
underlying health equity challenges that we must address as a nation.
For these and other reasons PEACH is proud to support Mr. Becerra's
nomination to be Secretary of Health and Human Services and asks you to
advance his nomination to the full Senate.
Sincerely,
Anne McLeod
President and CEO
______
Providence
1801 Lind Avenue SW
Renton, WA 98057
https://www.providence.org/
February 9, 2021
Dear Chairman Wyden,
On behalf of Providence, I am urging you to support Attorney General
Xavier Becerra's nomination for Department of Health and Human Services
Secretary. Our health system looks forward to working with Mr. Becerra
in his new capacity once confirmed, as we take on critical health
issues facing our nation and communities.
As one of the largest health care provider in Oregon, our belief that
health care is a basic human right animates much of our work. We are
strong proponents of Medicaid expansion under the Affordable Care Act
(ACA) and are working to preserve coverage gains achieved through the
ACA. We are leaders and innovators on community benefit and charity
care, and an advocate for our country's immigrants and refugees. Last
summer, Providence pledged $50 million to end disparities in health
care and we have been working diligently to reach communities of color
and other populations at highest risk for COVID-19 in terms of
education, testing, access to care and vaccinations. Many areas of
health policy can have a profound effect on very vulnerable
populations, and we are proud to be a leading voice on their behalf.
We know that Mr. Becerra shares these beliefs and priorities as well.
We have had the privilege of working with Mr. Becerra during his tenure
in Congress and as Attorney General in California, another state where
Providence has a large footprint. We have experienced, firsthand, Mr.
Becerra's leadership in ensuring access to care for vulnerable
communities and addressing racial and ethnic inequities in health care.
Thank you for your consideration of Mr. Becerra's deserving and
important nomination. Mr. Becerra is the leader our nation needs to
stem the tide of the COVID-19 pandemic, expand health care access to
the uninsured, and steer the nation's health care system under the new
administration.
Please contact Jacquelyn Bombard, Executive Director of Federal
Relations, for any follow up and to schedule a meeting. She may be
reached at Jacquelyn.
[email protected] or (512) 569-3105.
Sincerely,
Rod Hochman, MD
President and CEO
______
Public Health Experts and Professionals et al.
The Honorable Charles Schumer The Honorable Mitch McConnell
Majority Leader Minority Leader
U.S. Senate U.S. Senate
Washington, DC 20510 Washington, DC 20510
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
The Honorable Patty Murray The Honorable Richard Burr
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Health, Education,
Labor, and Pensions Committee on Health, Education,
Labor, and Pensions
Washington, DC 20510 Washington, DC 20510
February 22, 2021
Dear Leaders Schumer and McConnell, Chairmen Wyden and Murray, and
Ranking Members Crapo and Burr,
As public health experts and professionals, we write to urge that you
swiftly consider and confirm President Joe Biden's nominee for
Secretary of the Department of Health and Human Services (HHS),
California Attorney General Xavier Becerra. It has been roughly one
month since Joe Biden was sworn in as president. Given the once-in-a-
century pandemic that has infected roughly 80 million Americans and
caused the death of more than 500,000 Americans, it is critical that
the Department have leadership in place to guide and coordinate the
federal response and oversee many of the nation's most urgent
priorities, including the administration of COVID-19 vaccines, the safe
return to in-person learning, and ensuring Americans can sign up for
health coverage during the recently launched Special Enrollment Period.
HHS is charged with protecting the health of the nation and providing
essential human services to the American people. The role of the
Secretary has never been more critical as it is now--given the
responsibility for managing efforts between its vital agencies,
including the Centers for Disease Control and Prevention, the Food and
Drug Administration, the U.S. Public Health Service, the National
Institutes of Health, the Centers for Medicare and Medicaid Services,
and the Administration for Community Living. Each of these agencies
will play a critical role in the Biden-Harris administration's policy
responses to COVID-19, from CDC's role in tracking the virus and
supporting state and local health departments, CMS's role in providing
health insurance to tens of millions of Americans, and the FDA's role
in evaluating new treatments and vaccines.
Attorney General Becerra is the leader the Department needs during this
crisis. As California's Attorney General he has not only led the
nation's second-largest law enforcement agency but also prioritized
actions to protect the health of Californians. His health care legacy
includes challenging efforts to overturn the Affordable Care Act (ACA)
and actions by drug manufacturers to keep lower-cost generic drugs from
entering the market. He also secured a $575 million settlement with
Sutter Health, one of California's largest hospital chains, after
arguing the system was driving up the costs of medical care.
Even before his tenure as California's Attorney General, Mr. Becerra
has been a health care leader. Attorney General Becerra's longstanding
commitment to addressing health inequities will ensure that the
Department's response to the COVID-19 pandemic is centered on the
communities hardest hit by the crisis. And his service on the Ways and
Means Committee has given him a deep understanding of the federal
health care programs he will be charged with overseeing as Secretary.
Throughout his years in public service, Mr. Becerra has consistently
sought out consensus solutions, including reaching across the aisle to
find areas of common interest. During the debate over the ACA, then-
Congressman Becerra helped resolve a dispute between members from rural
and urban areas about the appropriate allocation of Medicare payments.
Most recently, he has joined broad coalitions of attorneys general to
advocate for a more robust COVID-19 federal response, such as leading a
multistate, bipartisan effort with Louisiana Attorney General Jeff
Landry to urge the federal government to use its legal authority to
increase the availability of the COVID-19 treatment, Remdesivir.
As the Biden administration enters its second month, it is deeply
alarming that the Senate has yet to confirm Mr. Becerra. We urge the
Senate to act quickly to ensure that the Department has in place a
capable and compassionate leader at its helm.
Sincerely,
Stacy Abrams, Physician Assistant, Karlotta Bartholomew, Psychologist,
Columbia University in the City of Former Kaiser Permanante
New York Psychologist
Carol Allen, MD, Retired William Beardslee, Director, Baer
Prevention Initiatives, Boston
Children's Hospital
Ivye Allen, President, Foundation Pamela Behrman, PhD/Adjunct
for the Mid South Professor, Department of
Psychology, College of Mt. St.
Vincent
Luzann Ampadu, FNP-BC, Highland Ann Behrmann, MD, Pediatrician,
Family Medicine ICATCH Program Director
Mari Armstrong-Hough, Assistant Leo Beletsky, Professor of Law and
Professor, NYU School of Global Health Sciences, Northeastern
Public Health University
Marice Ashe, Lecturer, Public Trude Bennett, Associate Professor
Health Law, UC Berkeley Law Emerita, Gillings School of Global
Public Health, University of North
Carolina, Chapel Hill
Heather Barr, RN, Public Health David Celentano, Professor and
Services Supervisor, Heather Chair, Epidemiology, Johns Hopkins
Bloomberg School of Public Health
Cheryl Berenson, Public Health Susan Cheng, Associate Professor
Nurse Practitioner, RN, MS, MPH, and Chair, Benedictine University
Seattle King County Public Health
Reserve Corps/ Medical Reserve
Corps
Barbara Berney, Producer, Power to Andrew Young Choi, Ph.D.,
Heal: Medicare and the Civil Psychologist Fellow, The
Rights Revolution; Associate University of Hawai'i at Manoa
Professor of Public Health Policy,
City University of New York
(Emeritus), BLB Productions
Robert Berry, MD, Attending Kim Clark, Attorney, Legal Voice
Physician, CHA
Sierra Black, Clinical Social Nancy Connolly, Clinical Assistant
Worker, Cambridge Health Alliance Professor of Medicine, University
of Washington
Susan Bonadonna, MD, Montefiore Robin Cooper, Associate Professor
Medical Center of Psychiatry, Physician
Julia Boyle, Psychology Dominick DeFelice, Physician,
Postdoctoral Fellow University of Rochester
Paula Braveman, Professor of Family Carlos del Rio, Distinguished
& Community Medicine, University Professor, Emory University
of California, San Francisco
Elizabeth Brown, MD, MPH, Associate Mary Dewar, Nurse Educator for
Professor, University of Rochester Public Health Nursing (Retired),
PNHP Metro
Loraa Burke, Professor of Nursing Victoria DiCicco, PhD, Clinical
and Epidemiology, University of Psychologist, Retired
Pittsburgh
Scott Burris, Professor of Law and George DuPaul, Professor and
Public Health, Temple Law School Associate Dean for Research,
College of Education, Lehigh
University
Robert Byron, MD, MPH Maria Ekstrand, Professor,
University of California, San
Francisco
Jesus Casas, Retired Psychologist, Ronald Epstein, Professor of Family
University of California, Santa Medicine, University of Rochester
Barbara
Sara Casey, Assistant Professor, Kathleen Fagan, MD, MPH
Heilbrunn Department of Population
and Family Health, Mailman School
of Public Health, Columbia
University
Joe Feinglass, Research Professor Gail Goodman, Distinguished
of Medicine, Northwestern Professor of Psychology,
University Feinberg School of University of California, Davis
Medicine
Marie Fioravanti, Director of Rhoda Goodwin, Ph.D., Psychologist
Nursing, University of Pittsburgh
School of Nursing
Joan Fiorello, Ph.D. Andrea Gordon, Faculty Physician,
Tufts University Family Medicine
Residency at Cambridge Health
Alliance
Kevin Fiscella, Professor, Family Scott Greer, Professor, Health
Medicine and Public Health Management and Policy, University
Sciences, University of Rochester of Michigan
Medical Center
Rachael Fite, Clinical Jodie Guest, Professor and Vice
Psychologist, Private Practice Chair, Department of Epidemiology,
Emory University School of
Medicine and Rollins School of
Public Health
Kenneth Freedland, Professor, Vincent Guilamo, Professor, NYU
Washington University School of
Medicine
Bryony Freij, LCSW, Private Jhumka Gupta, Associate Professor,
Practitioner George Mason University
Emily Galpern, Public Health Ravi Gupta, Physician, NCSP,
Consultant, Emily Galpern University of Pennsylvania
Consulting
Shelley Geballe, Assistant Michael Gusmano, Professor, Rutgers
Professor of Clinical Public University
Health, Yale School of Public
Health
Elizabeth Gershoff, Professor, Perry Halkitis, Dean and Professor,
University of Texas at Austin School of Public Health, Rutgers
University
Robyn Gershon, Clinical Professor, Lindsay Heckler, Supervising
NYU College of Global Public Attorney, Center for Elder Law and
Health Justice
Carly Goldstein, Assistant Tamara Henry, Professor, George
Professor (Research) and Research Washington University
Scientist, Alpert Medical School
of Brown University/The Miriam
Hospital
Andrew Goldstein, MD, Assistant Jennifer Hirsch, Professor of
Professor, NYU School of Medicine Sociomedical Sciences, Mailman
School of Public Health, Columbia
University
Gregg Gonsalves, Assistant Natalie Hogan, RN
Professor, Yale School of Public
Health
Jennifer Huer, Managing Director, Joseph Ladines-Lim, Resident
Center for Health Policy and Law Physician, Michigan Medicine
at Northeastern University School
of Law
Samuel Jackson, MD, Kings County Marc Lavietes, MD, Physicians for a
Hospital Center National Health Program
Peter Jacobson, Professor Emeritus Jane Leavitt, ARNP, Retired
of Health Law and Policy,
University of Michigan School of
Public Health
Elizabeth Jarpe, Clinical Assistant Jane Lester, MD, Seattle King
Professor, University of Illinois County Public Health
at Chicago
Jonathan Kahn, Professor of Law and ...................................
Biology, Northeastern University
Leslie Kantor, Professor and Chair, Jeffrey Levi, Professor of Health
Department of Urban-Global Public Policy and Management, George
Health, Rutgers University School Washington University School of
of Public Health Public Health
Matthew Kavanagh, Assistant Beth Linas, Infectious Disease
Professor, Georgetown University Epidemiologist, Johns Hopkins
Bloomberg School of Public Health
Susan Kegeles, Professor Amerita, David Loud, Retired, Health Care Is
Department of Medicine, University a Human Right WA
of California San Francisco
Albert Ko, Professor and Department Mark Lowenthal, Psychologist, NJPA
Chair, Yale School of Public
Health
Margaret Kozel, Pediatrician, Karina Maher, Physician
Retired
Barbara Kraft, MSW, Retired Duncan Maru, Associate Professor,
Mount Sinai School of Medicine and
NYC H&H/Elmhurst Hospital Center
Nancy Krieger, Professor of Social Marilyn Matthews, MD, Self Employed
Epidemiology, Harvard T.H. Chan
School of Public Health
Sunny Kung, Resident Physician, Kenneth Mayer, Medical Research
Brigham and Women's Hospital Director and Professor, Fenway
Health/Harvard Medical School
Theanvy Kuoch, Executive Director, Amy Mayfield, Family Nurse
Khmer Health Advocates Practitioner, NPA
Therese McGinn, Professor Emerita, Ann Mayo, Professor of Nursing,
Mailman School of Public Health, University of San Diego
Columbia University
Aimee McHale, Assistant Professor, Mary Ann McCabe, PhD, ABPP,
University of North Carolina at Associate Clinical Professor of
Chapel Hill Pediatrics, George Washington
University School of Medicine
James McKeever, Pediatric Susan Opotow, Professor, John Jay
Psychologist, Seattle Children's College, City University of New
Hospital York
Molly McNulty, Assistant Professor Melissa Palma, MD, MPH, Council of
of Public Health Law and Policy, Young Filipinx Americans in
University of Rochester Medicine
Gail McVey, Psychologist, Gail Wendy Parmet, Professor of Law,
McVey, Psy.D. LLC Northeastern University
Emily Mendenhall, Provost's Terence Patterson, Psychologist,
Distinguished Associate Professor, USF
School of Foreign Service,
Georgetown University
Angelica Millan, Registered Nurse Joanna Perkins, Medical Director,
and Nursing Faculty, Los Angeles Hematology-Oncology, PRA Health
County Community Colleges Sciences
Shan Mohammed, Clinical Professor, Janet Perlman, Physician, Stanford
Northeastern University Children's Health
Marjaneh Moini, MD, JMH ...................................
Donald Moss, Dean, College of Nina Piazza, MD, Family Physician,
Integrative Medicine and Health University of Rochester
Sciences, Saybrook University
Elizabeth Naumburg, Associate Dean, Tonia Poteat, Assistant Professor,
Advising; Professor of Family University of North Carolina at
Medicine, University of Rochester Chapel Hill, School of Medicine
Gina Novick, Associate Professor, Tracy Rabin, Associate Professor of
Yale School of Nursing Medicine, Yale University School
of Medicine
Joseph Nunes, Ph.D., Practicing Michele Ribeiro, Licensed
Mental Health Clinician Psychologist, APA Div 49
Iyabo Obasanjo, Assistant Kayla Ringelheim, MBA, MPH, Yale
Professor, College of William and University
Mary
Elizabeth Samuels, Assistant Tamara Rissman, Epidemiologist, CT
Professor of Emergency Medicine, Emerging Infections Program
Brown Emergency Medicine
Javier Sanchez, MD, Associate Cheryl Ritenbaugh, Professor
Professor of Family Medicine, UC Emerita of Family and Community
Riverside School of Medicine, Medicine, University of Arizona
Southern California Permanente
Medicine, UC Riverside School of
Medicine
Andrew Saxon, MD, Professor and Dr. Ellen Rosenberg, The Chicago
Director, University of Washington Psychoanalytic Institute
School of Medicine/ VA Puget Sound
Health Care System
Manisha Sharma, MD, FAAFP, Margie Sable, Professor Emerita,
Physician Retired Social Work
Mark Siegel, MD, Professor of Catherine Stanger, Associate
Medicine, Yale School of Medicine Professor, Geisel School of
Medicine at Dartmouth
Vincent Silenzio, Professor of Steffanie Strathdee, Associate
Urban-Global Public Health, Dean, Global Health Sciences,
Rutgers University University of California, San
Diego
Jennifer Silverstein, LCSW Lara Sucheston-Campbell, Associate
Professor, The Ohio State
University
Robin Simon, Professor of Mary Tinetti, Professor of Medicine
Sociology, Wake Forest University and Public Health, Yale School of
Medicine
Heidi Sinclair, MD, Doctors for Kelly Vinehout, Clinical
America; American College of Psychologist, IL Psychological
Physicians Association
Nirbhay Singh, Professor, Augusta Anna Walden, Psychologist
University
Stephen Soldz, Professor and Echo Warner, Postdoctoral Research
Director of Research, Boston Associate, University of Arizona
Graduate School of Psychoanalysis Cancer Center
Sandra Springer, MD, Associate William Watson, Psychologist,
Professor of Medicine, Yale School Associate Professor of Psychiatry
of Medicine and Neurology, University of
Rochester Medical Center
Sanjeev Sriram, Senior Advisor, Linda Webb, LCSW, Clinical Social
Social Security Works Worker, Catskill Addiction
Coalition
Judy Wessler, Retired Community Amy Williams, Clinical Health
Health Policy Director Psychologist, Henry Ford Health
System
Jennifer Weuve, Associate Kathryn Wouk, PhD, Postdoc
Professor, Boston University
School of Public Health
______
Purchaser Business Group on Health
275 Battery Street, Suite 480
San Francisco, CA 94111
(415) 281-8660
https://www.pbgh.org/
The Honorable Ron Wyden The Honorable Mike Crapo
Chair Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
Washington, DC 20510 Washington, DC 20510
February 24, 2021
Dear Chairman Wyden and Senator Crapo:
On behalf of the Purchaser Business Group on Health (PBGH), I write to
offer our strong support for the nomination of Xavier Becerra for
Secretary of the Department of Health and Human Services. PBGH is a
nonprofit coalition representing nearly 40 private employers and public
entities across the U.S. that collectively spend $100 billion annually
purchasing health care services for more than 15 million Americans and
their families.
As a national health care focused business coalition based in
California, PBGH has had the opportunity to work closely with Mr.
Becerra on numerous initiatives, including his successful efforts to
stop anti-competitive business practices by large health care systems,
saving consumers and purchasers millions of dollars and improving
access to care. During his four years as the attorney general of the
most populous state in the country, Mr. Becerra demonstrated
exceptional leadership in his efforts to improve the affordability and
quality of health care. He has a deep knowledge of health policy and
law, and he understands how health care markets should work to benefit
consumers and employers.
Before returning to California to serve as Attorney General, Mr.
Becerra had a distinguished career on Capitol Hill, serving as a senior
member on the Health Subcommittee of the House Committee on Ways and
Means, where he was widely recognized for his leadership on health care
legislation. We are confident that he will provide effective leadership
in his role as Secretary, and we look forward to working with him.
Thank you for your consideration.
Sincerely,
Elizabeth Mitchell
President and CEO
______
Service Employees International Union
1800 Massachusetts Ave., NW
Washington, DC 20036
202-730-7000
https://www.seiu.org/
February 19, 2021
Dear Senators:
On behalf of the two million members of the Service Employees
International Union, I write to express strong support for the
confirmation of Attorney General Xavier Becerra as the next Secretary
of the United States Department of Health and Human Services (HHS).
With more than one million home care workers, nursing home workers, and
hospital workers, we are the largest health care union in the country
and have a long-time commitment to ensuring high quality universal
health coverage, including our work to pass and implement the
Affordable Care Act (ACA). Our commitment to these issues has only
deepened during the pandemic, when many of our members--especially in
nursing homes and hospitals, but also in other sectors of the economy--
have been on the front lines of the COVID-19 pandemic, risking their
own lives to provide essential services.
Now that more than 27 million Americans have contracted COVID-19 and
more than 488,000 have died of the disease, it is clear that the
country needs leaders like Attorney General Becerra. Attorney General
Becerra will work to help correct course to finally create and
implement a national strategy to get the pandemic under control,
improve access to affordable quality healthcare, and strengthen the
country's care infrastructure and vital services that are essential to
ensuring an inclusive and successful economic recovery. We also believe
that we must finally begin to address the issue of health disparities,
both in the context of the pandemic--which has had a disparate impact
on communities of color--and in the longer term, and are pleased that
Attorney General Becerra has committed to addressing this issue in
policy and practice. His extensive background in governance, together
with his expertise in healthcare policy, demonstrate his extraordinary
qualifications for the role of HHS Secretary.
During his 12 terms in Congress, where he served in Congressional
Leadership and as the first Latino Representative on the Ways and Means
Committee, Attorney General Becerra fought for significant improvements
to the US healthcare system and helped extend quality, affordable
coverage to millions of Americans. Attorney General Becerra played a
significant role in the construction and passage of the ACA and then
stood up against repeated repeal attempts that would have disrupted
access to healthcare for millions of people. He regularly championed
the Medicare and Medicaid programs and their beneficiaries, tirelessly
working to make benefits and prescription drugs more affordable by
supporting premium and cost-sharing assistance for low-income older
Americans, improving the generosity of Medicare benefits for physical
therapy, and providing incentives to expand the use of electronic
health records.
As Attorney General for California, Mr. Becerra continued his work to
improve the American healthcare system. He once again demonstrated his
strong commitment to preserving and strengthening the ACA by leading
more than twenty states in the defense against the legal challenge to
the ACA intended to invalidate the law that now sits before the Supreme
Court. In addition, through his work with the California State
Legislature, Attorney General Becerra gained a keen understanding of
the evolving healthcare system and the importance of protecting
consumers from the negative impacts of consolidation. He required the
California Attorney General's office to review affiliations and
acquisitions of healthcare systems, facilities, and provider groups to
ensure that patients, especially those who live in underserved
communities, do not lose access to care because of these transactions.
Furthermore, he continued his long pursuit to make sure prescription
drugs are affordable by defending a California state law banning ``pay
for delay'' agreements used by the pharmaceutical industry to delay
making cheaper and equally effective generic drugs available to
consumers.
Attorney General Becerra has been at the forefront of fighting the
COVID-19 pandemic, stepping into a leadership role when the past
Administration's federal response caused uncertainty and chaos. He
repeatedly called on President Trump to invoke the Defense Production
Act in order to increase the supply of personal protective equipment.
In May 2020, Mr. Becerra joined with other attorney generals to demand
CMS improve nursing home transparency and accountability as COVID-19
ravaged facilities. In August 2020, he joined a bipartisan group of
attorney generals who banded together to urge HHS to increase the
availability of groundbreaking and life-saving COVID-19 medical
treatments. Additionally, Attorney General Becerra supported the
implementation of an emergency temporary standard by the California
Division of Occupational Safety and Health to protect workers from
COVID-19 exposure hazards.
The COVID-19 pandemic has only worsened the disparities that have
always existed in our healthcare system and economy with devastating
consequences. Attorney General Becerra is a trusted and admired leader
in impacted communities, and we believe that he is well positioned to
bring stakeholders together to begin to address these issues. For
example, we remain deeply concerned and disturbed by data demonstrating
COVID-19 vaccinations lag significantly behind in communities of color
even though these communities are among the hardest hit. SEIU and our
members are currently engaged in aggressive outreach and education. We
have done over 100 events, including education events through social
media, city, state and national town halls, making events available in
nine different languages. We have already worked closely with the Biden
Administration to move our vaccination outreach and education program
forward and stand ready to get to work with Attorney General Becerra as
soon as the Senate moves his confirmation forward.
As a union, we also deeply appreciate Attorney General Becerra's
support for the rights of working people and families. This commitment
is not only evidenced through his work to ensure people have access to
affordable healthcare and his most recent work to address the COVID-19
pandemic including worker health and safety, but also in understanding
the essential role home care workers, 90 percent of who are women and
mostly women of color, play in our long term care system and in our
lives. When the Trump Administration tried to weaken the rights of home
care workers paid through Medicaid to be able to join together in
unions and have self determination over how to use their own pay,
Attorney General Becerra led a challenge to this ill-designed rule,
which a federal judge recently deemed was based on an erroneous reading
of Medicaid law. This action to defend the home care workforce and
preserve access to in-home care for older Americans and people with
disabilities was yet another example of Mr. Becerra's commitment to
health care and vulnerable populations. He understands that the
strength of our long term care system, and the care system overall, is
tied directly to the quality of this work and these jobs. President
Biden has articulated a groundbreaking economic plan that finally
recognizes care, including home- and community-based services such as
home care, as essential American infrastructure that holds the promise
of building back a more inclusive and thriving economy. We believe
Attorney General Becerra has the expertise necessary to make this plan
a reality.
The HHS mandate is expansive. Not only will the Secretary oversee
health care and public health, but also vital human services and early
childhood education programs that help our communities thrive, as well
research, training, and education activities. Attorney General
Becerra's career and actions demonstrates that he has a holistic
approach and understanding of community well-being and that our
nation's health and safety requires that all people--no matter where we
come from or what we look like--have access to healthcare and crucial
support. He challenged the Trump Administration's public charge rule,
also known as the wealth test, that has made immigrant families afraid
to access critical care and services that keep them and our communities
healthy. HHS contains the Office of Refugees and Resettlement, an
agency that implemented some of the previous Administration's cruelest
policies and will continue to play a key role in reuniting children
with their families. We have full confidence that Attorney General
Becerra, the son of immigrants and, if confirmed, the first Latino to
hold the office of Secretary of HHS, has the skills and expertise
necessary to correct the humanitarian crisis caused by past policies
such as family separation.
For all these reasons, we urge you to confirm Attorney General Xavier
Becerra to Secretary of HHS. We may add this vote to our legislative
scorecard. Should you need any additional information, please contact
Rebecca Wasserman, SEIU's Government Relations Director, at
[email protected].
Sincerely,
Mary Kay Henry
International President
______
Ujima, Inc.
5 Thomas Circle, NW
Washington, DC 20005
O: 202-299-1181
F: 202-299-1193
https://ujimacommunity.org/
February 12, 2021
U.S. Senate
Committee on Health, Education, Labor, and Pensions
U.S. Senate
Committee on Finance
Dirksen Senate Office Building
Washington, DC 20510
Dear Chairwoman Murray, Chairman Wyden, Ranking Member Burr, Ranking
Member Crapo, and Committee Members:
Ujima, Inc. is a national Culturally Specific Services Issue Resource
Center funded by the Administration of Children and Families, Family
and Youth Services Bureau within the U.S. Department of Health and
Human Services by and through the Family Violence Prevention and
Services Act. The name Ujima was derived from one of the Kwanzaa
principles which means Collective Work and Responsibility. This
principle is critical to addressing violence against Black women in the
United States. Ujima Inc. through its education and outreach; training
and technical assistance; resource development; research; and public
policy efforts mobilizes the Black community and allies to strengthen
our families, recognizing that the safety and viability of our families
is connected to the health and well-being of our individual
neighborhoods and communities at large. We are part of a network of
domestic violence programs that work collaboratively to promote
practices and strategies to improve our nation's response to domestic
violence, sexual assault, and community violence.
Survivors of domestic violence seek help from a multitude of systems
for safety and healing, however those same systems can cause harm and
are often difficult to navigate. Black women are almost 3x as likely to
be killed by an intimate partner than white women--we are particularly
concerned that this statistic will increase as we grapple with the
COVID-19 pandemic and dearth of resources. We believe Xavier Becerra is
uniquely qualified to lead the U.S. Department of Health and Human
Services during this unprecedented time. His depth and breadth of
experience over the past thirty years includes addressing violence
against women and supporting survivors, ensuring access to healthcare,
and protecting Social Security and Medicare. These are life-saving
safety nets for survivors.
In May of 2020 as California Attorney General, Mr. Becerra called for
the reauthorization of the Violence Against Women Act stating
``[t]here's no place for violence against women anywhere.'' He has been
at the forefront of legal efforts to protect the Affordable Care Act
and a vocal advocate for women's health. His legal background and
expertise in health and welfare issues exemplifies his commitment to
social change that promotes access to services and justice for all
people. We fully support the confirmation of Xavier Becerra as
Secretary of the U.S. Department of Health and Human Services by the
Senate Committees on Health, Education, Labor and Pensions and Finance.
Respectfully,
Karma Cottman
Executive Director
______
United Steel Workers
60 Boulevard of the Allies
Pittsburgh, PA 15222
412-562-2400
412-562-2598 (Fax)
www.usw.org
February 23, 2021
U.S. Senate
Washington, DC 20515
RE: United Steelworkers supports the confirmation of Xavier
Becerra as Secretary of Health and Human Services.
Dear Senator:
On behalf of the 850,000 members of the United Steel, Paper and
Forestry, Rubber, Manufacturing, Energy, Allied Industrial and Service
Workers International Union (USW) and working people everywhere, I
write in strong support of the nomination of Xavier Becerra to serve as
the Secretary of Health and Human Services.
As a former member of the House of Representatives and the current
Attorney General of the state of California, Mr. Becerra will bring
years of health policy experience to this role. During his 24 years in
Congress, he served as a member of the House Ways and Means Committee,
fighting to protect, strengthen, and expand Medicare and Social
Security. He supported numerous measures to expand healthcare access to
thousands of Americans and has been a strong proponent of making
healthcare more affordable for all working families across the country.
In his current role as the Attorney General of California, he has
challenged hospitals for their anti-competitive actions which had
driven up healthcare costs for thousands of consumers throughout the
state. He has pursued settlements that limited out-of-network costs and
increased transparency, improving medical services for patients across
California. He's taken on the powerful pharmaceutical industry in an
effort to curb skyrocketing drug costs, pursuing violations of
agreements that delay generic drugs from entering the market and take
money out of consumer's pockets by keeping drug prices high. And during
the COVID-19 pandemic, he not only called on the previous
Administration to invoke the National Defense Production Act to ensure
that workers had access to personal protective equipment, he called on
the Centers for Medicaid and Medicare Services (CMS) to increase
transparency and accountability at long term care facilities hit hard
by the virus.
Having devoted countless hours to expanding access to healthcare,
reducing drug prices, and fighting the COVID-19 pandemic, we are
confident that Mr. Becerra will work to strengthen the health and well-
being of our country. Under Mr. Becerra's direction, we look forward to
the Department of Health and Human Services taking a more active role
in addressing the healthcare needs and skyrocketing healthcare costs
plaguing our nation's working families. We urge you to confirm Mr.
Becerra as the new Secretary of Health and Human Services.
Sincerely,
Thomas Conway
International President
University of California
Office of the President
1111 Franklin St.
Oakland, CA 94607
https://www.universityofcalifornia.edu/
February 4, 2021
The Honorable Ron Wyden
221 Dirksen Senate Office Building
Washington, DC 20510
Dear Senator Wyden:
I write to express my support for the Honorable Xavier Becerra to be
the next Secretary for the U.S. Department of Health and Human
Services.
Mr. Becerra has spent a lifetime in service to California and the
nation. As a Member of Congress for more than 2 decades, Mr. Becerra
gained a deep understanding of the health care needs of his
constituents, which informed his important work on the House Ways and
Means Committee--the panel with jurisdiction over health care and
health delivery systems.
He left Congress to serve Californians as attorney general, managing
thousands of lawyers, investigators, peace officers, and others.
Throughout his tenure in that office, Mr. Becerra demonstrated a deep
and consistent commitment to the well-being of his constituents. He has
been a fierce advocate for patients, health care access, and health
equity.
Mr. Becerra is a committed leader whose personal and professional
skills have prepared him well to lead HHS.
There is no doubt that the tasks before the next HHS secretary are
daunting. Mr. Becerra will meet those challenges with experience,
empathy, and leadership. For these reasons, I encourage the Senate to
approve Mr. Becerra's nomination.
Sincerely,
Michael V. Drake, M.D.
President
cc: Senator Richard Burr
Senator Mike Crapo
Senator Patty Murray
______
Submitted by Hon. Todd Young,
a U.S. Senator From Indiana
STATE OF INDIANA
OFFICE OF THE GOVERNOR
State House, Second Floor
Indianapolis, Indiana 46204
Eric J. Holcomb
Governor
_______________________________________________________________________
February 1, 2020
Mr. Jeffrey Zients
COVID-19 Response Coordinator
The White House
1600 Pennsylvania Ave., NW
Washington, DC 20500
Dear Mr. Zients;
Thank you for your service as the COVID-19 Response Coordinator at the
White House. We look forward to working closely with you to manage the
pandemic and rebuild our economy safely and quickly.
Indiana, like all states, has suffered great loss due to this scourge.
However, there is hope and healing in our great State. The viral spread
is trending in the right direction in the majority of Indiana counties;
hospitalizations are the lowest they have been in a month; and the
majority of schools in Indiana have largely been open for at least
hybrid instruction between online and in person learning.
As we get closer to a return to some form of normalcy with each
vaccination, I write to express my appreciation for all of the work
your team has done in just two weeks and to request a call with you at
your earliest convenience to discuss the following issues of critical
importance to Indiana.
First, the Moderna vaccine is manufactured in Bloomington, IN at
Catalent Pharma Solutions. We respectfully request an additional supply
of 4,000 vaccines (2/worker) so that we are able to offer vaccinations
to their workforce immediately to ensure there are no disruptions to
this national priority manufacturing facility. As most of their workers
do not meet our current guidelines (65+/healthcare worker in direct
patient contact/first responder), they are not eligible under our state
policy. With an allocation from the federal government for the express
purpose of this national priority, we would set up on onsite clinic
expressly for the Catalent workforce.
Secondly, while we fully support and applaud increased federal
assistance for vaccination supply, I respectfully request close and
complete coordination with state governments in developing your plan
and priorities. In Indiana, we have worked to develop a vaccine
administration network of over 200 sites and have plans to grow this
network to over 1,000 sites as soon as vaccine allotment allows. These
sites have been carefully selected to ensure we are reaching all of our
disparate populations, and it includes the utilization of mobile units
to reach disparate populations, and federally qualified health clinics.
Indiana ranks among the top states nationally and first in the Midwest
in vaccination delivery because we have put in place a statewide system
that includes centralized scheduling suppo1ted via online
(ourshot.in.gov) and a statewide call center (2-1-1) that allows
Hoosiers to s directly and efficiently schedule their vaccine. We are
successfully making first and second dose appointments with no lines or
situations where vaccination runs out before fulfilling appointments.
We also have partnered with our public libraries, aging agencies, and
the AARP to train their staffs and volunteers to help citizens with
appointments. Soon, we will begin a homebound vaccination program in
cooperation with EMS professionals.
All of this has allowed us to closely monitor our program's
effectiveness, including being just one of a few states which closely
monitors and publicly reports vaccinations by race. In short, our
distribution system has high integrity and credibility with our
citizens. Any disruption to this system could have a detrimental impact
to ensuring we vaccinate all Hoosiers in a rapid and equitable manner.
I am concerned the yet to be announced Federal Pharmacy Retail Program
which calls for additional vaccine to be shipped directly to federally
selected pharmacies outside of state's current allotment process could
create confusion among Hoosiers. Our robust communication and outreach
plan focuses on ourshot.in.gov and 2-1-1 as THE way to get a vaccine,
especially as we work through the first few phases and supply is
limited. I strongly urge you to hold off on moving away from the
current state-based system of distributing vaccine or consider giving
states the option of participating in this federal program or opting
for an increased allotment to be included in the state's weekly federal
allocation.
Once again, thank you for your service to our great nation and I look
forward to our continued partnership.
Sincerely,
Eric Holcomb
Governor
______
National Governors Association
444 N. Capitol Street, NW, Suite 267
Washington, DC 20001
202-624-5300
https://www.nga.org/
February 15, 2021
President Joseph R. Biden Jr.
The White House
1600 Pennsylvania Avenue, NW
Washington, DC 20500
Dear Mr. President:
The Nation's Governors again congratulate you on your victory and look
forward to a working partnership as we battle these difficult times
together. We thank you for the coordination that your team has already
extended to the Governors. We are the front line in the battle against
COVID-19 and we will only succeed if we work together.
We have two immediate issues of concern. First, we believe it is
essential that the American people understand the vaccine distribution
process and the extent of the effort that governments on both the
federal and state level are extending. There has been an ongoing issue
since last year with which we would ask your assistance. Due to the
anxiety created by the demand and supply of the vaccine, it is
imperative that the American people fully understand the process.
Currently the Centers for Disease Control and Prevention (CDC) provides
public information on a state and territory level as to the number of
vaccines distributed to each state and the number of vaccinations
performed. The CDC reporting mechanism has created unnecessary
confusion. We would ask that the CDC reporting accurately reflects the
reality.
The vaccine is delivered and administered through several different
programs. By one program, the federal government administers a program
in which it contracts with private pharmacies for vaccinations in
nursing homes and long-term care facilities (LTCF program). The program
is not controlled by the states. Your Administration has started a new
federal program to directly deliver vaccines to certain pharmacies in
our states the federal government selects. Your Administration has also
announced another new federal program whereby the federal government
will directly distribute to Federally Qualified Health Centers (FQHC)
that it selects. These are three separate federal efforts beyond our
control.
State and territorial governments then receive vaccine allocations for
``first doses'' and ``second doses'' from the federal government. We
appreciate transparency, accountability and our responsibility for the
administration of the first and second doses. However, the federal LTCF
program, federal pharmacy program and the federal FQHC program, are
federally administered and beyond the states' control.
We believe it is important that the CDC in its reporting distinguish
between these separate efforts to avoid confusion and provide a clear
understanding to the American people. States also need visibility into
the federal vaccination efforts at the facility level happening in our
borders.
Second, we believe that federal decisions to use pharmacies and FQHCs
should be coordinated with state governments. States also allocate
doses often to these same pharmacies and FQHCs. We understand the
capacity of the individual entities and we know the range of the
individual entities throughput and their inventory. As usual, some
pharmacies and FQHCs are better suited for the task than others.
Following the performance data on these entities is essential. We also
know the need in the respective communities they serve and other
efforts in the geographic vicinity. If the federal government
distributes independently of the states to these same entities without
state coordination and consultation, redundancy and inefficiency may
very well follow.
We are most appreciative of our relationship with your administration
and Mr. Jeff Zients in particular, who has been doing great work, and
we look forward to working through these issues in a mutually
productive manner. Thank you in advance.
Sincerely,
Governor Andrew Cuomo, New York Governor Asa Hutchinson, Arkansas
Chairman Vice Chairman
Governor Charlie Baker,
Massachusetts Governor Larry Hogan, Maryland
Member, NGA Executive Committee Member, NGA Executive Committee
Governor Kay Ivey, Alabama Governor Doug Ducey, Arizona
Member, NGA Executive Committee Member, NGA Executive Committee
Governor Michelle Lujan Grisham,
New Mexico Governor Jared Polis, Colorado
Member, NGA Executive Committee Member, NGA Executive Committee
Governor Gretchen Whitmer, Michigan
Member, NGA Executive Committee
Communications
----------
Letter Submitted by Cassandra Alcala
To United States Senate HELP and Finance Committees:
I want to take the opportunity to first say that I am so very sorry, as
a fellow citizen, to all those who were at the U.S. Capitol doing the
people's work and who were forced to experience those horrific events
of January 6th. I deeply sympathize with the ongoing concern expressed
in news coverage about the safety concerns of working around others in
the workplace. That is a big part of the reason why I am writing this
letter--attempting once again to express to the U.S. Senate in its of
the harmful events I've been through in a space that the U.S. Senate
has oversight capacity on--and compelled because I also saw Senator
Murray's interview with PBS's Judy Woodruff detailing out her
experiences in her workplace on January 6th. I began to feel perhaps
she and other senators will now be better able to understand what I am
going to express in these pages and help me find some answers as well,
or at least be in some way responsive to it in some humane way. The
scale of those events were on a different level, but the reaction not
so different from my own experiences of observing troubling events from
a very unique and specific vantage point and thus having to be a
whistleblower and title IX complainant and the stress and worry of that
and having that process completely disrupt my successful career and
only to ultimately lead to experiencing retaliation and spending so
much time (like so many other University of California whistleblowers
and title IX complainants) trying over a years long process to get
answers and conclusive findings for my cases. This took place at a
significantly federally funded research university known as University
of California, Berkeley, which has been under title IX compliance
review at both the federal and state level for many years and
complainants continue to detail procedural problems and anomalies in
case handling. UC continues to boast claims of great positive economic
impact on their graduates, they don't talk about their negative
economic impact on whistleblowers and title IX complainants who are
also their alumni.
The work I was doing was in support of and was being conducted as a
result of funding from the California Attorney General's Office. The
funding for the creation of the center came from federal anti-trust
case settlement funds. The work I did and the retaliation I experienced
long predate AG Becerra's appointment as AG but my inability to get
answers or a response from the CA AG office when I have contacted the
AG multiple times and asked about their understanding of the status on
the case findings in my whistleblower and title IX case has continued
into the Becerra administration because each AG has continued to rely
on the research produced by the center that is directed by the
professor I complained against and the AG continues to be non-
responsive to me when I inform them of my case and his prior history. I
was told by the Locally Designated Official at UC Berkeley that the
AG's office was aware of my case and was weighing in on it as it was
investigated. The AG office has some of their Deputy AG in their anti-
trust division continuing to serve as active advisory board members for
the research center where I worked and offering up their writings for
research purposes to be cited by the university; they are also claiming
the creation of the research center in their accomplishments in their
CVs--but they have never approached me to find out the details of my
experiences at that center. In my whistleblower case the campus
Director of Audit and Advisory found that the professor had engaged in
bad business practices and also misused university resources. The
findings substantiated what I claimed. Many of the financial
transactions funded travel and entertainment transactions for multiple
intimate relationships and personal expenses over years--yet in the
title IX concurrently investigated case the campus refused to address
the financial transactions as part of the title IX evidence. I could
not get an opinion/finding/conclusion from the title IX officer on the
financial transactions as part of the title IX case. I was told that I
was under the protection of the general counsel for the campus but if I
discussed the case with anyone I would lose that protection. After a
period of no response to the questions on the title IX case, I sought
answers from AG Becerra's predecessors (Lockyer, Brown, and even
Harris) but they did not respond to me either. In later years, I sent
certified mail to then-U.S. Senator Harris and received no response.
Yet, they all continued to collaborate with and relied on the ongoing
partnership with the UC Berkeley professor I had to blow the whistle on
and who I filed a title IX complaint about. AG Becerra has held
multiple press conferences with that same UC Berkeley professor as he
and the CA DOJ proceeded intensively over the past 2 years with the
complex litigation case of Sutter Summit.
https://petris.org/california-attorney-general-holds-press-conference-
dr-scheffler-announce-new-petris-report-californias-healthcare-market-
concentration/
https://petris.org/los-angeles-times-discusses-ca-attorney-general-
lawsuit-sutter-health-based-new-petris-center-report/
Now that a settlement has been reached and is about to be finalized AG
Becerra has gone on 60 Minutes news magazine show to be interviewed by
Lesley Stahl. Politicians and universities covet such media attention
when they can tout a figure of over $500 million dollar settlement. Any
researcher at the principal investigator/professor level at a public
university--one who began as an expert witness on a paid consulting
contract with then--AG Lundgren; and who was next awarded a $2+ million
dollar endowed chair by then-AG Lockyer to start up a research center;
and who has spent years working with the AG and CA DOJ offices on
crafting multiple attempts at a successful anti-trust case with (albeit
only a fraction of the real $3 billion in damages to CA residents but)
with a high number fraction of damages as settlement of the case--a
researcher would be only to eager to have a moment with Lesley Stahl on
60 Minutes to talk about that result. Interestingly though, that
interview excluded the UC Berkeley faculty member AG Becerra was on a
first name basis with in their earlier press conferences--instead
suddenly 60 Minutes included a faculty member from University of
Southern California as the researcher the AG office highlighted as
collaborator. The UC Berkeley professor the AG's office has
collaborated with over years via a CA AG sponsored funded research
center--a research center that at inception prominently featured the
current AG's photo on its materials and office entry walls--none of
that was included or referenced during the 60 Minutes interview.
https://www.cbsnews.com/news/california-sutter-health-hospital-chain-
high-prices-lawsuit-60-minutes-2020-12-13/
Perhaps because two months prior to the 60 Minutes piece on Becerra and
Sutter Summit, I submitted a declaration to the San Francisco Superior
Court that was ruling on the terms of the settlement agreement and I
paid significant fees to expedite service to the Judge and attorneys--
that declaration went to both lead attorneys in the case which includes
Becerra's anti-trust division staff. But I still have not heard any
outreach from AG Becerra to respond to what I experienced and ongoing
issues resulting from my whistleblower and title IX cases. It seems AG
Becerra's approach to my cases involving the professor is either: to
ignore, be non-responsive or not see my experiences OR perhaps his
staff have kept the intake of the details from him entirely--I don't
know which is true . . . perhaps he and former CA AG Harris have a
policy to maintain distance from correspondence so that the staff can
just make invisible a long term collaborator once something like a
declaration to the court on the settlement raises those trouble facts
about him, and then they don't have to deal with the complainant or any
details they might have. I don't know. It is something I need AG
Becerra to speak to if I am to believe his testimony when he went
through confirmation hearing as AG in CA where he claimed he would
champion the rights of workers, or if we are to believe him when he
testified to the HELP committee on February 23, 2021 and said many
times all the ways that he believes in ``transparency in order to get
Americans to believe in the science,'' equity, equality etc. Politico
has a story from February 22, 2021 stating ``Becerra will pledge to
protecting government scientists and career workforce from political
interference''--but protection from basic harassment, retaliation, etc
is important as well. In her closing comments in that February 22nd
session Senator Murray even highlighted discrimination and bias and all
the factors that weigh on getting and keeping women into or back into
the workplace and his response was in support of all of that, yet. . .
I also need to make the committee members aware of some other important
facts:
- The professor at UC Berkeley was under investigation for over a
decade and a half prior to my hire to work for him. It was a scandal
known as the Western Consortium for Public Health and UC scandal.
Several articles cover the few details that were made public and there
is a very small group of UC community who actually know what really
transpired. Ultimately the University had to repay the U.S. Government,
specifically and ironically HHS, back $600,000.00+ circa 2000 that was
considered a significant amount of research money at that time and it
still is now:
One telling of it: https://www.sfgate.com/education/article/UC-
Professors-Cleared-After-Federal-Probe-Into-2932967.php
And another:
https://cshe.berkeley.edu/sites/default/files/publications/
2003_dont_ask_dont_tell_
evolution_of_the_uc_conflict_of_commitment_policy.pdf
- And it occurred just before the professor was awarded the $2 million+
anti-trust case settlement funds as an endowed chair by the CA AG as
the funding agency.
- Further compounding my distress in trying to assess who could be
trusted, during the then CA AG Harris term there was a sexual
harassment case that originated in the immediate office of AG Harris,
who is now U.S. Vice President Harris. There was a human resource
manager who was blamed for the non-disclosure settlement agreement that
the complainant had to sign in order to achieve a settlement
resolution. This has been downplayed during the election year and not
much of a response has been required. Harris has stated she did not
know about it and the can was kicked over to Becerra's staff were
responsible for the handling of the resolution. I believe it is
important to highlight the case because the human resource manager was
someone who was former staff to Senator Feinstein and Senator Stabenow
and she has either been scapegoated as being responsible for the failed
handling of the complaint, the handling of the case and the resulting
non-disclosure agreement which during the era of #MeToo many
progressive and Democrats have frowned on such instruments to dispose
of difficult cases. The public is left an unclear understanding of who
authorized the NDA and whether or not it is a common practice the CA AG
office uses with their employees.
See:
https://www.rollcall.com/2018/12/14/harassment-claim-arrived-at-
california-doj-months-before-sen-kamala-harris-left/
https://www.washingtonpost.com/politics/longtime-aide-to-sen-kamala-d-
harris-resigns-amid-sexual-harassment-allegations/2018/12/06/b748934c-
f94b-11e8-8c9a-860ce2a8148f_story.html
https://www.usatoday.com/story/news/politics/2018/12/06/kamala-harris-
aide-resigns-sexual-harassment-settlement/2223882002/
https://www.latimes.com/politics/la-pol-ca-sexual-harassment-
settlement-20181206-story.html
https://www.presstelegram.com/2018/12/12/harassment-case-tarnishes-sen-
kamala
-harris/
https://www.sacbee.com/news/politics-government/capitol-alert/
article223053155.
html
In the above, it reads like the staff member was blamed for the
handling: ``the first Latina chief of staff in the history of the U.S.
Senate.''
https://www.igs.berkeley.edu/people/amanda-renteria
- The Hartley case raises those NDA questions about the real policy
position the AGs have on it:
The Harris and Becerra AG administrations were employing NDA to resolve
cases involving employees in the immediate office of the CA AG Harris.
Harris has repeatedly claimed she is in touch with her staff--interacts
with them, appreciative of them. It seems the ``body person'' (the
person who travels with the principal) for the AG was the person who
was the respondent in the case. I found this treatment of that case by
Harris and Becerra really chilling and not dissimilar to the worst
aspects of my experiences.
There is the outward expression of CA AG Becerra's stance on title IX :
https://oag.ca.gov/system/files/attachments/press-docs/
Memorandum%20of%20
Law_IX.pdf
Source: CA. DOJ
https://goldrushcam.com/sierrasuntimes/index.php/news/local-news/23792-
california-attorney-general-leads-multistate-lawsuit-challenging-
erosion-of-title-ix-protections-for-survivors-of-sexual-violence-and-
harassment
``California Attorney General Leads Multistate Lawsuit Challenging
Erosion of title IX Protections for Survivors of Sexual Violence and
Harassment''
- but then they don't match up to my own experiences with the CA AG
over time.
Adding to my deep concern and inability to really trust the stance of
the CA AG on sexual harassment cases and equity issues is an almost not
talked about aspect of the Sutter case, it was a development that
occurred in the last half of 2020 and revolved around the appointment
of a monitor or administrator of the case settlement funds.
- Stunningly in the court documents of the Sutter Summit case dated
circa October 2020 the Judge in the case places into the record a
shocking rebuke of both the plaintiff and respondent--both the CA AG
office and Sutter Summit attorneys in their failure to conduct an
equitable recruitment of an administrator of the case settlement funds.
They apparently did not seek to include female candidates in the
applicant/potential candidates pool. See:
The full context of the Judge's remarks and frustration with the
applicant process Becerra headed up is in 13 pages of her decision
here: https://2zele1bn0sl2i91io41
niae1-wpengine.netdna-ssl.com/wp-content/uploads/2020/10/Sutter-Order-
09.22.20
20.pdf
and some coverage here:
https://sourceonhealthcare.org/sutter-case-watch-court-officially-
rejects-sutters-proposed-settlement-due-to-inadequate-compliance-
monitor-selection/
includes:
The court found such a ``limited and confidential selection process in
which applications to be monitor were solicited by personal invitation
only'' to be unreasonable and inadequate, particularly as it resulted
in ``an applicant pool in which all of the candidates interviewed were
white men.'' Judge Massullo noted that given the parties had identified
potential candidates while negotiating a settlement on the brink of
trial, it necessitated the selection process to move quickly and
quietly. As such, it resulted in applications to be solicited in
confidence, without sufficient time for the parties to conduct a
nationwide search for applicants. In summary, Judge Massullo found
``the idea that in 2020 there are only five white men in the United
States who are qualified to be interviewed for this position is
anathema to what are today basic notions of fairness, equity, and
justice.''
In denying the motion to appoint . . . as compliance monitor, the court
also denied the motion for preliminary approval of the settlement, both
without prejudice, as the identity of the monitor is a material term of
the settlement. The court order provides that the parties may refile
both motions after addressing the issues the court identified. In the
renewed motion, the parties should describe their efforts to broaden
the applicant pool and consideration of any additional applicants,
whether they agree on a new monitor or determine that . . . is still
the best candidate.
[Sutter Case Watch] Sutter Health Preliminary Approval of Settlement
Agreement Held up by Compliance Monitor Selection
See case page: UFCW & Employers Benefit Trust v. Sutter Health
https://sourceonhealthcare.org/sutter-case-watch-sutter-health-
preliminary-approval
-of-settlement-agreement-held-up-by-compliance-monitor-selection/
With regard to research, I now need to turn back to the University of
California and the UC Berkeley professor who collaborates with AG
Becerra on Sutter Summit. That UC Berkeley professor has now been
highlighted by the current UC Berkeley Chancellor for his interest in
research on the subject anxiety in students and mental health services
for students. The basis of his research is data that also claims to see
connection between the level of mothers' education with increased
levels of anxiety for their children. The UC Berkeley professor who
created an environment where I had to make a title IX claim and a
protected disclosure and in doing so threw me into an abyss the UC
creates for such complainants, that professor recently laughed about
that aspect of the research when he shared the stage with the current
UC Berkeley Chancellor in presenting that research.
See:``Rising anxiety on campuses linked to finances, phones in UC
Berkeley study''
https://www.sfchronicle.com/bayarea/article/Rising-anxiety-on-campuses-
linked-to-finances-13781698.php ``Students with a mother who has a
college degree have a 45% higher chance of having anxiety.''
- you can watch the professor laugh about that part in this talk here:
https://www.youtube.com/watch?v=5xil1eP9HRg
Currently female faculty are also being told that they are lousy
mentors by other unrelated research findings--this stuff can be toxic
to the academy and become harmful to young scholars if not presented in
a thoughtful manner, with a light on the full context and with rebuttal
or counter arguments or findings.
And those who offer such research findings should also be trusted and
reliable figures who don't have history of investigations on their work
practices over decades or title IX complaints against them.
I appreciate that Democratic Senators and their staff are pushing for
President Biden's nominees to clear all hurdles and be confirmed. In
many ways I am in support of that effort and there are many
commonalities between myself and Vice President Harris's and AG
Becerra's upbringing that they have detailed out over this past year.
We are all very proud of the particular part of California where we
were born and raised in and we have all grown up in a tradition that
has lifelong connections to and respects the research university--but I
believe the questions I raise in this document need answers from AG
Becerra while he is still in his capacity as CA AG, to fill in gaps,
get answers to important questions and make clarifications and avoid
the same shortcomings in a transition to HHS , and to make clear what
direction he will take HHS which will have nationwide impact.
I also worry about the continued collaboration after Becerra become HHS
secretary and this sort symbiotic relationship:
``What To Expect From Biden In Health Policy And How Will It Affect
YOU?''
https://www.youtube.com/watch?v=nvE3c0_OaEE
and
https://publichealth.berkeley.edu/news-media/what-does-california-att
and
I also raise this because there will be other title IX complainants and
whistleblowers who attempt, like me to FOIA documents from HHS to
understand in some way the history or origins of the behavior that led
to their title IX or WB cases at their home research institutions,
ultimately AG Becerra as HHS Secretary will be responsible for how
those requests for records are responded to or not. I had great
difficulty finding out the details of the WCPH-UC scandal that occurred
before my hire but played a huge role in my work life. I also had no
assistance from any federal agency or state agencies in getting a
resolution either.
There are also news stories on access for journalists and lists and
public records access decisions that have not come up as questions to
answer for Becerra in the confirmation hearing on 2/23--but prior to
COVID-19 they were important issues in CA and it seems there is the
danger that things are viewed only through a COVID-19 centered
framing--forgetting other issues and values that are important in
normal times and those values and clear mission need to be buttressed
and communicated and nominees need to speak on them.
At the state level I also had the misfortune of reaching out to state
politicians for help those who shortly thereafter were investigated and
had serious cases that shocked the state's residents. So even reaching
out to your state representative who speaks to your issues is a fraught
experience and even more so today. I ask that you remember this as I
submit this letter to your committees.
When I talk about retaliation some of what I am referencing is what
occurred to me after I gave my whistleblower statement and title IX
statement. I was placed in the campus administration's Human Resources
department in the HRIS section--Human Resources Information Systems
unit. There were all sorts of behaviors there that ran counter to the
ideals of human resources but my specific concern was that job
applicants could see other job applicants profiles and the university's
systems analysts did not know how frequently this was occurring but it
was being detailed in the system's task database and by alarmed users
alerting us to it. I was an administrative analyst who worked on the
functional team side of maintaining the system and we were tasked with
highlighting to counterparts on the technical team these issues--when I
noticed these issues unaddressed and raised them--I was shut out,
ostracized and my coworkers referenced my placement on waiver into the
unit because of my earlier whistleblower case, this also happened in
other instances. I detailed all of this out to then CA AG Harris in
that certified letter, and prior to that to her predecessors. I also
informed the CA State Auditor, but CSA has no enforcement power over
UC--only the AG does and the CA AG as I have said before has been non-
responsive to me. Shortly after I sent that letter to the CA AG Harris,
the UC President at that time basically gave a blank check to a project
called UC PATH which has become so botched the state auditor believes
it will come in at almost $1 billion in costs for the HRIS project.
https://www.auditor.ca.gov/reports/2016-125.2/auditresults.html
https://www.courthousenews.com/california-auditor-blasts-1-billion-
system-latest-look-uc-president/
This handling of cases involving electronic records also lends itself
to scenarios of handling of digital medical records and I don't
understand why the CA AG did not respond back to me on this aspect if
only to do away with my concerns with facts to the contrary, debunk
them if they have facts from the university that run contrary or to at
least tell me they feel it is already being addressed. Senator Romney
asked CA AG Becerra yesterday if CA is just big and a mess of an
example and CA AG Becerra replied back about many of the good things
about California but the tech sector does not benefit from just
remaining a blind spot on oversight of the products they put out and
just a lucrative locale for political contributions. There are other
nominees coming from CA into the Biden cabinet, administration and it
would be refreshing if they would state that what CA is wrestling with
is what the country is also wrestling with--so CA big approaches to
resolving can inform nationwide attempts to bring real advancements--
things are running smoothly in CA and the commitment to transparency
has to be real from the state level to the federal.
I also want to highlight to the HELP and Finance committee that I sent
email to the senate email account Senator Grassley highlights on his
web pages it is set up to receive whistleblower testimony of procedural
complaints. I also received no response to that and have no idea what
was done with that information and that exacerbated my anxiety rather
than being a source of support for whistleblowers. I thought I could
trust that contact point because of Grassley's assistance to Dr. David
Kessler, who is now assisting the White House in the COVID-19 response,
in Kessler's years long whistleblower case on budget finance anomalies
at UCSF:
https://www.nytimes.com/2009/12/12/education/12kessler.html
https://www.latimes.com/local/la-me-ucsf15dec15-story.html
https://www.bizjournals.com/sanfrancisco/stories/2010/01/18/story5.html
- but I did not get even a courtesy acknowledgement from Grassley's
office and I also did not hear from my home state senators Feinstein
and Boxer at that time who I also addressed the emailed correspondence
to back then. Even to this day I remain concerned that the U.S. Senate
has this email account in existence over all these years and it is
directed at whistleblowers in need of help but does not explain to
those constituents who use that account what is done with the content
or who has access to it or what level of confidentiality or type of
response can be assured. In the current climate in DC I think that
needs to be made clear and protected disclosures need to be handled
appropriately.
This is what I can provide to you in a very short time frame and there
is much more to state. I only just learned of the confirmation hearings
for AG Becerra but if you need additional back up documentation or
examples or for me to fill in any gaps, please let me know via reply to
my email submission of this testimony. I would be very grateful for an
acknowledgement ensuring committee members receipt and I ask that a
courtesy copy be provided to the U.S. Senate Majority Leader Schumer
and the President of the U.S. Senate VP Harris.
Sincerely,
Cassandra Alcala
______
California Hospital Association
499 South Capitol Street, SW, Suite 410
Washington, DC 20003
Telephone: 202-488-3740
Facsimile: 202-488-4418
www.calhospital.org
February 22, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
219 Dirksen Senate Office Building 219 Dirksen Senate Office Building
Washington, DC 20510 Washington, DC 20510
Dear Chairman Wyden and Ranking Member Crapo:
On behalf of the California Hospital Association (CHA) and our more
than 400 member hospitals and health systems, I write in strong support
of the nomination of Xavier Becerra as Secretary of the Department of
Health and Human Services (HHS).
In his time as California's Attorney General and his many years
representing Los Angeles in the U.S. House of Representatives, Mr.
Becerra has been a strong advocate for ensuring access to health care
for all. As a champion of the Affordable Care Act--from the time of the
law's conception to leading its defense in the courts--he has expanded
and protected health care access for millions of Americans. Mr. Becerra
also shares our goals of addressing disparities and health equity, as
well as improving access to behavioral health services.
CHA looks forward to working with Mr. Becerra as HHS Secretary while
hospitals continue to respond to the most challenging health crisis of
our time. We believe Mr. Becerra is well-equipped to provide leadership
as the ongoing public health emergency has exposed the need for a more
centralized, stable, and coordinated approach to managing the COVID-19
pandemic.
We urge the Senate to act swiftly to confirm Mr. Becerra as HHS
Secretary. If you have any questions about CHA's support, please do not
hesitate to contact Anne O'Rourke, senior vice president, federal
relations, at [email protected].
Sincerely,
Carmela Coyle
President AND CEO
______
Law Office of Patrick J. Evans
16897 Algonquin Street, Suite F
Huntington Beach, CA 92649-3832
Tel.: (714) 594-5722; Fax: (714) 840-6861
E-mail: [email protected]
February 17, 2021
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
221 Dirksen Senate Office Building 239 Dirksen Senate Office Building
Washington DC 20510 Washington DC 20510
The Honorable Patty Murray The Honorable Richard Burr
Chairwoman Ranking Member
U.S. Senate U.S. Senate
Committee on Health, Education,
Labor, and Pensions Committee on Health, Education,
Labor, and Pensions
154 Russell Senate Office Building 217 Dirksen Senate Office Building
Washington, DC 20510 Washington, DC 20510
RE: Secretary of Health and Human Services Nominee Xavier Becerra
Dear Chairman Wyden, Ranking Member Crapo, Chairwoman Murray and
Ranking Member Burr:
My senior citizen clients comment and provide information regarding
Xavier Becerra, the Biden administration nominee for Secretary of
Health and Human Services (``HHS''). Based on his California attorney
general record, the committees should consider if Mr. Becerra is
suitable for the secretary post.
Attorney General (``AG'') Mr. Becerra has been hostile and obstructive
to government transparency, police and prosecutor accountability, and
applying rule of law to judges.
Mr. Becerra derailed new law for disclosure of police misconduct
records. In 2018 he obstructed the ``Right to Know Act,'' which
mandated public access to police misconduct records. AG Becerra
declined to prosecute district attorneys that engineered a clandestine
and illegal ``jailhouse snitch'' informant program. The scheme trampled
the rights of suspects and victims. It is documented that Mr. Becerra
gives preferential treatment, a ``pass,'' to judges engaged in criminal
conduct from the bench.
Xavier Becerra acts to undermine justice on all levels: (1) police
misconduct; (2) prosecutorial wrongdoing; and (3) judge corruption. Mr.
Becerra's cover up of police misconduct records and not prosecuting
``snitch'' scheme district attorneys are reported in the attached
references. My clients have experienced Mr. Becerra's misuse of his
attorney generalship to allow judge crime under apparent ``quid pro
quo'' with the judge oversight commission.
I. Transparency and Open Government--Mr. Becerra Fought to Keep Police
Misconduct Records Secret
The Biden administration will ``bring transparency and truth back to
the government to share the truth even when it's hard to hear.''\1\ Mr.
Becerra has been adverse to transparency and accountability. From 2019-
2020 Mr. Becerra wasted taxpayer resources on litigation he brought to
keep police misconduct records secret despite public access rights to
the records.\2\ His zeal to keep the records clandestine went against
the open government laws.\3\
---------------------------------------------------------------------------
\1\ President Biden's press secretary Jen Psaki stated the
administration and the press ``have a common goal, which is sharing
accurate information with the American people,'' and that Biden plans
to ``bring transparency and truth back to the government to share the
truth, even when it's hard to hear.'' (1/20/21)
\2\ In California, ``access to information concerning the conduct
of the people's business is a fundamental and necessary right'' of
every person in the state. See, California Government Code Sec. 6250.
\3\ See, i.e., the California Public Records Act, Government Code
Sec. Sec. 6250-6276.48.
The Mercury News and East Bay Times editorial boards referred to Mr.
Becerra as a ``coddler of bad cops.''\4\ The Orange County Register op-
ed title was ``Xavier Becerra's empty words about police abuse.''\5\
``Becerra's decision to keep misconduct records secret betrays public
trust and the law'' stated the editorial board of the Sacramento
Bee.\6\ Courthouse News Service pointed out that Mr. Becerra's
objective was to ``dodge police transparency law.''\7\
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\4\ ``Becerra, Coddler of Bad Cops, Offers Hypocritical Post-Floyd
Reforms.'' San Jose Mercury News, East Bay Times editorial June 21,
2020.
\5\ ``Xavier Becerra's Empty Words About Police Abuse.'' Orange
County Register editorial bd. June 9, 2020.
\6\ ``Becerra's Decision to Keep Misconduct Records Secret Betrays
Public Trust and the Law.'' Sacramento Bee editorial board, February 9,
2019.
\7\ ``California AG Faces Tough Slog in Bid to Dodge Police
Transparency Law.'' Maria Dinzeo, Courthouse News Service, December 19,
2019.
Mr. Becerra's vain attempt to undermine police transparency came to an
end on January 29, 2020 when, in a published opinion,\8\ a California
Court of Appeal ruled against the attorney general, enforcing the
citizen initiative law and ordering police records release.\9\
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\8\ Becerra v. Superior Court, (2020) 44 Cal. App. 5th 897.
\9\ See, i.e., ``Appeals Court Rules California Must Release Police
Misconduct Records.'' Maria Dinzeo, Courthouse News Service, January
29, 2020; ``State Attorney General Must Disclose Police Misconduct
Files on Local Cops, Appeals Court Rules.'' Alex Emslie, NPR-KQED,
January 29, 2020.
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II. Failure to Prosecute Prosecutors that Conducted Illegal
``Jailhouse Snitch'' Scheme
In October 2011 Orange County California suffered its worst mass
shooting. A deranged armed man stormed the hair salon where his ex-wife
worked. He shot and killed her and seven more people. With eyewitness
and substantial evidence, the perpetrator faced swift conviction.
While in jail, the perpetrator was taken in by another prisoner who was
part of an Orange County District Attorney created and implemented
illegal ``jailhouse snitch'' operation. Working for prosecutors, the
``snitch'' informant would befriend the fellow prisoner to elicit
confessional or self-incriminating statements.
The public defender uncovered the ``snitch'' scheme, and the case had
to be delayed. For the victims' families and friends, the ``snitch''
compromised prosecution, protracted the anxiety of anticipating and
going to trial, excluded a possible death penalty choice for the jury,
and caused all manner of complications to what otherwise would have
been a straightforward prosecution.
The Orange County District Attorney and Sheriff deputies conducted the
``snitch'' operation for years. Its exposure tainted the validity of
many criminal convictions. The California Attorney General, then Kamala
Harris, stepped in. After Ms. Harris became Senator, AG Becerra took
over. Ultimately the shooter was convicted and received life sentence.
But many asked, what should be done about the District Attorney and
deputies that had illegally created and conducted the ``snitch''
operation?
The ``snitch'' scheme tormented the victims' families and friends by a
prolonged and complicated prosecution that ended up being more about
``snitch'' prosecutor illegality than the mass murder tragedy and
grief. Families and friends of the murdered called for criminal
prosecution and legal action against the Orange County attorneys that
had trampled constitutional constraints in order to notch higher
conviction rates for their resumes.
There ensued a four-year examination of the scandal with inquiry into
the Orange County Sheriff's Department and District Attorney's office.
Mr. Becerra heard the victims' survivors' grief and outrage. The
inquest dragged on.
In April 2019, AG Becerra abruptly dropped inquiry into the jailhouse
informant scandal.\10\ AG Becerra exonerated the offenders by letting
the statutes of limitation lapse. He squandered public resources on an
investigation that he ultimately squelched to shield wrongdoer local
prosecutors and deputies.
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\10\ ``State Ends Four-Year Investigation into O.C. Jail Snitch
Scandal,'' LA Times, 4/19/19; ``California Ends Orange County Jailhouse
Informant Probe without Explanation from Attorney General,'' KABC, 04/
27/19.
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III. Crime Committing Judges Not Prosecuted; Judge Oversight
Commission Disciplines Becerra's Republican Rival
in 2018
My clients lived in Palm Beach Mobilehome Park, situated on a valuable
coastal parcel in San Clemente, Orange County, CA. A self-dealing real
estate broker and HOA President with accomplices perpetrated a
fiduciary fraud on the seniors to sell the Park. They bribed a judge to
``fix'' a case to enable the Park sale by which they stole millions in
real estate equity from seniors.
The judge ``fix''\11\ happened when the seniors filed for temporary
restraining order (``TRO'') to stop the fraudulent give-away of their
Park. The judge, previously disqualified by presiding judge decision,
suddenly called in from vacation, ordered himself re-qualified, and
issued an order to thwart the TRO. Four (4) hours later the Park sale
real estate deed was recorded.
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\11\ The California Judicial Conduct Handbook, 4th Ed. 2017,
describes ``quintessential'' judicial misconduct where the judge puts
in a ``fix'' for the benefit of a relative, friend, or other person.
(Id. pgs. 174 et seq., Sec. 3:32, and pg. 468, Sec. 7.52) The judge
breaks the law in order to award the ``win'' to whomever the judge is
fixed to favor for whatever the judge will receive as benefit or bribe.
See, In re Koven (2005) 134 Cal.App.4th 262, 271 ``The term `fix'
carries the connotation that for money consideration, a certain result
can be purchased from a judge. This is also known as bribery.'' CJP
warns that judge fix makes for ``both the appearance and the reality of
a two-track system of justice--one for [the judge's] friends and family
and another for all others.'' (See, Inquiry Re: Judge William R.
Danser, No. 172 (6/2/05; CJP); Danser v. CALPERS (2015) 240 Cal.App.4th
885).
The facts and evidence of the fiduciary fraudulent sale and judge
``fix'' were provided to Attorney General Xavier Becerra. He said he
``lacked resources'' to investigate and prosecute the judge.\12\ It
turned out that AG Becerra policy was not to investigate judge crime.
Instead, he referred those who sought his help with judge criminal
misconduct to the Commission on Judicial Performance (``CJP''), the
judge oversight arm of the judicial branch.
---------------------------------------------------------------------------
\12\ Attorney General ``no action'' and ``lacks resources'' letter
to seniors, 03/03/17.
AG Becerra did nothing about the judge ``fix'' reported to him. In
April 2016, the seniors had complained about the judge to the CJP. Over
4 years later, on May 14, 2020, CJP sent its ``no action'' letter.\13\
The judge commission, like AG Becerra, did nothing about the judge
``fix'' that took the seniors' homes.
---------------------------------------------------------------------------
\13\ CJP letter acknowledging receipt of complaint against judge,
4/26/16, and CJP ``no action'' letter, 5/14/20.
About judge crime generally, AG Becerra's office stated it had no way
to find any records of it. In contrast, the CJP publicly declared that
it referred ``judge crime'' to prosecutors on ``multiple
occasions.''\14\ But no evidence or information shows that CJP has ever
referred judge crime to prosecuting authorities. CJP asserts that its
rule compliance data as to referral, or lack thereof, is ``secret.''
---------------------------------------------------------------------------
\14\ Report Concerning [review of] Rules of the CJP 8/29/2017, page
15, item 10, CJP website.
The CJP and AG Becerra collude to conceal and suppress judge crime
evidence and to not investigate or prosecute judge crime. This
unconstitutional collaboration that shields wrongdoer judges is
reflected in the California State Auditor 2019 audit report,
``Weaknesses in Its [CJP] Oversight Have Created Opportunities for
Judicial Misconduct to Persist.'' The auditor recommended drastic CJP
constitutional amendment reform.\15\
---------------------------------------------------------------------------
\15\ https://www.auditor.ca.gov/reports/2016-137/index.html.
For 2015, the Center for Public Integrity, in its ``comprehensive
assessment of state government accountability and transparency,''
flunked California, grading it an ``F'' on ``Judicial Accountability.''
``[California's] . . . failing mark was for judicial
accountability.''\16\
---------------------------------------------------------------------------
\16\ https://publicintegrity.org/politics/state-politics/state-
integrity-investigation/California/.
Attorney General X. Becerra, in collusion with the CJP, allowed a judge
crime, the ``quintessential'' judge ``fix'' [See, fn. 11] The fixed
sale stole millions in real estate equity from seniors. Becerra does
not prosecute judge crime that inflicts catastrophe on seniors and
---------------------------------------------------------------------------
veterans--the fraudulent taking of their homes.
AG Becerra's ``no prosecution'' policy emboldens dishonest judges. They
know that AG Becerra puts judges above the law. Indeed, the judge that
``fixed'' the case against the seniors, having suffered no
repercussions for his ``fix,'' perpetrated more judge crime, perjuring
affidavits to collect his paychecks. The judge committed more crime,
comfortable nothing would be done about it.
The claims and contentions cited herein are documented in federal and
state courts. D. Padilla and F. Chodosh vs. Commission on Judicial
Performance, Xavier Becerra, in his official capacity, Sacramento
Superior Court Case No. 34-2018-00242031 (filed 10/5/18; on appeal in
Third Dist. Ct. of Appeal No. C091221) and Floyd Chodosh, et al. v.
John Saunders, et al. (U.S. Dist. Ct. no. 8:20-cv-01326-CJC-KES (filed
7/22/19; on appeal, Ninth Cir. No. 20-56252).\17\ In the federal court
RICO action, AG Becerra is an unindicted co-conspirator.
---------------------------------------------------------------------------
\17\ D. Padilla and F. Chodosh vs. Commission on Judicial
Performance, California Department of Justice, Office of the Attorney
General, and Xavier Becerra, in his official capacity as Attorney
General, Sacramento Superior Court Case No. 34-2018-00242031 (filed 10/
5/18; judgment 10/25/19; on appeal in Third Dist. Ct. of Appeal No.
C091221) and Floyd Chodosh, et al. v. John Saunders, et al., (U.S.
Dist. Ct. no. 8:20-cv-01326-CJC-KES (filed 7/22/19; on appeal, Ninth
Cir. No. 20-56252).
Apart from giving judges a ``pass'' to break the law, AG Becerra and
the CJP appear to have coordinated and colluded on publicly filed pre-
election charges against retired judge Steve Bailey, the 2018
Republican attorney general candidate opposite Becerra. There is
appearance of ``quid pro quo'' where CJP strategically and timely
launched charges against the Republican candidate in exchange for
Becerra not prosecuting judges for crimes reported by the public.
IV. Conclusion and Information Available
AG Becerra abuses his office to curry and keep favor on all levels in
the justice system, police, prosecutors, and judges, to secure
political support.
Documents, evidence and analysis that demonstrate the above stated
facts and contentions are available upon request. We appreciate your
consideration.
Sincerely,
Patrick J. Evans
cc. Committee's members
______
Hispanas Organized for Political Equality
634 S. Spring Street, Suite 920
Los Angeles, CA 90014
(213) 622-0606
https://www.latinas.org/
The Honorable Ron Wyden The Honorable Mike Crapo
Chairman Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
219 Dirksen Senate Office Building 219 Dirksen Senate Office Building
Washington, DC 20510 Washington, DC 20510
Re: Letter of Support for Xavier Becerra to serve as Secretary of the
U.S. Health and Human Services Agency. Senate Finance Committee,
February 24, 2021.
Dear Honorable Chair Wyden and Senator Crapo:
The leadership and national alumnae of Hispanas Organized for Political
Equality (HOPE) strongly supports the nomination of Xavier Becerra as
Secretary of the U.S. Department of Health and Human Services (DHHS).
We feel confident that he is exceedingly qualified to lead and will
execute the duties of DHHS with a strong commitment to health equity
for all Americans.
We are writing to strongly urge you to swiftly confirm Xavier Becerra
to serve as the Secretary of U.S. Department of Health and Human
Services.
As a longstanding champion of health equity and women's health, and a
dedicated public servant, we are certain that Mr. Becerra will serve as
the head of the Department of Health and Human Services with the strong
leadership and dedication that is needed to move our country forward.
Attorney General Becerra has an expansive legacy of leadership in his 2
decades in the U.S. House of Representatives and as California's
Attorney General since 2017. As an elected official and public servant,
Attorney General Becerra has proven that his values are rooted in
community, justice and fairness for all Americans. We are certain that
Mr. Becerra is the best candidate to fulfill the mandates of the
Department of Health and Human Services, whose mission is to enhance
the health and well-being of all Americans.
If confirmed, Xavier Becerra will be the first Latino to lead
Department of Health and Human Services in its history. This historic
nomination further highlights that it is time that the Latino Community
is fairly represented at all levels of our government. As the COVID-19
pandemic has disproportionately impacted Latinos across the nation,
this representation is critical to forging the path ahead to refocus on
health equity.
California Attorney General Xavier Becerra has demonstrated through his
experience, expertise and dedication to public service that he is
exceptionally qualified to serve in this role, and we strongly urge you
to swiftly confirm him as the next Secretary of the U.S. Department of
Health and Human Services.
Sincerely,
Lydia A. Aranda, M.A. Susana Mendoza
South Arizona Illinois State Comptroller
President, Chicanos Por La Causa
Sindy Benavides Ina Minjarez
Chief Executive Officer, LULAC Texas State Representative,
District 124
Washington DC
Julissa Ferreras Copeland Nathalie Molina Nino
Former New York City Council Member BRAVA Investments
New York
Melisa Lopez Franzen Eve Rodriguez Montoya
Minnesota State Senator, District
49 Founder & President
Rodriguez Media Communications
Illinois
Jane Gonzalez Nathalie Rayes
President, MEDWheels President and Chief Executive
Officer
Texas Latino Victory
Massachusetts
Janie Martinez Gonzalez Helen Iris Torres
Chief Executive Officer Chief Executive Officer of HOPE
WebHead Group California
Texas
Maria Regan Gonzalez Elizabeth Balli Van Sickle
Mayor of Richfield, Minnesota Managing Attorney and Owner
Van Sickle Law Firm, Texas
Rosario Marin
Former U.S. Treasurer under
President George W. Bush
______
National Hispanic Medical Association
1920 L Street, NW, Suite 725
Washington, DC 20036
Tel (202) 628-5895
Fax (202) 628-5898
[email protected]
https://www.nhmamd.org/
January 22, 2021
Senate Committee on Finance
Dirksen Senate Office Bldg.
Washington, DC 20510-6200
Chairman Ron Wyden (D-OR)
Ranking Member Mike Crapo (R-ID)
U.S. Senate Committee on Finance
Dear Chairman Wyden and Ranking Member Crapo:
On behalf of the National Hispanic Medical Association (NHMA), I
strongly support the nomination of Mr. Xavier Becerra to the position
of Secretary, U.S. Department of Health and Human Services (HHS).
I have known Mr. Becerra since the 1970s when we were college students
at Stanford University and met his family. Like most of the Chicano
students accepted to Stanford at that time, we were all first
generation from working class families of immigrant parents or
grandparents and understood the opportunity afforded us to help our
families with our education trajectories. During that time many of the
Chicano students were close and supportive of each other's strong
interest to pursue careers that would take us to decision-making
positions and public service efforts to give back to our communities.
I have worked with Mr. Becerra in Sacramento, California when he served
as Assemblyman and led a briefing on the healthcare workforce diversity
needs for the state and again in Washington, DC as Congressman and as a
member on the Ways and Means Committee and on the Congressional
Hispanic Caucus. He spoke at the first Annual Conference of the NHMA in
1997 and advised us to become advocates for the lifestyle of our
communities and not just to change the health care system.
I worked at HHS from 1994-1998 in the Office on Women's Health, and
following that, started at the NHMA. He and his staff met with NHMA
physicians and staff through the years and spoke at our Congressional
Briefings to discuss priorities for medical education and research
diversity, Medicare and GME, prevention and access to care issues, the
ACA and other areas that would improve policies and programs for the
health of Latinos and other underserved.
In summary, Mr. Xavier Becerra has the vision and the strong leadership
experience to build the programs and policies for HHS to support the
most vulnerable as well as healthcare institutions, public health
agencies, private sector companies which partner with the department,
and to lead HHS officials to support President Biden's vision for a
healthier America.
Sincerely,
Elena Rios, M.D., MSPH, FACP
President and CEO
National Hispanic Medical Association
______
National Human Services Assembly
1501 16th Street, NW
Washington, DC 20036
(202) 347-2080
https://www.nationalassembly.org/
February 23, 2021
Senator Ron Wyden Senator Mike Crapo
Chair Ranking Member
U.S. Senate U.S. Senate
Committee on Finance Committee on Finance
221 Dirksen Senate Office Building 239 Dirksen Senate Office Building
Washington, DC 20510 Washington, DC 20510
RE: Hearing to Consider the Nomination of Xavier Becerra, of
California, to be Secretary of Health and Human Services; February 24,
2021; 2pm ET
Dear Chairman Wyden and Ranking Member Crapo:
The National Human Services Assembly (NHSA) offers its enthusiastic
support for the confirmation of Xavier Becerra as U.S. Secretary of
Health and Human Services. NHSA members are 35 of the nation's largest
human services organizations which together, with their local service
networks, collectively serve nearly every household in America--as
consumers of services, donors, or volunteers. NHSA members comprise a
$32 billion sector that employs some 800,000 workers, operating from
over 100,000 locations.
In the midst of a global pandemic NHSA calls on the U.S. Senate
Committee on Finance to advance the confirmation of Xavier Becerra to
the full Senate without delay. As a twelve term Congressman and current
California State Attorney General (AG), Mr. Becerra has been a champion
of equity, fostering human services, and expanding access to quality
healthcare for all.
Both his life experiences and professional career have given him a deep
understanding of the importance and role of human services to foster
opportunity for all. Mr. Becerra was a leader on the Ways and Means
Committee for reauthorization of the Promoting Safe and Stable Families
Act and efforts to reform TANF to make poverty reduction an explicit
purpose of the program. His work to incorporate support in TANF for
human services demonstrate his commitment to advance opportunity for
all families and children. Furthermore, as a key architect of the
Affordable Care Act (ACA) and a member of the House Ways and Means
Committee he showed a deep understanding of the financing of health
care; and, as California AG was a national leader in state efforts to
protect the ACA.
As the head of a massive state agency in the largest state, Mr. Becerra
has the experience of overseeing an agency larger than some federal
departments. If confirmed, he would be the first Latino to lead the
Department of Health and Human Services (DHHS), making his confirmation
both critical and historic.
The people of the United States deserve a champion who will effectively
direct the urgent task of overseeing the agency that will guide the
nation out of this pandemic. We need a leader of DHHS who understands
that equity must be a guiding principle in meeting the nation's health
and human services challenges, including reversing the chapter of
harming immigrant children and ensuring that family reunification gets
accomplished without delay. Xavier Becerra is uniquely qualified to
lead DHHS to meet the challenges our nation is facing.
NHSA, on behalf of our national human services organization members and
those we serve, strongly urge members of the U.S. Senate Committee on
Finance to vote ``yes'' on the nomination of Xavier Becerra to be the
25th Secretary of Health and Human Services. The people of the United
States need a leader with extensive direct experience improving our
nation's health and human services systems, and one who is dedicated to
ensuring equity in advancing our national health and well-being.
Sincerely,
Jeff Fleisher
Chair, Board of Directors
Membership of the National Human Services Assembly --
[GRAPHIC] [TIFF OMITTED] T2421.001
Letter Submitted by Anne C. Taffe
Dear Finance Committee,
I object to Xavier Becerra due to his radical support for late term
abortion and his attack of the Little Sisters of the Poor. The
appointment of such a radical supporter of abortion is an affront to
all pro-life citizens. The failure of senators to protect the life of
the unborn goes directly against their constitutional right to life.
Anne C. Taffe
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